Perinatal Interventions Research Articles

Are rates of clinical interventions during pregnancy and childbirth different for refugees and asylum seekers in high-income countries? A scoping review.

Adequate maternity care and appropriate clinical interventions during labour and delivery can reduce adverse perinatal outcomes, but unnecessary interventions may cause harm. While studies have shown that refugees and asylum seekers face important barriers when accessing maternity care, there is a lack of high-quality quantitative data on perinatal health interventions, such as induction of labour or caesarean sections, among refugees and asylum seekers and the findings reported in the literature tend to be inconsistent. Our goal was to examine and synthesise the evidence regarding the rates of intrapartum clinical interventions in women who are refugees and asylum seekers in high-income countries compared to other population groups. We conducted a scoping review of peer-reviewed studies published in English since 2011 that report original quantitative findings regarding intrapartum clinical interventions among refugees and asylum seekers in high-income countries compared to those in non refugee, non asylum seeker populations. We examined reported rates of clinical pain relief, labour induction and augmentation, episiotomies, instrumental deliveries, and caesarean sections. Twenty-five papers were included in the review. Findings indicate that refugees and asylum seekers were less likely to receive pain relief, with 16 out of 20 data points showing unadjusted ORs ranging from 0.20 (CI: 0.10-0.60) to 0.96 (CI: 0.70-1.32). Similarly, findings indicate lower odds of instrumental delivery among refugees and asylum seekers with 14 of 21 data points showing unadjusted ORs between 0.25 (CI: 0.15-0.39) and 0.78 (CI: 0.47-1.30); the remaining papers report no statistically significant difference between groups. There was no discernable trend in rates of labour induction and episiotomies across studies. The studies included in this review suggest that asylum seekers and refugees are less likely to receive clinical pain relief and experience instrumental delivery than non-refugee groups in high-income countries. This review strengthens our understanding of the links between immigration status and maternity care, ultimately informing policy and practice to improve perinatal health and the provision of care for all.

Integrating Reproductive Health and Nutrition: A Breakthrough Solution to Combat Stunting

Objective: This study aims to explore the importance of integrating reproductive health and nutrition as a strategic approach in addressing stunting in Indonesia. Materials & Methods: Using a qualitative study, this research analyzed findings from observation and from various scientific journals, reports of international and national health organizations, and policies related to stunting, reproductive health, and nutrition. The study emphasizes the importance of comprehensive perinatal interventions and supports the strengthening of maternal and child health systems. Findings: The analysis shows that a comprehensive approach that integrates nutrition interventions and reproductive health initiatives can significantly reduce the prevalence of stunting. This approach highlights the importance of adequate nutritional supplementation, quality perinatal health care, and health education programs for expectant mothers. Conclusion: The findings of this study are expected to contribute to the development of health policies that aim to sustainably reduce stunting rates with a holistic approach that focuses on maternal and child health.

Developing a coaching manual to provide human support for the Mothers and Babies Online (eMB) perinatal mental health intervention

Developing a coaching manual to provide human support for the Mothers and Babies Online (eMB) perinatal mental health intervention

A gut-focused perinatal dietary intervention is associated with lower alpha diversity of the infant gut microbiota: results from a randomised controlled trial

ABSTRACT Objectives: In experimental models, the prenatal diet influences gut microbiota composition in mothers and offspring; however, it is unclear whether this occurs in humans. We investigated the effects of a gut-focused perinatal dietary intervention on maternal and infant gut microbiota composition four weeks after birth. Methods: This randomised controlled trial randomised pregnant women to receive dietary advice as part of standard care, or additionally receive a dietary intervention focused on the Australian Dietary Guidelines and increasing prebiotic and probiotic/fermented food intakes (ACTRN12616000936426). Study assessments occurred from gestation week 26 (baseline) to four weeks postpartum (follow-up). Faecal samples, collected at baseline for mothers, and follow-up for mothers and infants, underwent 16SrRNA sequencing. The primary outcome was a between-group mean difference in infant faecal Shannon index. Secondary outcomes included between-group differences in other microbiota measures, including maternal change from baseline CLR-transformed Prevotella abundance. Results: Forty-four women and 45 infants completed the study. The mean Shannon index of infants in the intervention group was −0.35 (95% CI: −0.64, −0.06, SD: 0.52) units lower than control group infants, corresponding to a medium effect size (Cohen’s D: −0.74, 95% CI: −1.34, −0.13). The findings were similar using other metrics of α-diversity. There were no between-group differences in β-diversity, nor any differentially abundant taxa in infants. The intervention increased abundances of the genus Prevotella in mothers compared to controls. Discussion: This gut-focused perinatal dietary intervention was associated with differences in the maternal and infant gut microbiota composition. Larger studies are required to replicate and extend these findings.

