Research in Latina PPD is relatively new; studies published suggest Latinas do not have a higher rate of prevalence of PPD yet a higher rate of nontreatment (Mukherjee et al., 2018). These studies used assessments based on common symptoms presented in White married women that have never experienced any of the stressors specific to women of color. Understanding the struggles of minority women in the United States and awareness that their symptoms will not always correlate with those of White women is key in proper diagnosis which can lead to accurate prevalence numbers (Ponting et al., 2020).
There has been an increase in research on PPD among Latinas in the United States the past twenty years (Zayas and Sampson, 2014). Low self-esteem, stressful life events, limited prenatal care, lack of social support, low income and reduced partner support are known risk factors for PPD. Latinas in the United States often experience many of the common risk factors yet are less likely to seek mental health treatment when they experience symptoms. Their higher rates of PPD and low levels of treatment are due to a variety of factors, including being both socially and emotionally disadvantaged as well as cultural beliefs on mental health issues.
Mental Health and Latino Culture
Beliefs regarding mental illness and seeking behavioral health services differ based on culture. Being subordinate to others, maintaining harmony with partners by remaining silent, and not sharing what happens in the home with those outside of the home are behaviors associated with increased risk of depression (Lara-Cinisomo et al., 2018). Stigma, lack of recognition of symptoms or misconceptions about PPD among Latinas and their physicians can complicate early detection of symptoms (Sampson et al., 2021). Most Latin American countries, believe that family problems should not be shared with those outside of the home. This leads to expectant mothers feeling alone or hopeless with their conditions. Educating the expectant mother and their support system on the possible effects of PPD on a newborn can emphasize the importance of early detection of PPD. Identifying concerns early on will allow time for the mother to get connected to a social worker or community resources prior to giving birth. Including any family members, partners, or caregivers in PPD education is also key to have a source of monitoring at home. The consequences of not receiving adequate treatment for PPD can be devastating for women, early detection is crucial for those at risk.
Edinburgh Postnatal Depression Scale
Healthcare workers are vital in assessing, identifying, and supporting expectant mothers at risk for PPD. An integral part of the interprofessional team role is to help expectant mothers and their families maintain optimal health of themselves and their unborn child. An interprofessional team, to provide adequate care to Latina expectant mothers, ideally include a physician or nurse practitioner, lactation consultant, social worker, a primary nurse and a community health worker (CHW).
CHWs build individual and community relationships by increasing health knowledge through outreach, community education, informal counseling, social support, and advocacy for a specific community (Early et al., 2016). Adding a CHW to the interprofessional team is beneficial because they can serve as trainers for the clinical staff on how to screen for symptoms specific to the Latina women in order to detect and treat PPD early. CHW can also assist the social workers with finding culturally appropriate resources for the specific Latino culture in the community.
Obstetric and gynecological providers are often utilized as the primary source of healthcare for women since they are regularly engaged throughout prenatal visits, delivery, and postpartum care. Referrals to a social worker and CHW should be arranged at the initial visit by the physician this allows time to establish rapport with the expectant mothers. Building rapport is crucial to be able to assess any differences in affect or demeanor since physicians are not always allotted the time necessary to establish those relationships. The CHW can be a supportive person for Latina expectant mothers as well as a trusted partner for providing adequate care to this population.
Latina women are more likely to suffer PPD during pregnancy and after childbirth. Latinas have cultural beliefs contradicting PPD and seeking mental health treatment. Providing adequate education on the possible effects PPD can have on their babies will challenge the stigmas they have grown to believe. Utilizing CHWs wi