Abstract
Despite the advancement of telemedicine and recent innovations in treatment, minoritized women continue to bear a disproportionate burden of pregnancy-related psychiatric conditions and complications, which the pandemic has further exacerbated. Research demonstrates that medical mistrust and systemic racism play central roles in the underutilization of services by racially and ethnically diverse women during pregnancy and postpartum. To effectively address these disparities, it is imperative to understand the drivers of medical mistrust in perinatal health care systems. This Perspectives article describes the historical context of medical mistrust in psychiatric and obstetric health systems and offers solutions to mitigate mistrust and the impact of systemic racism on perinatal care.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 238-247 |
| Number of pages | 10 |
| Journal | Harvard Review of Psychiatry |
| Volume | 30 |
| Issue number | 4 |
| DOIs | |
| State | Published - Jul 1 2022 |
Funding
Perinatal psychiatry or reproductive psychiatry is yet to be established by the American College of Graduate Medical Education as an accredited fellowship. Giving board certification to perinatal psychiatry may serve as a concrete and practical step toward addressing disparities in mental health care, increasing access to perinatal mental health services, bolstering collaborative care approaches, and providing a unified pathway to ascertain structural and cultural competency in perinatal psychiatry. Inclusion of topics related to racial equity and social determinants of health for psychiatry and obstetrics/gynecology residencies can be accomplished with the freely accessible National Curriculum of Reproductive Psychiatry. Increasing opportunities exist for obstetric clinicians to gain additional training in perinatal mental health. One statewide program, Massachusetts Child Psychiatry Access Program for Moms, offers centralized resources and support from perinatal psychiatrists. The program also leads educational sessions for clinicians on perinatal mental health disorders and provides online toolkits for the diagnosis and management of common disorders. The MassPPD Fund is a nonprofit organization that has partnered with the Masschusetts Child Psychiatry Access Program for Moms to address stigma around perinatal mood disorders, advocate for policies that expand perinatal mental health services, train more clinicians in how to identify and respond to perinatal psychiatric symptoms, and provide additional resources, such as information about peer support groups across Massachusetts.
Keywords
- medical mistrust
- obstetric care
- perinatal mental health
- postpartum depression
- racial disparities
ASJC Scopus subject areas
- Psychiatry and Mental health