Nursing care for women with perinatal depression

The perinatal period can be a challenging and difficult time for many women, during which they experience a shift in their social roles and a gradual transition to motherhood. Perinatal depression (PND) is one of the most common perinatal mental health conditions that jeopardizes mental health. health. Electronic database searches were conducted to find suitable papers; these publications included risk factors for perinatal depression, interventions, limitations and perspectives of interventions, and finally the information was extracted for narrative synthesis. Personal psychiatric history and addictive behaviors, mother-infant and husband conflicts in the family, economic and employment in the society and teenage pregnancy were associated with the risk of developing the disease. Medication and psychotherapy, providing professional help and family-centered care, improving the health care system and psychological screening and education, and providing social support were effective solutions. Perinatal depression is an important global public health problem that deserves some attention from individuals, families, and societies.

Prenatal Breastfeeding Education with or without Hand Expressing Human Milk and Breastfeeding Duration in a Rural Population.

The benefits of breastfeeding are well recognized. However, exclusive breastfeeding (EBF) rates are well below the Healthy People 2030 Guidelines, with a rapid drop in exclusive breastfeeding over the first 3 months of life. Although breastfeeding support has increased the initiation of breastfeeding, the role of perinatal interventions, particularly in the context of breastfeeding support, remains a topic of contradiction. This observational study was designed to assess the impact of a unique prenatal educational intervention in rural East Texas. The study had two aims: (1) to determine whether the addition of prenatal breastfeeding education increased the rate of exclusive breastfeeding at four time points, and (2) to assess the impact of hand expression education on breastfeeding exclusivity. Differences in breastfeeding behaviors were seen between those who received the education and those who did not for exclusivity and duration of breastfeeding. Participants who received the hand expression education were 1.79 times more likely to continue EBF practices at three months postpartum, 6.27 times more likely to continue EBF practices at six months postpartum, and 3.34 times more likely to continue breastfeeding at twelve months postpartum than those who did not receive any hand expression education. This study demonstrates that prenatal education is beneficial for increasing breastfeeding exclusivity and duration and underscores its potential to improve maternal and infant health outcomes. Further research is needed to resolve the ongoing debate and advance our understanding of interventions to increase breastfeeding duration.

Mothers and Babies Virtual Group (MBVG) for perinatal Latina women: study protocol for a hybrid type-1 effectiveness-implementation randomized controlled trial

BackgroundImmigrant Latinas (who are foreign-born but now reside in the USA) are at greater risk for developing postpartum depression than the general perinatal population, but many face barriers to treatment. To address these barriers, we adapted the Mothers and Babies Course—an evidence-based intervention for postpartum depression prevention—to a virtual group format. Additional adaptations are inclusion of tailored supplemental child health content and nutrition benefit assistance. We are partnering with Early Learning Centers (ELC) across the state of Maryland to deliver and test the adapted intervention.MethodsThe design is a Hybrid Type I Effectiveness-Implementation Trial. A total of 300 participants will be individually randomized to immediate (N = 150) versus delayed (N = 150) receipt of the intervention, Mothers and Babies Virtual Group (MB-VG). The intervention will be delivered by trained Early Learning Center staff. The primary outcomes are depressive symptoms (measured via the Center for Epidemiologic Studies-Depression Scale), parenting self-efficacy (measured via the Parental Cognition and Conduct Towards the Infant Scale (PACOTIS) Parenting Self-Efficacy subscale), and parenting responsiveness (measured via the Maternal Infant Responsiveness Instrument) at 1-week, 3-month, and 6-month post-intervention. Depressive episodes (Structured Clinical Interview for DSM-V- Disorders Research Version) at 3-month and 6-month post-intervention will also be assessed. Secondary outcomes include social support, mood management, anxiety symptoms, perceived stress, food insecurity, and mental health stigma at 1-week, 3-month, and 6-month post-intervention. Exploratory child outcomes are dysregulation and school readiness at 6-month post-intervention. Intervention fidelity, feasibility, acceptability, and appropriateness will also be assessed guided by the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework.DiscussionThis study will be one of the first to test the efficacy of a group-based virtual perinatal depression intervention with Latina immigrants, for whom stark disparities exist in access to health services. The hybrid effectiveness-implementation design will allow rigorous examination of barriers and facilitators to delivery of the intervention package (including supplemental components) which will provide important information on factors influencing intervention effectiveness and the scalability of intervention components in Early Learning Centers and other child-serving settings.Registration.ClinicalTrials.gov NCT05873569.

