Assigment .Apa seven . All instructions attached.

1

Category 3, Number 15: Maternal Mental Health During the First Postpartum Year

Ana Hernandez

Florida National University

Health Promotion & Role Development in Advanced Nursing Practice

Nora Hernandez-Pupo

July 11, 2026

Category 3, Number 15: Maternal Mental Health During the First Postpartum Year

Maternal mental health in the first postpartum year is a critical issue for women’s health, newborn development and family stability. The most common illness to be assessed is postpartum depression, but postpartum anxiety, trauma-related symptoms, obsessive thoughts, and severe mood disorders can also develop or persist after childbirth. Persistent symptoms may impair sleep, self-care, maternal-infant bonding, nursing, relationships, and access to routine health services. Maternal mental health cannot be addressed by individual responsibility alone, because risk is shaped by biological changes, poverty, violence, lack of social support, housing instability, language obstacles and fragmented care. This idea is congruent with a multilevel health-promotion model that includes recurrent screening in the first year postpartum, culturally sensitive education, timely referral, peer and family support, and integrated community services.

The scale and uneven distribution of the problem highlight the global significance of postpartum mental health. A synthesis of 565 research from 80 countries or regions that included over 1.2 million women was conducted by Wang et al. (2021), who calculated a global prevalence of postpartum depression of 17.22%. The same analysis revealed significant variation by geography, with a prevalence of 39.96% in Southern Africa , and pointed to national development and income as crucial drivers to interregional variances . Prevalence differences were also connected with social support, partner engagement, aggression, financial difficulties, stressful life events, pregnancy intention and living conditions. The results of this study demonstrate that postpartum depression is not a rare condition and is tightly linked with the social and economic contexts in which mothers recover and care for their infants.

Disparities are considerably more pronounced in resource-limited contexts. Roddy Mitchell et al. (2023) looked at 589 studies that included 616,708 women from 51 low- and middle-income countries and reported a pooled prevalence of prenatal depression of 24.7%, or about one in four women. The prevalence was 31.5% in Middle East and North Africa and was notably high among women exposed to intimate partner abuse (38.9%), women living with HIV (35.1%) and women affected by natural disasters (34.8%). Such figures imply that measures for health promotion should not be limited to teaching on symptoms. Successful programs globally should build capacity for primary care and maternal-child health providers, include mental health screening as part of prenatal and postpartum services, build functional referral systems in low-resource settings, and leverage community health workers or peer support when access to specialty care is limited.

Postpartum depression is frequent in the United States, and the load may occur at different time points within the first year. Robbins et al. (2023) reported that 7.2% of moms had depression symptoms at 9 to 10 months postpartum, using data from the Pregnancy Risk Assessment Monitoring System connected to a follow-up survey of 1,954 mothers (Robbins et al., 2023). Importantly, 57.4% of the moms having symptoms at this later assessment did not report depressed symptoms at 2 to 6 months. Strong associations were found between postpartum Medicaid coverage, a history of depression, and current postpartum anxiety with symptoms at 9 to 10 months. These findings highlight the inadequacy of a single screening at the usual postpartum visit and support screening at several touch points including obstetric follow-up, primary care visits, home visits, and pediatric well-child visits.

National evidence also shows increasing diagnosis and significant racial and ethnic discrepancies. In a varied health-system cohort of 442,308 births, diagnosed postpartum depression increased from 9.4% in 2010 to 19.0% in 2021, reported Khadka et al. (2024). Over the same period of time, the rates grew from 8.9% to 18.8% among Hispanic patients and from 9.2% to 22.0% among non-Hispanic Black patients. A separate nationwide analysis of PRAMS data indicated that 54% of mothers who reported postpartum depressive symptoms lived at or below the federal poverty limit, and that psychosocial stress during pregnancy was related with more than three times the odds of symptoms (O’Connor & Su, 2023). Collectively, these findings support programs that combine validated screening with tangible aid for food insecurity, insurance continuity, intimate partner violence, transportation, childcare, and access to linguistically appropriate behavioral health services.

