A Phenomenological Exploration of Maternal Mental Health Service Access Among Women in Tennessee
Abstract
Maternal mental health is a critical determinant of maternal and child well-being, yet persistent inequities continue to limit access to care across Tennessee. Perinatal mood and anxiety disorders (PMADs) affect 15–21% of pregnant and postpartum women, but underdiagnosis and undertreatment remain widespread, particularly in rural and underserved communities facing mental health workforce shortages. This study sought to understand how women in Tennessee experience and navigate maternal mental health challenges, addressing the question of how structural, cultural, and interpersonal factors shape their ability to recognize needs, seek help, reach services, and engage in care. Guided by the hypothesis that women's lived experiences would reveal multilevel barriers not captured in existing quantitative data, this project employed a Gadamerian hermeneutic-phenomenological design to conduct a secondary analysis of nine focus groups (n = 60) from the 2024 Tennessee Maternal Health Innovation Project. Purposeful sampling ensured representation across rural and urban counties, racial and ethnic backgrounds, and socioeconomic contexts. The analysis involved immersion, inductive coding, hermeneutic interpretation, and thematic analysis, supported by reflexivity, audit trails, and peer debriefing. Women described limited access to reliable mental health information and frequent reliance on peers for guidance. Stigma, fear of child protective services involvement, and the absence of culturally congruent providers discouraged help-seeking. Provider shortages, long wait times, and geographic isolation in rural areas further constrained access, while financial strain, insurance barriers, and childcare costs added additional obstacles. Many participants reported feeling dismissed or receiving inadequate follow-up after postpartum complications or miscarriage, whereas encounters with empathic, culturally responsive clinicians were described as transformative. These findings demonstrate how structural inequities, cultural dynamics, and relational quality converge to shape maternal mental health access in Tennessee and underscore the need for culturally grounded education, expanded rural mental health infrastructure, transportation supports, and provider training in trauma-informed, culturally responsive care.
Start Time
15-4-2026 2:30 PM
End Time
15-4-2026 3:30 PM
Room Number
304
Presentation Type
Oral Presentation
Presentation Subtype
Grad/Comp Orals
Presentation Category
Health
Student Type
Graduate
Faculty Mentor
Michael Smith
A Phenomenological Exploration of Maternal Mental Health Service Access Among Women in Tennessee
304
Maternal mental health is a critical determinant of maternal and child well-being, yet persistent inequities continue to limit access to care across Tennessee. Perinatal mood and anxiety disorders (PMADs) affect 15–21% of pregnant and postpartum women, but underdiagnosis and undertreatment remain widespread, particularly in rural and underserved communities facing mental health workforce shortages. This study sought to understand how women in Tennessee experience and navigate maternal mental health challenges, addressing the question of how structural, cultural, and interpersonal factors shape their ability to recognize needs, seek help, reach services, and engage in care. Guided by the hypothesis that women's lived experiences would reveal multilevel barriers not captured in existing quantitative data, this project employed a Gadamerian hermeneutic-phenomenological design to conduct a secondary analysis of nine focus groups (n = 60) from the 2024 Tennessee Maternal Health Innovation Project. Purposeful sampling ensured representation across rural and urban counties, racial and ethnic backgrounds, and socioeconomic contexts. The analysis involved immersion, inductive coding, hermeneutic interpretation, and thematic analysis, supported by reflexivity, audit trails, and peer debriefing. Women described limited access to reliable mental health information and frequent reliance on peers for guidance. Stigma, fear of child protective services involvement, and the absence of culturally congruent providers discouraged help-seeking. Provider shortages, long wait times, and geographic isolation in rural areas further constrained access, while financial strain, insurance barriers, and childcare costs added additional obstacles. Many participants reported feeling dismissed or receiving inadequate follow-up after postpartum complications or miscarriage, whereas encounters with empathic, culturally responsive clinicians were described as transformative. These findings demonstrate how structural inequities, cultural dynamics, and relational quality converge to shape maternal mental health access in Tennessee and underscore the need for culturally grounded education, expanded rural mental health infrastructure, transportation supports, and provider training in trauma-informed, culturally responsive care.