The Role of Infant Gut Microbiota Modulation by Perinatal Maternal Probiotic Intervention in Atopic Eczema Risk Reduction

Introduction: Probiotics have shown potential in reducing the occurrence of atopic eczema in high-risk infants. We aimed here to assess whether the preventive effect of maternal probiotic administration stems from compositional changes in early gut microbiota. Methods: This study included 46 mother-infant pairs from an original randomized controlled trial assessing the impact of maternal probiotic intervention with either the combinations of Lacticaseibacillus rhamnosus LPR and Bifidobacterium longum BL999, or Lacticaseibacillus paracasei ST11 and Bifidobacterium longum BL999, or placebo beginning 2 months before expected delivery and ending 2 months after birth. All children were vaginally delivered, full term and breastfed. During the 2-year follow-up period, the children were clinically evaluated by physicians for atopic eczema, and their gut microbiota was profiled at 1 and 6 months of age by 16S rRNA gene sequencing using an Illumina sequencing platform. Results: Altogether, 19 of 46 children developed atopic eczema by the age of 2 years. At 1 and 6 months of age, gut microbial diversity was similar between children who developed atopic eczema and their healthy controls, but at the age of 6 months, children who developed atopic eczema manifested with significantly higher relative abundance of Clostridia. Probiotic intervention did not significantly influence microbial diversity, and the effects on microbial composition were not consistent with the changes associated with the development of atopic eczema. Conclusion: The reduction of the risk of atopic eczema achieved by perinatal maternal probiotic intervention does not seem to require substantial gut microbiota modulation.

Early Infant Male Circumcision Decisions in Zambia: Demographic and Familial Influences

Public health initiatives in Zambia encourage the uptake of early infant male circumcision (EIMC) as an HIV prevention strategy. This study assessed EIMC parental decision-making during perinatal care in Lusaka, Zambia, focusing on the influence of sociodemographic factors, family, and friends. A longitudinal pilot perinatal intervention, Like Father Like Son (LFLS), was implemented among 300 couples attending antenatal clinics in four urban community health centers. Participants were assessed postpartum regarding subsequent EIMC decisions. Partners, religion, and marital status were associated with the EIMC decision-making. Large scale EIMC promotion interventions that target both parents during perinatal care should be explored.

Interventions for intimate partner violence during the perinatal period: A scoping review: A systematic review.

Intimate partner violence (IPV) is a prevalent global health problem. IPV that occurs before pregnancy often continues during the perinatal period, resulting in ongoing violence and many adverse maternal, obstetrical, and neonatal outcomes. This scoping review is designed to broadly capture all potential interventions for perinatal IPV and describe their core components and measured outcomes. We conducted a search for empirical studies describing IPV interventions in the perinatal population in June 2022. The search was conducted in MEDLINE, EMBASE, PsycInfo, CINAHL, Cochrane Central Register of Controlled Trials, Web of Science, Applied Social Sciences Index & Abstracts, ClinicalTrials.gov and MedRxiv. Hand searching of references from select articles was also performed. Included studies described an intervention for those experiencing IPV during the perinatal period, including 12 months before pregnancy, while pregnant or in the 12 months post-partum. The search encompassed January 2000 to June 2022 and only peer-reviewed studies written in either English or French were included. Included interventions focused on the survivor exposed to IPV, rather than healthcare professionals administering the intervention. Interventions designed to reduce IPV revictimization or any adverse maternal, obstetrical, or neonatal health outcomes as well as social outcomes related to IPV victimization were included. We used standard methodological procedures expected by The Campbell Collaboration. In total, 10,079 titles and abstracts were screened and 226 proceeded to full text screening. A total of 67 studies included perinatal IPV interventions and were included in the final sample. These studies included a total of 27,327 participants. Included studies originated from 19 countries, and the majority were randomized controlled trials (n = 43). Most studies were of moderate or low quality. Interventions included home visitation, educational modules, counseling, and cash transfer programs and occurred primarily in community obstetrician and gynecologist clinics, hospitals, or in participants' homes. Most interventions focused on reducing revictimization of IPV (n = 38), improving survivor knowledge or acceptance of violence, knowledge of community resources, and actions to reduce violence (n = 28), and improving maternal mental health outcomes (n = 26). Few studies evaluated the effect of perinatal IPV interventions on obstetrical, neonatal or child health outcomes. The majority of intervention studies for perinatal IPV focus on reducing revictimization and improving mental health outcomes, very few included obstetrical, neonatal, and other physical health outcomes. Future interventions should place a larger emphasis on targeting maternal and neonatal outcomes to have the largest possible impact on the lives and families of IPV survivors and their infants.