The local relevance of the topic is apparent in Miami, especially among moms experiencing housing and financial insecurity. Curzon et al. (2025) examined 182 mothers with infants age seven months or younger receiving services in a women’s shelter in Miami. At baseline, 15.3% had clinically high self-reported postpartum depression symptoms. This study represents a highly vulnerable local group and should not be generalized to the prevalence for all mothers in Miami-Dade County, but it provides direct evidence that postpartum mental health needs exist within local community settings where traditional office-based care may be difficult to access. The findings also underscore the necessity of implementing screening into trusted spaces for postpartum families, including shelters, home-visiting services, community centers, food-assistance programs, and others.

The Miami study also shows that relationship-based community intervention can lead to better results. Following 16 weeks of child-parent psychotherapy, the percentage of mothers with clinically high symptoms reduced from 15.3% to 6.7%, treatment satisfaction was 94%, and participants reported reductions in parenting stress and depressive symptom intensity (Curzon et al., 2025). These findings could inform a local health promotion program that includes bilingual English Spanish education, repeated screening with a validated instrument, same-day suicide risk assessment, when necessary, warm referrals to therapy or psychiatric care, peer support groups, partner and family education, navigation to housing, nutrition, insurance, and childcare resources. Advanced practice nurses can spearhead this paradigm by training community partners, doing clinical assessments, coordinating interdisciplinary referrals, assessing medication and breastfeeding issues, and following up to ensure women actually receive follow-up care.

Evidence supports promoting mother mental health globally, nationally, and locally throughout the first postpartum year. Statistics from worldwide and U.S. data suggest a significant burden, and late-onset symptoms demonstrate that moms who screen negative initially may nevertheless develop depression months after birth (Robbins et al., 2023; Wang et al., 2021). Local Miami data also demonstrate that relationship-based, community-integrated care can alleviate symptoms among moms enduring substantial social adversity (Curzon et al., 2025). Thus, a good program should not be restricted to the distribution of educational materials or to one screening. It should provide a continuous system of culturally relevant identification, connection to treatment, support and follow-up, and address the socioeconomic circumstances that promote risk. Advanced practice nurses can contribute to safeguarding mother functioning, improving early parent-child connections, and reducing preventable mental health inequities through leadership, advocacy, clinical competence, and partnering with community organizations.

References

Curzon, M. M., Graziano, P. A., Arcia, E., Cox, S. K., Ayala, M., Carnero, N. A., O'Mara, N., & Sundari Foundation (2025). Initial promise of child-parent psychotherapy in reducing stress and postpartum depression among mothers experiencing homelessness: a feasibility and pilot study.  Archives of women's mental health,  28(2), 385–394. https://doi.org/10.1007/s00737-024-01492-8

Khadka, N., Fassett, M. J., Oyelese, Y., Mensah, N. A., Chiu, V. Y., Yeh, M., Peltier, M. R., & Getahun, D. (2024). Trends in Postpartum Depression by Race, Ethnicity, and Prepregnancy Body Mass Index.  JAMA network open,  7(11), e2446486. https://doi.org/10.1001/jamanetworkopen.2024.46486

Roddy Mitchell, A., Gordon, H., Lindquist, A., Walker, S. P., Homer, C. S. E., Middleton, A., Cluver, C. A., Tong, S., & Hastie, R. (2023). Prevalence of Perinatal Depression in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis.  JAMA psychiatry,  80(5), 425–431. https://doi.org/10.1001/jamapsychiatry.2023.0069

O'Connor, S., & Su, L. J. (2023). Postpartum Depressive Symptoms: An Analysis of Social Determinants Using the Pregnancy Risk Assessment Monitoring System.  Women's health reports (New Rochelle, N.Y.),  4(1), 584–593. https://doi.org/10.1089/whr.2023.0050

