Experiences of Perinatal Mental Health Care among Minority Ethnic Women during the COVID-19 Pandemic in London: A Qualitative Study.

Sabrina Pilav,Sara Roberts,Abigail Easter,Kaat De Backer,Louise M Howard,Sergio A Silverio,Sushma Sundaresh

doi:10.3390/ijerph19041975

Abstract

(1) Background: Approximately one in five women will experience mental health difficulties in the perinatal period. Women from ethnic minority backgrounds face a variety of barriers that can prevent or delay access to appropriate perinatal mental health care. COVID-19 pandemic restrictions created additional obstacles for this group of women. This study aims to explore minority ethnic women’s experiences of perinatal mental health services during COVID-19 in London. (2) Methods: Eighteen women from ethnic minority backgrounds were interviewed, and data were subject to a thematic analysis. (3) Results: Three main themes were identified, each with two subthemes: ‘Difficulties and Disruptions to Access’ (Access to Appointments; Pandemic Restrictions and Disruption), ‘Experiences of Remote Delivery’ (Preference for Face-to-Face Contact; Advantages of Remote Support); and ‘Psychosocial Experiences’ linked to COVID-19 (Heightened Anxiety; Social Isolation). (4) Conclusions: Women from ethnic minority backgrounds experienced disrupted perinatal mental health care and COVID-19 restrictions compounding their mental health difficulties. Services should take women’s circumstances into account and provide flexibility regarding remote delivery of care.

Highlights

Around 20% of women meet criteria for mental health diagnoses, such as depression and anxiety [1], in pregnancy or the first year postpartum [2,3].Meta-analyses have shown that women from minority ethnic and lower socioeconomic backgrounds can be disproportionately affected by physical and psychological difficulties during the perinatal period, in comparison to white women [4]
This research aims to explore minority ethnic women’s experiences of perinatal mental health services during the first wave of the COVID-19 pandemic in the UK, as these are currently underrepresented in perinatal mental health research
The present study was conducted within a community perinatal mental health service in South London, covering an area of London where an estimated 17–34% of the population are from minority ethnic backgrounds [48,49,50]

Summary

Introduction

Meta-analyses have shown that women from minority ethnic and lower socioeconomic backgrounds can be disproportionately affected by physical and psychological difficulties during the perinatal period, in comparison to white women [4]. The reasons for this are multifactored, and likely intersectional with socioeconomic status, comorbidities, language, and social complexity. Poorer access to antenatal and mental health care, reduced identification and treatment of mental illness among women from minority ethnic backgrounds, and discrimination due to race, language, and culture are thought to play a significant role in widening health inequalities [5,6,7].

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Conclusion