March 17, 2025 Story by: Editor
A systematic review published in the Harvard Review of Psychiatry suggests that perinatal interventions rooted in reproductive justice principles can positively impact the mental health of Black birthing patients and potentially support the mental health development of their infants. The study is featured in a special issue of the journal, which is part of the Lippincott portfolio from Wolters Kluwer.
Addressing Racism-Related Trauma in Perinatal Care
Mental health interventions incorporating reproductive justice principles “utilize a trauma-informed approach to address the psychosocial stress and trauma of racism and their negative effects on pregnant parents and offspring,” explained Cristiane S. Duarte, PhD, MPH, of Columbia University Irving Medical Center (CUIMC) and the New York State Psychiatric Institute, along with her colleagues. “They link the health of pregnant parents to the upstream structural determinant of racism and attempt to combat its negative effects on both physical and mental health by giving agency back to Black birthing communities.”
Study Examines a Range of Interventions
Dr. Duarte’s team analyzed 12 randomized controlled trials that focused on reproductive justice or aimed to enhance autonomy, community involvement, racial equity, and culturally relevant perinatal care for Black birthing patients and their infants. These interventions were conducted in hospitals, prenatal clinics, birthing centers, and home settings. The trials assessed maternal and/or infant mental health outcomes or factors influencing mental health development.
The interventions included:
- Five studies using interpersonal psychotherapy (IPT) or culturally tailored cognitive-behavioral therapy (CBT).
- Two studies focused on group prenatal care.
- Four studies evaluating culturally tailored home visiting programs involving community health workers or doulas.
Of the 12 studies, ten examined maternal mental health outcomes, while one analyzed both maternal and infant mental health, and one focused solely on infant mental development.
Significant Mental Health Benefits Identified
Seven of the studies reported statistically significant positive outcomes. Six demonstrated improvements in maternal mental health, including:
- Reduced antepartum and postpartum depressive symptoms (five studies).
- Decreased antepartum anxiety and stress.
- Increased postpartum adjustment.
Another study found a significant impact on infant mental health through the REACH-Futures (Resources, Education, and Care in the Home by Black community health workers) program.
While some studies did not report statistically significant findings, one was a pilot trial that did not assess for statistical significance.
The most effective interventions included:
- Psychologically oriented approaches such as IPT and culturally tailored CBT.
- CBT integrated into home visits.
- Group prenatal care programs like CenteringPregnancy Plus, which included skill-building sessions.
- Educational tools like Birthly, an interactive online platform.
According to Simone Dreux, a CUIMC medical student and one of the study’s lead authors, “Most effective interventions were specifically geared toward birthing people deemed at risk for developing mental health conditions—including antepartum and postpartum depression, and antepartum anxiety—as well as those with a previous history of mental health conditions.”
Perinatal Mental Health Risks for Low-Income Black Patients
Eight of the studies focused on predominantly low-income participants. Among these, four showed significant improvements in maternal mental health, while the REACH-Futures program reported notable benefits for infant mental development. The researchers emphasized the importance of these findings, stating:
“This finding is notable because low-income Black birthing people are at even higher risk of developing perinatal mental health conditions than low-income people of other races.”
How Culturally Relevant Interventions Support Mental Health
Dr. Duarte’s team highlighted key factors that may explain these positive results:
- Engaging racially concordant community health workers fosters social belonging, reduces isolation, and enhances the emotional experience of pregnancy.
- Culturally relevant, psychologically focused interventions improve mental health by teaching communication skills, goal setting, and problem-solving techniques.
- Group prenatal care models empower birthing patients by promoting autonomy and allowing them to take greater control of their prenatal care.
The study underscores the need for reproductive justice-oriented approaches to improve perinatal mental health outcomes, particularly among Black birthing patients facing systemic challenges.
Source: News Medical
