title: Stigma and Postpartum Depression Treatment Acceptability Among Black and White Women in the First Six-Months Postpartum.
abstract: Objective To measure stigma associated with four types of postpartum depression therapies and to estimate the association between stigma and the acceptance of these therapies for black and white postpartum mothers. Methods Using data from two postpartum depression randomized trials, this study included 481 black and white women who gave birth in a large urban hospital and answered a series of questions at 6-months postpartum. Survey items included socio demographic and clinical factors, attitudes about postpartum depression therapies and stigma. The associations between race, stigma, and treatment acceptability were examined using bivariate and multivariate analyses. Results Black postpartum mothers were less likely than whites to accept prescription medication (64 vs. 81%, p = 0.0001) and mental health counseling (87 vs. 93%, p = 0.001) and more likely to accept spiritual counseling (70 vs. 52%, p = 0.0002). Women who endorsed stigma about receipt of postpartum depression therapies versus those who did not were less likely to accept prescription medication, mental health and spiritual counseling for postpartum depression. Overall black mothers were less likely to report stigma associated with postpartum depression therapies. In adjusted models, black women versus white women remained less likely to accept prescription medication for postpartum depression (OR = 0.42, 95% CI 0.24-0.72) and stigma did not explain this difference. Conclusions Although treatment stigma is associated with lower postpartum depression treatment acceptance, stigma does not explain the lower levels of postpartum depression treatment acceptance among black women. More research is needed to understand treatment barriers for postpartum depression, especially among black women.
authors.affiliation: Department of Sociology and Institute of Women's Health, Virginia Commonwealth University, 827 West Franklin Street, Richmond, VA, 23284, USA. smbodnar@vcu.edu.
authors.forename: Susan
authors.identifier: http://orcid.org/0000-0002-7040-5711
authors.initials: S
authors.lastname: Bodnar-Deren
authors.affiliation: Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, Box 1077, One Gustave Levy Place, New York, NY, 10029, USA.|Center for Biostatistics, Icahn School of Medicine at Mount Sinai, Box 1077, One Gustave Levy Place, New York, NY, 10029, USA.
authors.forename: E K T
authors.initials: EKT
authors.lastname: Benn
authors.affiliation: Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, Box 1077, One Gustave Levy Place, New York, NY, 10029, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Balbierz
authors.affiliation: Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, Box 1077, One Gustave Levy Place, New York, NY, 10029, USA.|Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, Box 1077, One Gustave Levy Place, New York, NY, 10029, USA.
authors.forename: E A
authors.initials: EA
authors.lastname: Howell
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology*; D003376:Counseling; D003863:Depression / Q000523:psychology; D019052:Depression, Postpartum / Q000208:ethnology / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008603:Mental Health; D008605:Mental Health Services / Q000706:statistics & numerical data*; D009035:Mothers / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D049590:Postpartum Period; D016032:Randomized Controlled Trials as Topic; D057545:Social Stigma; D044465:White People / Q000523:psychology*
keywords: Maternal mental health; Postpartum depression; Postpartum depression treatment acceptability; Race; Stigma