Robbins, C. L., Ko, J. Y., D'Angelo, D. V., Salvesen von Essen, B., Bish, C. L., Kroelinger, C. D., Tevendale, H. D., Warner, L., & Barfield, W. (2023). Timing of Postpartum Depressive Symptoms.  Preventing chronic disease,  20, E103. https://doi.org/10.5888/pcd20.230107

Wang, Z., Liu, J., Shuai, H., Cai, Z., Fu, X., Liu, Y., Xiao, X., Zhang, W., Krabbendam, E., Liu, S., Liu, Z., Li, Z., & Yang, B. X. (2021). Mapping global prevalence of depression among postpartum women.  Translational psychiatry,  11(1), 543. https://doi.org/10.1038/s41398-021-01663-6

Health Promotion & Role Development in Adv. Nursing Practice-DBX-DL01 Nora Hernandez-Pupo

Health Promotion Proposal, Part 1

Health Promotion Proposal, Part 1-this is the SAME TOPIC that was Approved in WEEK 2.

Description

Over the duration of this course,  you will submit a scholarly PowerPoint “Health Promotion Program Proposal,” addressing existing nursing knowledge related to health promotion and a written proposal.

In the written proposal, you will also develop a health promotion program to meet the health needs of a vulnerable population in your potential concentration area or community. The PowerPoint portion is your presentation of that proposal.

The proposal must demonstrate graduate school-level writing and critical analysis. The final version of

your proposal is due in week 8.

For this assignment you will submit  Part One of your proposal, detailing a health problem that is

prevalent within  your selected group and demonstrating your  research of health promotion strategies for addressing this specific health problem. At this point, you already developed in your discussions the core ideas of the topic contained in this assignment- this is the SAME TOPIC that was Approved in WEEK 2. You will use the same information, but it won’t be a copy-and-paste exercise. The purpose is that you enhance your ideas with the comments and outcomes of the weekly discussions and previous evaluations. 

Directions

1. Introduction. Describe the health problem. Don't type "Introduction".  (1 paragraph at least).

Using data and statistics, support your claim that the issue you selected is a problem.

What specifically will you address in your proposed health promotion program?

Be sure your proposed outcome is realistic and measurable.

2. Describe the vulnerable population.  (1-3 paragraphs).

What are the risk factors that make this a vulnerable population?

Use evidence to support the risk factors you have identified.

3. Provide a review of literature from scholarly journals (at least 2) of evidence-based interventions that address the problem. (2 paragraphs, one for each article).

After completing a literature search related to effective interventions for your chosen health promotion activity, write a review that evaluates the strengths and weaknesses of all the sources you have found. (2-3 paragraphs).

4. Select and present an appropriate health promotion/disease prevention theoretical or conceptual model that best serves as the guiding framework for the proposal.  (2-3 paragraphs).

For this assignment, a conclusion paragraph is not required.

Writing Assignment Requirements

Three to five pages in length MAXIMUM - do not exceed page limit- be concise (excluding title page, references, and appendices)

Follow APA format

Cite a minimum of 6 references

Please review the rubric prior to submission.

Sample APA paper for your reference:

APA 7 - Professional Sample Paper - 2020.pdf

REFERENCES Must have DOI Numbers for me to look them up- If I am unable to verify the references points will be deducted.

Great resource to assist you: Reference List: Author/Authors - Purdue OWL® - Purdue University

Submission

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1

Category 3, Number 15: Maternal Mental Health During the First Postpartum Year

Ana Hernandez

Florida National University

Health Promotion & Role Development in Advanced Nursing Practice

Nora Hernandez-Pupo

July 11, 2026

Category 3, Number 15: Maternal Mental Health During the First Postpartum Year

Maternal mental health in the first postpartum year is a critical issue for women’s health, newborn development and family stability. The most common illness to be assessed is postpartum depression, but postpartum anxiety, trauma-related symptoms, obsessive thoughts, and severe mood disorders can also develop or persist after childbirth. Persistent symptoms may impair sleep, self-care, maternal-infant bonding, nursing, relationships, and access to routine health services. Maternal mental health cannot be addressed by individual responsibility alone, because risk is shaped by biological changes, poverty, violence, lack of social support, housing instability, language obstacles and fragmented care. This idea is congruent with a multilevel health-promotion model that includes recurrent screening in the first year postpartum, culturally sensitive education, timely referral, peer and family support, and integrated community services.

