Barriers and Outcomes for Low-income Women with Mental Illness During Post-Partum: A Systematic Review [paper]




Bibles, Sharmelle

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Introduction: Maternal mortality among low-income mothers in the United States (U.S.) is steadily increasing (Eckert, 2020). The risk for developing mental illness is higher among middle- and low-income households, where 1 in 4 women report depression during pregnancy and 1 in 5 report having postpartum depression (Awini et al., 2023). Several research studies have examined social determinants of health (SDOH) impact on mental healthcare treatment among pregnant and post-partum women. However, gaps in the literature suggest that more research is needed to examine mental health outcomes for mothers and babies with untreated mental illness during the post-partum period. This systematic literature review aims to identify barriers to healthcare, patient outcomes, and helpful interventions for post-partum women with mental illness in low-income communities. Methods: The author extracted data from articles between 2018 and 2023 via CINHAL, Pubmed, and Psychinfo electronic databases. An ancestry search strategy was also used for data collection. Articles selected for this study meet inclusion criteria: (1) primary research articles, (2) published in English, (3) published in a peer-reviewed journal, (4) published within the last five years, and (5) addressed or related to barriers and outcomes for low-income, post-partum women with mental illness. The Rapid Quality Critical Appraisal Tool, adapted by Melnyk and Fineout-Overholt (2019), was used to appraise and evaluate quality of the literature. Results: 1,512 articles were identified, and seven studies met inclusion criteria. Five common themes were identified across studies as barriers for low-income post-partum women in need of mental healthcare: (1) lack of social and community support, (2) lack of transportation and community resources, (3) lack of financial assistance and income, (4) lack of provide education (understanding) and advocacy (5) lack of mental health education. Discussion: Results suggest a critical need for multiple stakeholders to address the complex barriers and social determinants of health that result in poor outcomes for low-income postpartum women with mental illness.



low-income, post-partum women, mental illness, access to care barriers, psychiatric post-partum treatment and outcomes


Bibles, S. (2023). Barriers and outcomes for low-income women with mental illness during post-partum: A systematic review [paper]. St. David's School of Nursing, Texas State University.


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