Socioeconomic and racial/ethnic disparities in postpartum consultation for mental health concerns among US mothers

Abstract

Limited research has examined factors that impact access to postpartum mental healthcare. We investigated the predisposing, enabling, and need factors associated with postpartum consultation for mental health concerns in US mothers with or without depressive symptoms and examined potential disparities in access. We utilized cross-sectional data from the Listening to Mothers II Survey, the second national US survey of women's childbearing experiences. The survey recruited 1573 women, aged 18-45 years, who spoke English and had given birth. Depressive symptoms were measured with the Postpartum Depression Screening Scale (PDSS-SF). The dependent variable was postpartum consultation for mental health concerns. Logistic regression analyses showed that mothers with scores of 14-21 and 22-35 on the PDSS-SF had higher odds of consulting a provider for mental health concerns (OR 3.97; OR 12.91). Latinas had lower odds of seeking mental health consultations than Whites (OR 0.39). Mothers who were employed prenatally full-time or part-time had lower odds of seeking consultations than non-employed mothers (OR 0.62; OR 0.52). Mothers with household incomes of $50,000-$74,999 had higher odds of seeking consultations than those with incomes less than $25,000 (OR 2.20). When regression analyses were restricted to mothers with PDSS-SF scores ≥ 14, findings were similar by race/ethnicity and prenatal employment. Significant depressive symptoms are common in women after giving birth and few sought any form of mental health consultation. Latinas and low-income women are less likely to seek postpartum mental health consultations. Mental health care interventions could be geared towards targeting these at-risk groups.

Keywords: Andersen’s behavioral model; Health care disparities; Mental health consultation; Postpartum depression.