Mental health needs among patients experiencing extended antepartum hospitalization: A qualitative study

Hospitalized antepartum patients are at risk for development or exacerbation of a mental health condition, with one in three screening positive for depression or anxiety. High-quality data are needed to characterize mental health needs and inform evidence-based interventions in this high-risk population. This study aimed to assess the perspectives of patients experiencing extended antepartum hospitalization regarding current mental health needs and potential interventions.

We interviewed hospitalized antepartum patients at a large referral center from May to September 2024. English-speaking adults admitted for at least 7 days were eligible. Those with stillbirth, major fetal anomalies or planned fetal surgery, intensive care unit admission, or primary psychiatric concerns were excluded. Individual, semi-structured interviews were conducted with each participant, including questions on impact of hospitalization on mental health, current stressors, and available support. Interviews were audio-recorded and transcribed. Rapid qualitative analysis was performed, and overarching themes were identified.

Participants included 23 antepartum patients hospitalized for at least 7 days. Mean gestational age was 26.6 weeks; mean hospitalization duration was 26 days. Common reasons for admission included preterm prelabor rupture of membranes (n = 7, 30%) and placenta accreta spectrum (n = 5, 22%). Rapid qualitative analysis identified five themes: (1) emotional distress during hospitalization; (2) varying stressors, depending on individual life circumstances; (3) feeling safe in the hospital while missing home; (4) openness to engaging in therapy during hospitalization; and (5) belief that increased interpersonal interactions would improve mental health.

Collectively, patients experiencing extended antepartum hospitalization describe unmet mental health needs and the desire for help navigating stressful life events during hospitalization. Findings from this qualitative study provide important insights into the mental health needs of patients experiencing extended antepartum hospitalization, a unique and high-risk population. These findings can inform future work to develop novel interventions to support mental health in patients experiencing antepartum hospitalization.