(PS4-60) Understanding Factors Associated with Access to Mental Healthcare Following a Traumatic Childbirth Experience

Abstract Text: Many women experience traumatic events during childbirth, increasing their risk for short- and long-term postpartum mental health complications. However, the lack of standardized screening procedures, guidelines, and consensus on what constitutes a traumatic birth contributes to under- detection and insufficient care. Individuals covered by publicly-funded insurance, such as Medicaid, face additional barriers and are less likely to attend postpartum follow-up visits. The factors influencing their access to mental healthcare after a traumatic birth remain unclear. The current study systematically investigated barriers, facilitators, and neutral determinants to mental healthcare access for birthing parents on Medicaid after a traumatic childbirth experience. Nine birthing parents completed semi-structured interviews that explored factors affecting treatment-seeking behavior, informed by the Consolidated Framework for Implementation Research (CFIR). Three raters independently coded the interviews using inductive and deductive processes to identify recurring themes. The coders identified twelve constructs from four CFIR Domains, including Outer Setting, Inner Setting, Individuals, and Implementation Process, with five of the constructs corresponding to existing CFIR constructs and seven emerging from the data. Interrater relatability, which was calculated by percent agreement, was strong at 81%. Barriers to care were primarily linked to mental health stigma, inconsistent screening and referral practices, and the lack of integrated mental health services. Facilitators included birthing parents’ positive attitudes toward mental health, tailored referrals, and screening for emotional distress. Psychoeducation about traumatic childbirth as well as the quality of provider interactions were found to be neutral determinants. Findings reveal critical gaps in current postpartum mental healthcare practices and suggest that the implementation of systematic screening, consistent follow-up, personalized referrals, and integrated behavioral health services could improve mental healthcare access for birthing parents. Addressing these issues using trauma-informed care approaches and hospital policy reforms could more effectively address the mental health needs of this vulnerable population.