Experiences and expectations of women from ethnic minority background on perinatal mental health

Abstract

Abstract Introduction Being from ethnic minority backgrounds is a risk factor for poor perinatal mental health (PMH). To enhance services and prevent the devastating impacts of mental health problems on maternal morbidity and mortality, it is important to understand the experiences and expectations of women and families regarding related service provisions. Methods This will present the results of a two staged study including: a) a systematic review examining the state of evidence on the experiences of women from ethnic minority backgrounds on PMH. We searched 4 databases and using a convergent approach, synthesised the data thematically. b) an exploratory survey, distributed through a maternity service user and parenting Facebook group. Quantitative data were analysed using descriptive statistics and a thematic analysis was used for the qualitative data. Results A total of 15 studies met the inclusion criteria for the systematic review, highlighting the need for an in-depth exploration of these women with issues related to culture stigma and relevance of care provision. The survey questions explored these issues further. There were 51 responses representing 14 different ethnic minority backgrounds, the largest groups being Pakistani and Indian (21.6% and 19.6% respectively). The majority of the respondents reported accessing support for mental health problems very challenging (58.5%). Qualitative data revealed several overarching themes; 'Suffering in silence', 'The need for a safe space to talk' 'What about women like me-community support'? Conclusions Women from ethnic minority groups face barriers to seeking help from PMH services due to ongoing stigma, poor attitudes and behaviours of health professionals and inappropriately designed services. Culturally competent care providers with appropriate training are required to ensure women feel safe to access care. The effects of peer supporters as part of PMH services require further investigation. Key messages Maternity services should ensure that support for perinatal mental ill health meets the needs of women from ethnic minorities. Research is needed to develop interventions on healthcare professionals' education and cultural competency and services which promote access to culturally appropriate spaces to talk and be listened to.