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  • Author
    Jessica Bodden
  • Co-author

    Shahrzad Bazargan-Hejazi, PhD

  • Title

    Postpartum Depression: Identifying Risk Factors and Barriers-to-Care Among Low-income Women: A Systematic Review

  • Abstract

    Introduction: Postpartum Depression (PPD) is a public health concern that impacts mothers, their children, and the overall family dynamic. PPD affects one in seven women and is the second most common cause of maternal morbidity, ahead of postpartum hemorrhage and preeclampsia. If left untreated, PPD can negatively impact maternal-child bonding, child development and can lead to maternal suicide and infanticide. Literature shows women who are racial/ethnic minorities or are low-income are more likely to develop PPD; however, there exists a need for additional research regarding risk factors and barriers-to-care that are unique to low-income women. 

    Study Design: A systematic literature review was conducted and sought to identify risk factors as well as barriers to screening and mental healthcare among low-income women. 

    Methods: We searched for articles published between January 2015 and December 2019 on PubMedⓇ, MEDLINE, and Google Scholar. 

    Results: Five articles were included in this systematic literature review. Among low-income women, those with a prior psychiatric history, multiple instances of childhood and sexual abuse, a traumatic birth experience (e.g., cesarean section), as well as an elevated perception of personal responsibility and limited time availability were significantly more likely to have PPD. Mental health stigmatization, inadequate social support, an inability to pay for mental health treatment, and fears of potential DCFS involvement were identified as barriers to screening and care.

    Discussion: Knowledge of population-specific risk factors can improve targeted screening practices; however, healthcare providers must create safe spaces that encourage the disclosure of sensitive areas. Interventions aimed at barriers-to-care can lead to timely diagnosis and treatment of PPD among low-income women. 

    Keywords: Peripartum Depression, Postpartum Depression, Low-income Population, Social Determinants of Health

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