Maria Muzik

Introduction: The COVID-19 pandemic increased perinatal mental health needs and disrupted routine obstetric care, disproportionately affecting Black and economically disadvantaged communities. Michigan’s Perinatal Collaborative Care Model (Peri CoCM), a publicly funded virtual program, launched during the pandemic and continued after the public health emergency. This qualitative study examined participant experiences with Peri CoCM, including perceived usefulness, acceptability, and barriers/facilitators to engagement, particularly among marginalized perinatal people to inform post-COVID service delivery. Methods: Eligible participants were pregnant or up to one year postpartum Peri CoCM patients recruited from a May–July 2025 referral cohort. Nine women ages 27–42 completed one-hour, semi-structured Zoom interviews between August and September 2025; the sample intentionally overrepresented self-identified Black women. Interviews were recorded, transcribed, verified against audio, and analyzed by a coding team using grounded-theory–informed thematic analysis with constant comparison. Results: Participants reported positive experiences with Peri CoCM across four thematic areas: (1) Pathways to care, (2) Perceived impacts of program, (3) Importance of culturally responsive care, and (4) Recommendations for program optimization. Trusted referrals from obstetric and other providers facilitated entry into care, often for anxiety, depression, grief, or first-time mental health support. Participants described Peri CoCM as accessible, supportive, and valuable during pregnancy and postpartum. Virtual options, flexible scheduling, compassionate behavioral health clinicians, and consistent follow-up reduced barriers and promoted openness. The short-term model helped some transition to longer-term therapy, while clinicians supported insurance navigation, medication decisions, and community resource connections. Participants gained coping skills, validation, and self-understanding. They emphasized culturally responsive provider fit and recommended longer continuity, broader wraparound services, and sustained no-cost access to reduce stress and improve engagement. Conclusion: Michigan’s Peri CoCM was perceived as a low-barrier, relationship-centered, culturally responsive virtual pathway supporting perinatal wellbeing and systems navigation in the post-COVID era. Cost transparency and flexible delivery were central to acceptability and expanded access to equitable care.

Purpose: This study evaluated the efficacy of an online intervention targeting intimate partner violence (IPV) in perinatal women, S trength for U in R elationship E mpowerment (SURE), relative to an attention, time, and information-matched control, on IPV severity, positive affect and well-being, and perceived emotional support across a 12-month follow-up. Methods: Perinatal women ( N = 122) who reported past 12-month IPV and recently engaged in mental health treatment were randomized to SURE ( n = 65) or control ( n = 57). SURE participants received a 40-minute online intervention based in motivational interviewing and empowerment. Control participants viewed a 40-minute online video of popular entertainment, followed by questions about preferences. Both conditions also included a brief 10-15-minute telephone-delivered booster session one month after the online session. Follow-up assessments occurred at 6 weeks, and 3-, 6-, and 12-months since the baseline visit. Results: Both interventions exhibited a significant drop in IPV severity from baseline to 12-month follow-up, with no significant differences between arms (range of standardized effect sizes for the time by group interaction = 0.20–1.65). Significant intervention effects were found for both positive affect and well-being (range of standardized effect sizes for the time by group interaction = -0.04-1.62) and perceived emotional support (range of standardized effect sizes for the time by group interaction = 0.65–2.10), where participants in SURE exhibited significant increases in both outcomes, while control participants did not. Conclusion: Results suggest that SURE provides a good model for an online intervention for perinatal women who have sought mental health services.

Purpose: Maternal adverse experiences, such as maltreatment in childhood and later intimate partner violence (IPV) during pregnancy, can disrupt the mother-child relationship and influence maternal perceptions of infant temperament. The present study explored how these adversities influence mothers’ views of their infants’ temperaments and examined the role of maternal emotion regulation and responsiveness to their infants as mediators of these relationships. Methods: Using data from a longitudinal study of highly stressed, vulnerable women, 355 mothers retrospectively reported on their own childhood maltreatment, as well as their experiences of IPV and emotion regulation during pregnancy. Maternal responsiveness was coded using mother-infant interactions at one month postpartum, and maternal perception of infant temperament was reported at six months postpartum. Results: Results indicated that maternal emotion dysregulation significantly mediated the relationship between childhood maltreatment and perceptions of difficult infant temperament. When examining subtypes of maltreatment, emotional abuse influenced perceptions of infant difficult temperament through emotion dysregulation, and emotional neglect was directly related to perceptions of infant difficult temperament. Physical and sexual abuse were not related to perceptions of infant temperament. Furthermore, pregnancy IPV was associated with perceptions of difficult temperament through maternal emotion regulation. Interestingly, maternal responsiveness was not a significant mediator in any pathway. Conclusion: These findings highlight the critical role of maternal emotion regulation in shaping perceptions of infant temperament for mothers who experienced child maltreatment and pregnancy IPV, suggesting that targeted interventions focused on improving maternal emotion regulation may improve maternal perceptions of their infant.

Background: Depression and anxiety in the perinatal period affect many women and have multiple negative impacts on the mother and baby. The Integrated Infant Mental Health approach embeds a Behavioral Health Consultant (IMH-BHC) who has specialized training in Infant Mental Health into OB/GYN clinics. This manuscript reports a quasi-experimental comparison of two groups of women through pregnancy and the first year postpartum, receiving integrated IMH care versus standard OB care. We hypothesized integrated IMH care patients would show less anxiety and depression across pregnancy and postpartum than comparison patients. Methods: Using a quasi-experimental design, we compared integrated IMH care patients with standard OB care patients to evaluate the primary outcomes of depression and anxiety symptoms from pregnancy through 12 months postpartum across ten obstetric clinics (seven treatment clinics and three comparison clinics) between 2018 and 2021. Data collection included questionnaires in-person, then over the phone during the COVID-19 pandemic. Regression analysis, using fixed effects models to accommodate differences between clinics, compared changes in number of symptoms over time between treatment and comparison groups. Logistic regression was used for comparing number of participants above clinical cutoffs for anxiety and depression symptoms in late pregnancy and at 12-months postpartum. Piecewise linear modeling was used to examine trajectories of symptoms of anxiety and depression. Results: During pregnancy, depression scores for the intervention group ( n = 90) remained constant whereas depression in the comparison group ( n = 68) increased across the later stage of pregnancy. The slope of change for depression scores across the postpartum year was not significantly different in the two groups. Anxiety symptom trajectories did not differ significantly by group membership during pregnancy or in the postpartum period. The intervention group was less likely to be married, to own their homes, or to have completed schooling beyond high school. More participants in the intervention group identified as Black or non-White. Propensity score weighting achieved equivalence in demographics between intervention and comparison groups. Conclusions: Our findings suggest possible benefits of the integrated IMH model for maternal wellness, most notably for depression symptoms during late pregnancy in a sample of women with high comorbid risk. Supporting at-risk dyads through programs like integrated IMH care represents a much-needed intervention that may make a meaningful difference in the lives of families.