Empowering Maternal Mental Health Wellness: A Pilot Program

Perinatal depression (PD) is the most common complication of childbirth in the United States and has devastating consequences for women, their infants, families, employers, and communities. Mindfulness Based Cognitive Behavioral Therapy (MBCBT) is an effective method for treatment and prevention of PD. The Empowering Maternal Mental Health Wellness program is an adaptation of MBCBT that is designed to promote wellness and prevent depression in pregnant and postpartum women using a telehealth platform. The goals of this pilot program were (1) to evaluate the feasibility and acceptability of engaging pregnant and postpartum female employees in mental health wellness practices using a 6-week group telehealth MBCBT program and (2) to evaluate the potential of the program to increase psychological flexibility and reduce the occurrence of PD. The pilot program included 17 female participants, who were employees at an urban, tertiary care hospital. Criteria for participation included female employees of childbearing age who were currently pregnant or within the first year postpartum and not currently diagnosed with moderate or severe PD, as indicated by Edinburg Postnatal Depression Scale (EPDS) scores. Eligible participants were assigned into three groups of 5-6 women. Each group met for one hour weekly for 6 weeks over an online telehealth platform, to learn, discuss, and practice mindfulness skills. A Registered Nurse in the Doctor of Nursing Practice (DNP) program was trained in MBCBT and facilitated each session. Self-reported measures of depression and psychological flexibility were completed upon enrollment and post-intervention using validated screening tools (EPDS and AAQ-II). Analyses revealed decreases in both EPDS and AAQ-II scores, reflecting a decrease in PD symptoms and an increase in psychological flexibility. A Wilcoxon Signed-Ranks Test indicated that median post-intervention depression scores were statistically significantly lower than the median pre-intervention depression scores (critical value = 25, test statistic = 10, p < .05). Although AAQ-II scores did show mild improvement from baseline, a Wilcoxon Signed-Ranks Test indicated that the intervention did not elicit a statistically significant change (critical value = 25, test statistic = 44, p > .05). Accessibility and feasibility of the pilot program were assessed through documentation of attendance and participant feedback from post-intervention focus groups. Participant statements from focus groups were recorded, transcribed, and inductively coded into common themes. Overwhelmingly, participants reported their experience in the program to be positive and worthwhile. Common themes from focus groups included appreciation of a supportive community, convenience of telehealth platform, and well-rounded approach to mindfulness. The Empowering Maternal Mental Health Wellness Program holds potential to provide effective wellness promotion and depression prevention for pregnant and postpartum women. These findings warrant further testing with a randomized control trial.