Presentation description

Mental health conditions during pregnancy and postpartum exhibit a cause of maternal morbidity and mortality, particularly in the weeks and months after delivery. Pregnancy complications and community, social, and healthcare pressures and experiences may aggravate conditions like depression and anxiety. With the objective of better understanding the community and societal drivers of maternal morbidity and mortality among Native and Indigenous mothers, we conducted a series of focus groups. In partnership with a local tribal-owned clinic and Native partners, we recruited individuals who identified as American Indian/Alaska Native, Native American, or Indigenous and had given birth in Utah in the last 5 years. Focus groups consisted of 3-6 individuals and followed a semi-structured interview guide which focused on community and health care experiences during pregnancy. Focus groups were transcribed and analyzed using Crabtree's editing methodology. Our results demonstrated that lack of community support, dismissiveness and discrimination or racism within the health care system, and not being heard were salient themes. Another theme was experiences and concerns pertaining to mental health. Many of the participants experienced isolation during and after their pregnancy experiences. Native mothers in our focus groups shared their increased levels of stress, depression, and anxiety during pregnancy. Sometimes they reported that worsening stress or mental health concerns were due to the inability to use cultural/spiritual practices. Such practices included not being able to smudge in the hospital (during admission for a complex pregnancy) and not being able to keep the placenta to take home for burial. Participant's experiences revealed that providers dismissed the importance of mental health access or access to cultural rituals in providing support for and relief from the stressors of pregnancy. Participants also feeling exacerbated by the fact that they were Native, along with undertones of racism and discrimination.