Session: Maternal Mental Health during the COVID-19 Pandemic and Beyond: Disrupting Systems of Inequity and Advancing Solutions (Society for Social Work and Research 27th Annual Conference - Social Work Science and Complex Problems: Battling Inequities + Building Solutions)

Maternal mental health issues can begin during pregnancy and persist long after the birth of a child. They can have significant consequences for mothers, children, and maternal-child relationships. Yet even prior to the COVID-19 pandemic, mothers faced barriers to accessing mental health care, including cost, provider shortages, stigma about mental health and substance use, and lack of time off work or childcare. Mothers with low income and mothers who are Black, Indigenous, or from other communities of color face heightened barriers due to structural racial inequities. Although the urgency of early identification and response to maternal mental health issues is clear, research is needed to better understand factors that support or impede maternal wellbeing and access to care in the perinatal period. The four papers in this symposium use qualitative and quantitative data collected from diverse populations of expectant and new mothers to examine previously under-studied processes, relationships and constructs as they relate to maternal mental health. The first paper increases understanding of complex factors that contribute to parenting for mothers with substance use disorders (SUDs) by exploring relationships among attachment, reflective functioning, mental health, and substance use in a sample of pregnant women with SUDs participating in a RCT of a therapeutic parenting intervention. Findings demonstrate that prenatal attachment style and reflective functioning were somewhat differentially associated with mental health, trauma, and substance use, perhaps because they draw on different aspects of the self and relationships. The second and third papers utilize data collected from mothers recruited via social media mothers' groups. The second paper examined the contribution of mothers' expectations, perceived breastfeeding and parental self-efficacy to maternal emotional wellbeing. Results indicated that supporting flexible expectations and confidence in baby feeding is likely to contribute to mothers' enhanced wellbeing. Using qualitative data from semi-structured interviews with mothers who gave birth early in the pandemic, the third paper explores compound psychological impacts of the perinatal period and the pandemic and mothers' access to mental health care during the pandemic. Mothers' accounts revealed the profound toll of the pandemic on maternal mental health and multiple ways that it undermined access to care, demonstrating the urgency of enhanced support for perinatal women in times of heightened stress and uncertainty. The final paper uses survey data from the Baby's First Years study, a RCT of poverty reduction during early childhood, to examine depression, anxiety, and sleep quality among low-income mothers of one-year-olds early in the pandemic when social distancing was at its peak. Inconsistent with most research on maternal mental health during the pandemic, this study found that mothers reported significantly better mental health during the early phase of the pandemic, raising the idea that these mothers may have felt temporary relief in pulling back from complex life stressors. Collectively, this set of papers advance understanding of contextual factors that contribute to maternal mental health and access to care and inform directions for social work science and strategies for practitioners to battle inequities and build solutions in the area of maternal mental health.