Comprehensive Perinatal Substance Use Disorder Intervention—A Window of Opportunity to Prevent Child Maltreatment Equitably

Comprehensive Perinatal Substance Use Disorder Intervention—A Window of Opportunity to Prevent Child Maltreatment Equitably

Cost-effectiveness and benefits of perinatal health interventions in high-income settings: A protocol for a systematic review of economic evaluations.

Despite ongoing efforts, perinatal morbidity and mortality persist across all settings, imposing a dual burden of clinical and economic strain. Besides, the fragmented nature of economic evidence on perinatal health interventions hinders the formulation of effective health policies. Our review aims to comprehensively and critically assess the economic evidence for such interventions in high-income countries, where the balance of health outcomes and fiscal prudence is paramount. We will conduct a comprehensive search for studies using databases including EconLit (EBSCO), Cost Effectiveness Analysis (CEA) Registry, Medline (Ovid), Embase (Ovid), CINAHL Ultimate (EBSCO), Global Health (Ovid), and PubMed. Furthermore, we will broaden our search to include Google Scholar and conduct snowballing from the final articles included. The search terms will encompass economic evaluation, perinatal health interventions, morbidity and mortality, and high-income countries. We will include full economic evaluations focusing on cost-effectiveness, cost-benefit, cost-utility, and cost-minimisation analyses. We will exclude partial economic evaluations, reports, qualitative studies, conference papers, editorials, and systematic reviews. Date restrictions will limit the review to studies published after 2010 and those in English during the study selection process. We will use the modified Drummond checklist to evaluate the quality of each included study. Our findings will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 statement. A summary will include estimated costs, effectiveness, benefits, and the incremental cost-effectiveness ratio (ICER). We also plan to conduct a subgroup analysis. To aid comparability, we will standardise all costs to the United States Dollar, adjusting them to their 2022 value using country-specific consumer price index and purchasing power parity. This systematic review will not involve human participants and requires no ethical approval. We will publish the results in a peer-reviewed journal. We registered our record on PROSPERO (registration #: CRD42023432232).

Environmental Determinants of Islet Autoimmunity (ENDIA) longitudinal prospective pregnancy to childhood cohort study of Australian children at risk of type 1 diabetes: parental demographics and birth information

IntroductionThe Environmental Determinants of Islet Autoimmunity (ENDIA) Study is an ongoing Australian prospective cohort study investigating how modifiable prenatal and early-life exposures drive the development of islet autoimmunity and type...

Characteristics and outcomes of community-based perinatal peer support: Protocol for a systematic review.

Mental health issues and parenting difficulties in the perinatal period are common, and have significant negative impacts on individuals, families, and broader society. Community-based peer support programs might be an effective adjunct to standard mental health interventions in perinatal mental health issues, specifically where low-cost interventions are required, or access to professional care is limited. A systematic review will be undertaken. Searches will be conducted on four electronic databases (Pubmed, Embase, Cinahl, and PsycINFO), using terms related to perinatal mental health and peer support. Literature will be screened by title and abstract and then by full text. Selected studies will be evaluated using the Quality Assessment with Diverse Studies (QuADS) tool. Data relevant to community-based perinatal peer support intervention characteristics and outcomes will be extracted, and synthesised narratively. This review will contribute to the existing evidence about perinatal mental health peer support, by synthesising information about community-based interventions specifically. The findings will be used to inform the design, implementation, and evaluation of a community-based perinatal mental health peer support program in urban and rural/remote hospital and health services in Australia. Systematic review registration: CRD42023451568.

