The Role of Resiliency Education in Prenatal Classes on Maternal Mental Health

Purpose: Pregnant women with low incomes and racial/ethnic minorities experience higher rates of maternal depression and anxiety, which negatively impact maternal and infant well-being. Racial minorities experience increased stress due to social factors and ongoing systemic inequalities in the United States. To address these disparities, the Los Angeles County Department of Health Services (LACDHS) developed a novel prenatal education and support curriculum that incorporated resilience-building to deliver in-person, interactive prenatal education content. Methods: An evidence-based resilience curriculum was integrated with prenatal education content to create a hybridized series of classes. Between January 2016 and March 2020, Medicaid-eligible pregnant women were recruited from LACDHS clinics. Participants met weekly for a 2.5-hour class at one of five clinics for 8 weeks. Mental health screening questionnaires—General Self-Efficacy scale, Generalized Anxiety Disorder-7 scale, and Patient Health Questionnaire-9—were collected during the first class and at curriculum completion. Analysts used paired t- tests and chi-square tests to examine pre- and post-scores. Survey data missingness were addressed using inverse probability weighting and multiple imputation. Results: Five hundred and four participant responses met inclusion criteria for analysis. Participants’ average age was 29 years ± 6. Most identified as Latina (63%), completed high school (71%) and lived with their partner (59%). Participation was associated with improvement in all measures: increased self-efficacy, and fewer anxiety symptoms and depressive symptoms. Conclusions: Results suggest hybridized resilience education with prenatal education was associated with positive peripartum mental health and self-efficacy.