Am I a bad mom? A comparative examination of stigma in postpartum mental health conditions

Sierra Budd

Authors:  Sierra Budd, Danielle Cooke, Ryan McCarty, Rebecca Henderson, Dikea Roussos-Ross, Ashley Ordway, Andrea Guastello, Carol Mathews, Joseph McNamara

Faculty Mentor: Joseph McNamara

College:  College of Medicine


Stigma in mental health care, and postpartum mental health care in particular, is a public health burden and can act as a barrier to treatment, and thus lead to poor outcomes for both mothers and their children (Pinto-Foltz & Logsdon, 2008; Thurgood et al., 2009). These results have not been extended to postpartum obsessive-compulsive disorder (POCD), recent research suggests that obsessive-compulsive disorder (OCD) is associated with stigma, particularly when symptoms involve concerns about harm or taboo subjects (McCarty et al., 2017). This is of particular concern given that these symptoms are common in women with POCD (Uguz et al., 2007, Challacomb et al., 2016). This study aims to examine the stigma and familiarity associated with different POCD symptoms as compared to other postpartum mental health conditions. To examine these differences, an online survey that assesses recognition, social distance and perceived danger based on a randomly assigned vignette diagnosis describing a mother’s postpartum experience is used with participants recruited via Amazon’s Mechanical Turk service. The findings of this study will be used to better understand public perception of postpartum mental health conditions, to improve understanding of barriers to treatment and to inform future public health educational efforts.

Poster Pitch

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29 Responses
  1. Sierra Budd

    Hi all! Thank you for visiting my page and participating in the symposium! If you have any questions or comments, just leave a reply on this page and I will answer from 2-3pm. Or, if you prefer to ask your question face to face, feel free to click the zoom link I’ve provided: the zoom meeting will start at 2:40pm and end at 3:00pm. Should the internet connection become unstable, I may have to ask you to repeat yourself, or the call may drop and you’ll have to retry the link after a few minutes. I look forward to hearing from or seeing all of you!

  2. Danielle Cooke

    Hi Sierra! Great presentation. I really liked your point on the importance of correct diagnosis. Certainly there’s some literature on OCD symptoms being interpreted as being psychotic, but there’s not much looking at the impact of this. I’m also really curious about the impact of missing psychotic symptoms entirely following pregnancy. It would be interesting to follow up and see if maternal suicides are linked to psychotic symptoms.

  3. Anonymous

    Thank you Dani, and thank you for all your help and support throughout this process! I do think it would be interesting to look at the relationship between maternal suicide and psychotic symptoms, as well as what happens if psychotic symptoms go undetected.

  4. Joe McNamara

    Great work presenting your poster in this new format. You did a really nice job of explaining your results.

  5. Hello Sierra! Your poster is fantastic, it really allows the reader to follow your project and seek additional material if necessary! I am interested to see, given this research, if there is a way to decrease the stigma/fear associated with postpartum mental health conditions/ what role the healthcare provider plays in that?

    1. Danielle Cooke

      To add to Sierra’s observations below, our team has also gathered data on information seeking behaviors and what educational programs participants would consider to be most helpful. We certainly would like to use that data to inform future public health efforts.

  6. Valeria Castro-Ariza

    Hi Sierra! I found your presentation really interesting and engaging! I was wondering why social distance was the only measure where there was a difference between contamination and control conditions. Why do you think that is?

    1. Sierra Budd

      Thank you Valeria! So the vignette for the contamination condition described a mother who’s compulsions were excessive hand washing and bathing. While this may not lead the mother to be perceived as dangerous in general, or as a danger to her child, it may cause some people to desire more social distance, meaning they would be less likely to want to be friends with mother, to live next door to her, to work with her, etc. That’s why I think social distance was the one measure where contamination was significantly different from the control condition.

  7. Alejandra Sanchez-Sarmiento

    Hi Sierra! Your poster is really well done. For those individuals that are not as familiar with POCD, this is a great introduction, as well as touching on sensitive topics such as fear, stigma, and danger appropriately. I wonder how this will affect the mother’s relationship with her baby as her child grows.

    1. Sierra Budd

      Thank you Alejandra! While I haven’t looked into how these conditions impact the mother/child relationship, I do think it would depend on what kind of care, if any, the mother received, and on what condition the mother was experiencing.