Along the way: Pilot study of a perinatal interpersonal psychotherapy group on distressed women

ObjectiveThis is the first perinatal interpersonal psychotherapy group (P-IPTG) implemented for distressed women from pregnancy to postpartum. The aim is to explore the changes in postpartum adjustment for women who receive/do not receive P-IPTG and compare the changes of the two groups. MethodsA quasi-experimental longitudinal design was applied to Taiwan community women. The sample sizes of the intervention and control groups were 25 and 233, respectively. Participants replied to measures four waves from their third trimester to one year postpartum. The intervention group participants received an eight-session P-IPTG, which consisted of four sessions in pregnancy and four in postpartum. Within-group changes were examined by repeated measure ANOVA, and between-group changes were compared by generalized estimating equations (GEE). ResultsANOVA results showed that depression decreased from baseline to four months postpartum in the intervention group (p < 0.05). In the general dyadic relationship, no change was noted in the intervention group, while there was a reduction in the control group (F = 13.52, p < 0.001, eta2 = 0.055). GEE comparison indicated favorable changes in the intervention group: greater reduction in depression at four months postpartum (β = -3.35, Wald χ2 = 6.17, p = 0.013), greater improvements in perceived partner support at four and eight months postpartum (βs = 3.18, 3.12, Wald χ2s = 4.59, 3.95, ps = 0.032, 0.047), and greater enhancement in relationship satisfaction with mothers-in-law at eight months postpartum (β = 0.59, Wald χ2 = 4.81, p = 0.028). ConclusionP-IPTG can make favorable trends of change in postpartum depression and partner/in-law relationships. This pilot study lays a foundation for further research in longitudinal perinatal interventions.

Perinatal intervention strategies providing food with micronutrients to pregnant and breastfeeding women in low‐ and middle‐income countries: A scoping review

AbstractIn resource‐constrained settings, pregnant and breastfeeding women and girls (PBW/G) are particularly vulnerable to undernutrition. Micronutrient‐fortified balanced energy protein (BEP) supplementation may be provided to boost maternal nutritional status and improve birth and infant outcomes. We conducted a scoping review of the published literature to determine the impact of BEP and other related nutrition interventions that provided fortified food or cash along with a minimum of 3 micronutrients on maternal, birth, and infant/child outcomes in low‐ and middle‐income countries. We conducted a PubMed search using pre‐defined keywords and controlled vocabulary search terms. All titles and abstracts were reviewed for eligibility by two independent reviewers, and data were extracted according to outcome type. We identified 149 eligible research articles that reported on a total of 21 trials and/or programme evaluations which assessed the health impact of one or more products (fortified lipid‐based nutrient supplement [LNS, n = 12], fortified blended flours [n = 5], milk‐based beverages [n = 2], and local food/snacks [n = 3]) that provided 118–750 kcal/day and varying levels of protein and micronutrients. Only one of these programme evaluations assessed the impact of the provision of cash and fortified food. Effects on maternal outcomes such as gestational weight gain and duration of gestation were promising but inconsistent. Birth outcomes were reported in 15 studies, and the effects on birthweight and birth length were generally positive. Seven studies demonstrated sustained benefits on infant and child growth out of the 15 studies that reported at least one of these outcomes, although data were sparse. Additional research is needed to investigate issues of dose, cost‐effectiveness, and incorporation into multi‐component interventions.

The ethics and practice of perinatal care at the limit of viability: FIGO recommendations.

An arbitrary gestational age limit of viability cannot be set, and in clinical practice the focus should be on a periviability interval-the so-called "gray zone" of prognostic uncertainty. For cases within this interval, the most appropriate decision-making process remains debatable and periviability has emerged as one of the greatest challenges in bioethics. Universally recognized ethical principles may be interpreted differently due to socioeconomic, cultural, and religious aspects. In the case of periviability, there is considerable uncertainty over whether interventions result in a greater balance of clinical good over harm. Furthermore, the fetus or neonate is unable to exercise autonomy and the physicians and parents will act as patient surrogates. When parents and physicians disagree about the infant's best interest, a dialogue without paternalistic attitudes is essential, whereby physicians should only offer, but not recommend, perinatal interventions. Parental choice, based on thorough information, should be respected within the limits of what is medically feasible and appropriate. When disagreements between parents and physicians occur, how is consensus to be achieved? Professional guidelines can be helpful as a framework and starting point for discussion. In reality, however, guidelines only rarely draw categorical lines and in many cases remain vague and ambiguously worded. Local ethics committees can provide counseling and function as moderators during discussions, but ethics committees do not have decision precedence. Counseling assumes the most significant role in periviability discussions, taking into consideration the particular fetal and maternal characteristics, as well as parental values. Several caveats should be observed relative to counseling: message fragmentation or inconsistence should be minimized, prognosis should preferably be presented in a positive framing, and overreliance on statistics should be avoided. It is recommended that decisions regarding neonatal resuscitation in the periviability interval be made before birth and not conditional on the newborn's appearance at birth. Regardless of decision, it is important to assure pre- and postnatal coherence. The present article describes how individual physicians, centers, and countries differ in the approach to the decision to initiate or forgo intensive care in the periviability interval. It is impossible to provide a global consensus view and there can be no unifying ethical, moral, or practical strategy. Nevertheless, ethically justified, quality care comprises early involvement of the obstetric and neonatal team to enable a coherent, comprehensible, nonpaternalistic, and balanced plan of care. Ultimately, physicians will need to adjust the expectations to the local standards, local outcome data, and local neonatal support availability.

