Perinatal mental health among sexual minority women in two-mother families: Healthcare experiences and co-design of an inclusive mHealth preventive intervention

Abstract Introduction . Perinatal mental health among sexual minority women (SMW) remains underexplored despite growing recognition of health care inequities affecting LGBTQIA+ populations. This study aimed to examine the perinatal mental health and care experiences of SMW and co-design a prototype of [blinded for review] , a mobile health (mHealth) intervention for the prevention of perinatal mental disorders (PMDs), informed by participants’ lived experiences. Methods . This study was conducted as part of the European-funded [blinded for review] project. A qualitative design was employed, involving two focus groups with SMW in the perinatal period and healthcare professionals (n = 17). Methodological quality and Patient and Public Involvement were appraised using COREQ and GRIPP2 standards. Results . Participants described emotional challenges associated with assisted reproduction, alongside experiences of discrimination, invisibility and microaggressions within healthcare settings and the broader community. Heteronormative assumptions embedded in perinatal care affected recognition, communication, and access to support. Participants identified the need for more inclusive and tailored forms of support. The co-design process identified priorities for inclusive digital support, including affirming communication, representative imagery and profile customization. Conclusions . This study contributes to understanding how structural inequities shape perinatal mental health among SMW and highlights the importance of participatory approaches in developing more equitable and inclusive perinatal care and support systems.