Evaluating Contextual Factors and Implementation of Peer Support Interventions to Address Postpartum Mental Health: A Scoping Review

Background: In the United States, only 15% of women with postpartum behavioral health (BH) conditions receive timely treatment. Peer support, an evidence-based strategy deploying nonclinical individuals with lived experience to provide support, may improve postpartum BH service delivery and can serve as a critical linkage for individuals who lose care access through prenatal structures. Yet, implementation barriers have hindered integration and scaling of postpartum peer support. We conducted a scoping review to synthesize implementation strategies for postpartum peer support interventions. Methods: Eleven interventions were identified through comprehensive searches of four databases. The study analysis identified contextual factors and implementation outcomes according to the Practical, Robust Implementation and Sustainability Model framework. Results: Successful programs incorporated flexible delivery formats, consistent supervision, and structured peer training to support fidelity while accommodating participant needs. Feasibility and acceptability were high among both participants and peer supporters; however, reach remained limited by exclusion of non-English-speaking individuals and those without technology access. Implementation was further influenced by local public health infrastructure, availability of clinical supervision, and societal norms. Sustainability challenges, including cost and integration within existing health systems, were common. Conclusions: While peer support interventions may improve postpartum depressive symptoms, their reach to vulnerable populations and sustainability are limited. Further work is needed to strengthen the implementation of peer support interventions in limited-resource communities and non-English-speaking populations. Tailored strategies include adaptation of intervention components to local contexts, enhancing supervision of peer supporters, and identification of sustainable models for integration within existing systems.