Addressing Perinatal Mood and Anxiety Disorders (PMADs) in rural places: A knowledge infrastructure

Abstract

Researchers and policymakers concerned with Addressing Perinatal Mood and Anxiety Disorders (PMADs) in rural places tend to implicitly center on rural physical and informational infrastructures. As a result, distance, professional shortages, and digital barriers are largely foregrounded in recommended interventions and initiatives. This manuscript recognizes but also exceeds these dimensions by turning to “knowledge infrastructure.” As we demonstrate, a knowledge infrastructure framework illuminates the often-overlooked relationships, routine interactions, and non-dominant forms of expertise that enable a wide range of stakeholders, including but not limited to medical professionals, to mitigate many of the risks and barriers associated with perinatal mental health care in rural spaces. Bringing together anthropological theory, health policy, and qualitative interviews with over 75 individuals across a rural region in the U.S., our findings outline the ways in which critical mental health supports reach diverse perinatal individuals, shape community awareness, and reflect trusted forms of expertise in an otherwise professionally and socio-economically marginalized rural context. By presenting these data through a knowledge infrastructure framework, this manuscript highlights novel practices and new entry points for meaningful, rurallyrelevant interventions that benefit individual health and community wellbeing.