Analysis of the Effect of Midwives’ Psychological Care Intervention on the Progress of Labor and Cesarean Rate of Elderly Women in Labor

Objective: To analyze the effect of midwife psychological nursing intervention in the clinical care of elderly women in labor. Methods: According to the order of admission, 74 elderly women were divided into the control group and the observation group. In addition to the routine perinatal nursing interventions, the observation group strengthened the implementation of midwives’ psychological nursing interventions. The duration of labor, mode of delivery, psychological state, and stress response indexes of the two groups were analyzed and compared. Results: The observation group had a shorter duration of all labor stages and total duration of labor than the control group, a lower cesarean section rate than the control group, and a higher degree of improvement in anxiety, depression, and stress response indexes in the 3-day postpartum period as compared to the control group (P &lt; 0.05). Conclusion: The implementation of midwife psychological care intervention in perinatal care of elderly women can further shorten the duration of labor, reduce the cesarean section rate, and improve the psychological state and stress indicators, which is worth promoting.

The role of lack of grandparental support in perinatal depression

BackgroundLow social support has been identified as a risk factor for perinatal mental health problems. However, previous studies mainly focused on partner support or general social support and neglected the roles of grandparents. Here, we examine whether a lack of grandparental support is related to increased risk of a diagnosis of perinatal depression. In addition, we examine whether poor grandparental support is related to more depressive symptoms in mothers with and without previously diagnosed perinatal depression and whether perceived grandparental support buffers against parenting difficulties in mothers with perinatal depression. MethodsThe sample was drawn from an Australian pregnancy cohort study and consisted of 725 women, including 230 women who met criteria for Major Depression. At 12 months postpartum, women reported on grandparental geographical proximity and hours of grandparental childcare support. Perceived grandparental support was assessed with the Postpartum Social Support Questionnaire and parenting difficulties and depressive symptoms with the Parenting Stress Index and the Edinburgh Postnatal Depression Scale. ResultsPerceived grandparental support was related to fewer depressive symptoms among mothers with perinatal depression. In addition, higher levels of perceived grandparental support were related to lower parenting stress in mothers with and without perinatal depression. LimitationsIntergenerational conflicts and quality of grandparenting were not assessed. ConclusionsOur findings indicate that supportive grandparents may prevent the development of more severe perinatal depression in mothers experiencing perinatal mental health problems. Future studies should examine whether involving grandparents in treatment may add to the effectiveness of existing perinatal mental health interventions.

Effectiveness of a Behavioral Activation Intervention for Peripartum Women with Opioid Use Disorder.

Pregnant women with opioid use disorder show elevated rates of comorbid mental health problems, both of which are associated with negative health outcomes for mothers and children. There is substantial evidence supporting the benefits of treatment of perinatal opioid use disorder, as well as perinatal depression and anxiety, but there are gaps in knowledge about the effectiveness of perinatal behavioral health interventions in the context of co-occurring substance use disorder. The current study seeks to address this gap by examining outcomes of a behavioral activation treatment in a group of peripartum women with opioid use disorder (N = 68). Behavioral activation has shown promise in treating co-occurring depression and substance use problems. The intervention was delivered as part of an integrated care treatment model, in which patients received co-located obstetric, substance use, and mental health care in a hospital-based clinic. Hierarchical linear modeling was used to assess change in symptoms over time. Results suggest that the group behavioral activation intervention was associated with reduced depression and anxiety symptoms, demonstrated by significant reductions in PHQ-9 and GAD-7 scores over the course of treatment. Moreover, there were indications that increased attendance was associated with further reductions in depressive symptoms. Results contribute to understanding the effectiveness of behavioral activation in the context of peripartum opioid use disorder. Findings also add to the evidence supporting integrated care models and offer a potential blueprint for improving outcomes and reducing barriers to care in this population.