(WITHDRAWN) We Are Here Too: Keetoowah Mother's Perinatal Experiences

Background and Purpose: American Indian/Native American (AI/NA) mothers have the highest prevalence of postpartum depression (PPD) out of any other group in the United States; an estimated 17.5% of AI/NA mothers experience PPD. There are multiple factors that contribute to these higher rates, such as physical and mental health disparities, disparate poverty, cultural erasure, and communal isolation, which can be directly tied to a continued perpetuation of oppression and a result of historical trauma. The way that AI/NA mothers experience the role transition to motherhood, or Becoming a Mother, is also one possible experience related to the development of PPD for this population. Also, historical contexts of reproductive justice have influenced BAM for AI/NA mothers and may contribute to their uniquely high rates of PPD. That said, individual tribal cultures and histories may impact the BAM experience, and therefore, evaluating a more homogenous AI/NA cultural group may give insight into the specific intersections of historical trauma and reproductive justice as they relate to BAM. As such, this study sought to evaluate the BAM experiences, specifically their experiences with perinatal providers, of one tribe- the United Keetoowah Band, through the theoretical frameworks of historical trauma and reproductive justice.

Methods This study used story inquiry, a decolonizing research method, to consolidate the past, present, and future of maternal mental health and perinatal experiences among the Keetoowah women into a shared story experience. Using snowball sampling, 8 newer mothers were recruited to share their experiences of becoming a mother within their community. They were interviewed, using a story inquiry interview guide, either in person or by phone per their preference. The interviews were transcribed using Rev.com then uploaded into Atlas.ti software for coding. After initial researcher coding, Systematic Member Checking was used wherein the codes and quotes were returned to elders, mothers, and other tribal members to ensure that the themes were representative of the community as well as did not contain sacred knowledge not to be shared.

Results One primary theme regarding the present story of Keetoowah mothers was related to the perinatal care they received. Within this theme, there were subthemes of wanting their providers to focus on them, as well as the baby, once they were born. The second subtheme involved another aspect of perinatal care, which was the constant changing of care providers, with whom they could never develop a trusting relationship. In part, due to the dismissive care received, the third subtheme centers around not being able to listen to their bodies during the perinatal process.

Conclusions and Implications The importance placed on the need to have perinatal and postpartum mental health providers be culturally responsive within this study demonstrates the need for the social work profession to engage actively and maintain a commitment to increasing the numbers of maternal mental health specialists and providers. Furthermore, social workers are often involved in multi-disciplinary teams in care settings, and part of their role could be to advocate for culturally derived care and welcoming of culturally appropriate practices.