Pregnancy and childbirth are life events often filled with joy, but for many women, they can also bring feelings of anxiety and depression. Approximately 1 in 8 women experience mental health conditions in the weeks before and just after childbirth. Despite their common occurrence, they often go untreated, which can produce a cascade of negative consequences for both mother and child, as well as for those in the rest of their family.

To address this often-overlooked issue, a new project will focus on improving mental health outcomes for women during and after pregnancy. Led by Elissa Faro, PhD, assistant professor in General Internal Medicine, this 5-year, $3.79M R01 project funded by the National Institute for Mental Health (NIMH) aims to improve maternal mental health care through a combination of innovative methods with a foundation in social justice focused on centering the experiences of birthing people, families, and front-line professionals.

“The project recognizes the stark disparities that exist in the diagnosis and treatment of perinatal depression and anxiety,” Faro said, “particularly among underserved populations and those in rural areas.” By working closely with stakeholders from diverse backgrounds, including state departments of health and front-line providers, Faro and the rest of her team will develop tailored implementation approaches that meet the specific needs of each community.

“Not only is this set to improve dramatically mental and overall health for birthing people, their families, and communities,” Faro said, “but it is a methodologically innovative study design that will move the field of implementation science forward.”

At the heart of the project is the implementation of a well-proven evidence-based cognitive behavioral intervention, Mothers and Babies, into existing home visiting programs (HVPs). These programs can provide crucial support to pregnant and postpartum women, yet they often struggle to effectively address mental health issues.

Through a comprehensive approach that combines implementation facilitation, stakeholder input, and rigorous evaluation methods, the project aims to improve the implementation and sustainment of a mental health intervention within HVPs. By doing so, they hope to not only alleviate the burden of perinatal depression and anxiety but also reduce disparities in maternal outcomes and improve community health overall.

Faro will collaborate with DeShauna Jones, PhD, and Morolake Adeagbo, PhD, two members of the Engagement, Integration, and Implementation Core in the UI’s Institute for Clinical and Translational Science. Hyunkeun Cho, PhD, associate professor of biostatistics in the UI’s College of Public Health rounds out the team of co-investigators at Iowa.

To increase the project’s reach and impact, Faro has also partnered with researchers at three other institutions across the Midwest. At Indiana University, Kelli Ryckman, PhD, will serve as the MPI on this grant with Faro. Ryckman is a professor of epidemiology and the associate dean of research in Indiana’s School of Public Health. Also serving as co-investigators are Karen Tabb Dina, PhD, and Darius Tandon, PhD, professors in University of Illinois’ School of Social Work and Northwestern University’s medical school, respectively.

Their combined efforts will focus on communities in both Iowa and Indiana, two states which rank 23rd and 42nd, respectively, on overall measures of mental illness prevalence and access to care, making them “an ideal location to improve sustainable and equitable implementation of Mothers and Babies.”