Advisor(s)

Meredith Gartin

Committee Member(s)

Anne Brisendine
Jessica Chambliss
Tamika Smith
Verna Keith

Document Type

Dissertation

Date of Award

6-18-2026

Degree Name

Doctor of Public Health (DrPH)

School

School of Public Health

Department

Public Health

Abstract

Perinatal mental health (PMH) of African-born women (ABW) is underrepresented in research and practice in the United States (US) despite known consequences of poor mental wellbeing on one’s overall health, relationships and productivity. Beyond their fundamental role in family support, ABW contribute significantly to the US workforce, education sector, and economy. This three-paper dissertation enhances understanding on PMH outcomes, perception and experiences of ABW in the US. Perinatal depression (PD), one of the most common mood disorders affecting 1 in 8 women, is highlighted. The overarching question is to what extent does the US health system address PMH of ABW in the US, and how can public health approaches be more culturally adapted to reflect the values and experiences of ABW in order to better support their mental health and wellbeing during pregnancy and postpartum period? Several systematic methodologies are used to compile data. First, we conducted a scoping review to investigate the extent of existing literature, recurring themes and gaps to inform the subsequent studies. Twenty-nine records between 2010 to 2023 were found. Major themes included 1. healthy immigrant effect, 2. perinatal depression outcomes, 3. cultural norms, stigma & beliefs, 4. resiliency, 5. preference for informal support and sociocultural practices, 6. negative healthcare experiences, and 7. willingness to use mental health services. Second, we determined the prevalence and predictors of PD among US Black foreign-born women (BFBW) using population-based data from the CDC PRAMS to report odd ratios from weighted logistic regressions. BFBW had a lower prevalence of PD compared to Black US-born women, consistent with the healthy immigrant effect. Predictors significantly associated with symptoms of PD among BFBW included age, insurance type, income, marital status and region (p<0.05). Third, we conducted semi-structured interviews with postpartum ABW exploring support systems, sociocultural practices and preferred approaches to support PMH. Findings revealed emerging importance of mental health, poor PMH experiences, and willingness to use mental health services. Culturally tailored and service delivery recommendations included diversity among mental health providers, strategic community outreach, and integration of wellbeing assessments. Future US research on PMH should discuss the holistic wellbeing of African families.

Keywords

African immigrants;maternal mental health;perinatal depression;perinatal mental health;sociocultural practices;support systems

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