Feven Desta

Background: Perinatal loss is a deeply emotional experience that impacts both parents. Yet, much of the literature is skewed toward women to the neglect of Black men whose experiences may be intertwined with masculine expectations. Purpose: The purpose of this study was to explore the experiences of Black Canadian men navigating perinatal loss and masculine expectations. Methods and Procedures: An exploratory descriptive qualitative design was used, and a semi-structured interview was conducted with thirteen Black men whose partners experienced perinatal loss. Data was analyzed using thematic analysis. Results: Four key themes capturing the experiences of thirteen Black Canadian men were identified a) responding to unexpected perinatal loss, b) reconciling grief and masculine expectations after perinatal loss, c) contending with a fractured identity after perinatal loss, and d) coping in the face of limited resources after perinatal loss. These themes and their sub-themes highlight the challenges Black Canadian men face navigating perinatal loss in the context of masculine expectations. Conclusion: Black men's experiences of navigating grief after pregnancy are influenced and shaped by masculine expectations as well as cultural norms and beliefs. This study underscores the need for broader and culturally responsive grief support and counseling programs that address the cultural nuances surrounding grief after perinatal loss.

Background: Maternal mental health disorders are associated with adverse maternal and infant health outcomes. Despite advances in screening and treatment, disparities in maternal mental health disorders continue to disproportionately affect Black mothers and birthing persons. While there are studies that have examined maternal mental health, a gap in research remains in understanding the protective and risk factors of Black maternal mental health in Canada. Identifying the risks and protective factors is critical for advancing equitable and inclusive policies and practices that promote maternal well-being and optimal outcomes for Black perinatal populations. Objective: This paper presents an outline of a study protocol that seeks to identify the protective and risk factors of Black maternal mental health and to engage Black mothers and birthing persons from the Greater Toronto Area in codesigning a culturally safe and inclusive best practices model to inform policy and interventions. Methods: The proposed study will use an exploratory 3-phase sequential mixed methods approach underpinned by the principles of health equity and community-based participatory research. Phase 1 will involve engaging Black mothers and birth persons (n=300) in a survey to examine the psychosocial determinants of Black maternal mental health, including depression, anxiety, discrimination, strong Black women trope, attitude toward seeking mental health, support, and stigma. In phase 2, we will conduct 6 focus groups and individual interviews (n=60) to explore the stressors in the context of Black mothers and birth persons’ everyday lives, psychosocial and support needs, and conditions that promote their resilience. Finally, phase 3 will engage Black women and birthing persons (n=30) in a codesign session using the concept mapping method to identify priority areas for action to inform policy and programming. We will use SPSS version 26 (IBM Corp) to analyze the survey data, drawing on both descriptive and inferential statistics. NVivo (Lumivero), a qualitative data analysis software, will be used to organize the data from phase 2 into meaningful themes informed by Braun and Clarke’s thematic analysis approach. Results: Ethics approval was granted in July 2024. Data collection for phase 1 started in December 2024 and will be completed in April 2025. Findings from phase 1 will inform phases 2 and 3 of this study, which will be conducted in the third quarter of 2025. We will disseminate the results of this study in the second and third quarters of 2025. Conclusions: The findings will generate the much-needed knowledge to shift policy, practice, and research and support capacity building among Black mothers and birthing persons. In addition, the proposed study will contribute to informing policy initiatives and interventions at the health system and community level to advance mental health equity and build capacity among service providers to provide culturally safe and equitable mental health care. International Registered Report Identifier (IRRID): PRR1-10.2196/70076

BACKGROUND Maternal mental health disorders are associated with adverse maternal and infant health outcomes. Despite advances in screening and treatment, disparities in maternal mental health disorders continue to disproportionately affect Black mothers and birthing persons. While there are studies that have examined maternal mental health, a gap in research remains in understanding the protective and risk factors of Black maternal mental health in Canada. Identifying the risks and protective factors is critical for advancing equitable and inclusive policies and practices that promote maternal well-being and optimal outcomes for Black perinatal populations. OBJECTIVE This paper presents an outline of a study protocol that seeks to identify the protective and risk factors of Black maternal mental health and to engage Black mothers and birthing persons from the Greater Toronto Area in codesigning a culturally safe and inclusive best practices model to inform policy and interventions. METHODS The proposed study will use an exploratory 3-phase sequential mixed methods approach underpinned by the principles of health equity and community-based participatory research. Phase 1 will involve engaging Black mothers and birth persons (n=300) in a survey to examine the psychosocial determinants of Black maternal mental health, including depression, anxiety, discrimination, strong Black women trope, attitude toward seeking mental health, support, and stigma. In phase 2, we will conduct 6 focus groups and individual interviews (n=60) to explore the stressors in the context of Black mothers and birth persons’ everyday lives, psychosocial and support needs, and conditions that promote their resilience. Finally, phase 3 will engage Black women and birthing persons (n=30) in a codesign session using the concept mapping method to identify priority areas for action to inform policy and programming. We will use SPSS version 26 (IBM Corp) to analyze the survey data, drawing on both descriptive and inferential statistics. NVivo (Lumivero), a qualitative data analysis software, will be used to organize the data from phase 2 into meaningful themes informed by Braun and Clarke’s thematic analysis approach. RESULTS Ethics approval was granted in July 2024. Data collection for phase 1 started in December 2024 and will be completed in April 2025. Findings from phase 1 will inform phases 2 and 3 of this study, which will be conducted in the third quarter of 2025. We will disseminate the results of this study in the second and third quarters of 2025. CONCLUSIONS The findings will generate the much-needed knowledge to shift policy, practice, and research and support capacity building among Black mothers and birthing persons. In addition, the proposed study will contribute to informing policy initiatives and interventions at the health system and community level to advance mental health equity and build capacity among service providers to provide culturally safe and equitable mental health care. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/70076