The scale and uneven distribution of the problem highlight the global significance of postpartum mental health. A synthesis of 565 research from 80 countries or regions that included over 1.2 million women was conducted by Wang et al. (2021), who calculated a global prevalence of postpartum depression of 17.22%. The same analysis revealed significant variation by geography, with a prevalence of 39.96% in Southern Africa , and pointed to national development and income as crucial drivers to interregional variances . Prevalence differences were also connected with social support, partner engagement, aggression, financial difficulties, stressful life events, pregnancy intention and living conditions. The results of this study demonstrate that postpartum depression is not a rare condition and is tightly linked with the social and economic contexts in which mothers recover and care for their infants.

Disparities are considerably more pronounced in resource-limited contexts. Roddy Mitchell et al. (2023) looked at 589 studies that included 616,708 women from 51 low- and middle-income countries and reported a pooled prevalence of prenatal depression of 24.7%, or about one in four women. The prevalence was 31.5% in Middle East and North Africa and was notably high among women exposed to intimate partner abuse (38.9%), women living with HIV (35.1%) and women affected by natural disasters (34.8%). Such figures imply that measures for health promotion should not be limited to teaching on symptoms. Successful programs globally should build capacity for primary care and maternal-child health providers, include mental health screening as part of prenatal and postpartum services, build functional referral systems in low-resource settings, and leverage community health workers or peer support when access to specialty care is limited.

Postpartum depression is frequent in the United States, and the load may occur at different time points within the first year. Robbins et al. (2023) reported that 7.2% of moms had depression symptoms at 9 to 10 months postpartum, using data from the Pregnancy Risk Assessment Monitoring System connected to a follow-up survey of 1,954 mothers (Robbins et al., 2023). Importantly, 57.4% of the moms having symptoms at this later assessment did not report depressed symptoms at 2 to 6 months. Strong associations were found between postpartum Medicaid coverage, a history of depression, and current postpartum anxiety with symptoms at 9 to 10 months. These findings highlight the inadequacy of a single screening at the usual postpartum visit and support screening at several touch points including obstetric follow-up, primary care visits, home visits, and pediatric well-child visits.

National evidence also shows increasing diagnosis and significant racial and ethnic discrepancies. In a varied health-system cohort of 442,308 births, diagnosed postpartum depression increased from 9.4% in 2010 to 19.0% in 2021, reported Khadka et al. (2024). Over the same period of time, the rates grew from 8.9% to 18.8% among Hispanic patients and from 9.2% to 22.0% among non-Hispanic Black patients. A separate nationwide analysis of PRAMS data indicated that 54% of mothers who reported postpartum depressive symptoms lived at or below the federal poverty limit, and that psychosocial stress during pregnancy was related with more than three times the odds of symptoms (O’Connor & Su, 2023). Collectively, these findings support programs that combine validated screening with tangible aid for food insecurity, insurance continuity, intimate partner violence, transportation, childcare, and access to linguistically appropriate behavioral health services.

The local relevance of the topic is apparent in Miami, especially among moms experiencing housing and financial insecurity. Curzon et al. (2025) examined 182 mothers with infants age seven months or younger receiving services in a women’s shelter in Miami. At baseline, 15.3% had clinically high self-reported postpartum depression symptoms. This study represents a highly vulnerable local group and should not be generalized to the prevalence for all mothers in Miami-Dade County, but it provides direct evidence that postpartum mental health needs exist within local community settings where traditional office-based care may be difficult to access. The findings also underscore the necessity of implementing screening into trusted spaces for postpartum families, including shelters, home-visiting services, community centers, food-assistance programs, and others.

