Haitian Mamas: The Development and Two-Year Implementation of an OB/GYN-Based Preventive Behavioral Health Group in a Safety-Net Hospital Setting

Perinatal mental health conditions are among the leading causes of maternal mortality in the United States. However, 50% to 70% of perinatal mental health cases go undiagnosed, and of those diagnosed, fewer than 30% receive treatment. At Boston Medical Center, a large safety-net academic medical center in the northeastern United States (US), this treatment gap became apparent when new Refugee Women’s Health Clinic patient visits increased by 138% following an influx of Haitian forced migrants starting in 2021. In response, we developed and implemented Haitian Mamas, a same-day access preventive behavioral health group within the Obstetrics and Gynecology department. This quality improvement study evaluates the development of Haitian Mamas from August 2023 to 2025, using four Plan–Do–Study–Act (PDSA) cycles. We evaluated the feasibility of this program across six domains: reach, engagement, integration of measurement-based care, financial viability, adaptability, and provider-perceived acceptability. Over two years, 196 women participated in the group, with an average of eight members per group, and there was a progressive improvement in integrating measurement-based care, which rose from 11.5% in Cycle 1 to 67.4% in Cycle 4. 35% screened positive for moderate to server mental health concerns. A thematic analysis of qualitative data from providers’ weekly post-group reflections identified implementation barriers and facilitators for Haitian Mamas. Our findings suggest that the development and implementation of a same-day access, OBGYN-based preventive behavioral health group for perinatal patients in a safety-net hospital setting is operationally feasible.