  8. Elianne Rodriguez

    Hi Sierra! Great poster! I really enjoyed your topic since it is rarely discussed in the general public. Your results were really well explained and easy to understand. How would you suggest physicians, such as OB-GYNs and pediatricians, create appropriate and effective programs that tackle these conditions?

    1. Sierra Budd

      Thank you Elianne! I think it is important that physicians collaborate with experts on postpartum mental health conditions, and perhaps create new screening mechanisms that will allow these conditions to be caught early, so that treatment can occur as quickly as possible.

  9. Lacie Lazaroe

    Hey Sierra! Do you have any ideas on what health care workers should ideally be doing to combat this stigma? I.E. what should nurses do? What should OBGYNs do?

    1. Sierra Budd

      Hi Lacie! I think there needs to be a better bridge between nurses/physicians working with postpartum mothers and mental health care workers, so that nurses and physicians can better identify the signs of postpartum mental health conditions. Ideally, with a better knowledge of such conditions, nurses and physicians would be able to combat stigma by being open to hearing mother’s concerns, being more proactive in asking about their patient’s mental health and not just their physical health alone, and by providing encouragement and resources when a mother comes to them with mental health problem.

  10. Marylin Shandor

    Hi Sierra, great job on your presentation. It’s very educational and easy to follow. It seems like you did a great job of collecting a representative sample. What would you say the limitations of your research were? Also, throughout your research did you come across any potential solutions to bring awareness to this stigma?

    1. Sierra Budd

      Thank you Marylin! I would say that although our sample was representative, the sample size was not as large as we would’ve like it to be; however, we are continuing with the study and hope to recruit many more participants for each condition. As far as potential solutions bringing awareness to stigma goes, I think the first step needs to be improved education. I think a lot of people either don’t have any knowledge regarding postpartum mental health conditions, or they have received information from unreliable sources (the media, movies, tv shows, etc.): if we can improve the public’s knowledge of these conditions I think we can take a big step towards reducing stigma. It’s common for people to be weary of/fear what they don’t understand, so I believe the more light we can shed on postpartum mental health conditions, the more support we can gain for mother’s experiencing these conditions.

  11. Sierra Budd

    Hi Marissa! Thank you for comment! I also thought it would be interesting to look at ways in which we can decrease stigma and fear and perhaps reduce some of those barriers to treatment. I would also like to see what role providers/doctors will play.

  12. Isabella Schultz

    Hi Sierra,

    I just wanted to say that your poster is very interesting and looks great! I was also curious if you knew what is currently done to educate mothers on POCD and PPD and in what ways it should be improved to reduce stigma?

    1. Sierra Budd

      Thank you Isabella! I’m not sure what current education is provided to mothers on postpartum mental health conditions, although I’m sure it varies between providers; however, I think that any education provided to mothers on these conditions should include how common they are, and perhaps provide other mother’s experiences with these conditions. If moms know that they are not alone in their feelings, that others have gone through this and have received help and support, they may be more willing to disclose any mental health problems they experience postpartum to their health care providers and get the help the need.

  13. Hannah Fechtel

    Hi Sierra,

    Extremely interesting presentation. I’m curious about what the specific case descriptions given to participants were for each group: Psychosis, taboo, etc. Is there any way we can access what those descriptions?

    1. Sierra Budd

      Thank you Hannah! And yes! There is a QR code in the methods section of the poster that you can scan and gain access to all vignette diagnoses for each condition.

  14. Hannah Gracy

    Hello Sierra!
    I know you’re acting as the “audience” right now, but I couldn’t help looking at your project. This topic is really close to my heart, thank you for researching it! As aspiring health professionals, what do you think we can do to reduce PPD, POCD, and PPP stigma in our future careers? Thanks again!

    1. Sierra Budd

      Thank you Hannah! It’s great to know some one else is as interested in this topic as I am! I think the best way we, as future health professionals, can reduce stigma is to become knowledgable on these postpartum conditions and be willing to step out of our comfort zone by getting involved in our patient’s mental health. While physical health is extremely important, mental health cannot be overlooked, as the two are connected in numerous ways. Health care professionals must help build the bridge between both mental and physical health in order to provide the best care to their patients: I think the best way to do this is to learn the signs of postpartum mental health conditions, be willing to listen to your patients when they want to talk about how their doing mentally and provide a supportive environment, and also be aware of and provide resources available to mothers experiencing mental health concerns so that they can get the treatment they need.