The Miami study also shows that relationship-based community intervention can lead to better results. Following 16 weeks of child-parent psychotherapy, the percentage of mothers with clinically high symptoms reduced from 15.3% to 6.7%, treatment satisfaction was 94%, and participants reported reductions in parenting stress and depressive symptom intensity (Curzon et al., 2025). These findings could inform a local health promotion program that includes bilingual English Spanish education, repeated screening with a validated instrument, same-day suicide risk assessment, when necessary, warm referrals to therapy or psychiatric care, peer support groups, partner and family education, navigation to housing, nutrition, insurance, and childcare resources. Advanced practice nurses can spearhead this paradigm by training community partners, doing clinical assessments, coordinating interdisciplinary referrals, assessing medication and breastfeeding issues, and following up to ensure women actually receive follow-up care.

Evidence supports promoting mother mental health globally, nationally, and locally throughout the first postpartum year. Statistics from worldwide and U.S. data suggest a significant burden, and late-onset symptoms demonstrate that moms who screen negative initially may nevertheless develop depression months after birth (Robbins et al., 2023; Wang et al., 2021). Local Miami data also demonstrate that relationship-based, community-integrated care can alleviate symptoms among moms enduring substantial social adversity (Curzon et al., 2025). Thus, a good program should not be restricted to the distribution of educational materials or to one screening. It should provide a continuous system of culturally relevant identification, connection to treatment, support and follow-up, and address the socioeconomic circumstances that promote risk. Advanced practice nurses can contribute to safeguarding mother functioning, improving early parent-child connections, and reducing preventable mental health inequities through leadership, advocacy, clinical competence, and partnering with community organizations.

References

Curzon, M. M., Graziano, P. A., Arcia, E., Cox, S. K., Ayala, M., Carnero, N. A., O'Mara, N., & Sundari Foundation (2025). Initial promise of child-parent psychotherapy in reducing stress and postpartum depression among mothers experiencing homelessness: a feasibility and pilot study.  Archives of women's mental health,  28(2), 385–394. https://doi.org/10.1007/s00737-024-01492-8

Khadka, N., Fassett, M. J., Oyelese, Y., Mensah, N. A., Chiu, V. Y., Yeh, M., Peltier, M. R., & Getahun, D. (2024). Trends in Postpartum Depression by Race, Ethnicity, and Prepregnancy Body Mass Index.  JAMA network open,  7(11), e2446486. https://doi.org/10.1001/jamanetworkopen.2024.46486

Roddy Mitchell, A., Gordon, H., Lindquist, A., Walker, S. P., Homer, C. S. E., Middleton, A., Cluver, C. A., Tong, S., & Hastie, R. (2023). Prevalence of Perinatal Depression in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis.  JAMA psychiatry,  80(5), 425–431. https://doi.org/10.1001/jamapsychiatry.2023.0069

O'Connor, S., & Su, L. J. (2023). Postpartum Depressive Symptoms: An Analysis of Social Determinants Using the Pregnancy Risk Assessment Monitoring System.  Women's health reports (New Rochelle, N.Y.),  4(1), 584–593. https://doi.org/10.1089/whr.2023.0050

Robbins, C. L., Ko, J. Y., D'Angelo, D. V., Salvesen von Essen, B., Bish, C. L., Kroelinger, C. D., Tevendale, H. D., Warner, L., & Barfield, W. (2023). Timing of Postpartum Depressive Symptoms.  Preventing chronic disease,  20, E103. https://doi.org/10.5888/pcd20.230107

Wang, Z., Liu, J., Shuai, H., Cai, Z., Fu, X., Liu, Y., Xiao, X., Zhang, W., Krabbendam, E., Liu, S., Liu, Z., Li, Z., & Yang, B. X. (2021). Mapping global prevalence of depression among postpartum women.  Translational psychiatry,  11(1), 543. https://doi.org/10.1038/s41398-021-01663-6