Year of Award

2026

Document Type

Dissertation

Degree Type

Doctor of Philosophy (PhD)

Degree Name

Public Health

Department or School/College

School of Public and Community Health

Committee Chair

Jessica L. Liddell

Commitee Members

Sarah Reese, Ethan Walker, Erin Semmens, Jess Conner

Keywords

LGBTQ2S+ parents, perinatal mental health, rural, social support

Abstract

Perinatal mood and anxiety disorders (PMADs), which include depression and anxiety symptoms occurring during pregnancy and up to one year postpartum, are highly prevalent and frequently untreated, severely impacting family health. The immediacy of this issue is backed by CDC data showing mental health issues as the leading cause of pregnancy-related deaths. Improved methods for identifying PMADs, connecting parents to care, and understanding the broader social factors that shape perinatal mental health are critical. Guided by ecological systems theory, this dissertation research explores informal and formal social support and perinatal mental health among LGBTQ2S+ parents in Montana, contributing knowledge of diverse families and rural communities with limited access to perinatal healthcare.

The primary purpose of this research is to estimate and describe perinatal mental health and the provision of social support among rural LGBTQ2S+ parents. Rural populations face elevated risk of PMADs while experiencing reduced access to healthcare and formal support services, increasing reliance on informal support from partners, family, and friends. LGBTQ2S+ parents also appear to be at greater risk for PMADs and social isolation because of structural inequities, yet their experiences remain absent in the literature. Population-based estimates of PMADs among LGBTQ2S+ parents are unavailable due to underrepresentation of sex and gender minorities in health surveillance systems. In addition, stigma may shape access to family and community support, making social support distinct for LGBTQ2S+ parents.

This dissertation uses mixed methods to examine social support and perinatal mental health at the intersection of rurality and Queerness: Aim 1: A scoping review of literature on social support for rural perinatal populations in the United States. Aim 2: A Cross-sectional statewide survey on mental health and social support among LGBTQ2S+ rural parents. Aim 3: Semi-structured interviews with LGBTQ2S+ rural parents.

Together, these studies provide a comprehensive overview of perinatal social support in rural populations, the first prevalence estimates of PMADs among a sample of rural LGBTQ2S+ parents, and qualitative insights into their mental health and support experiences. The findings address a critical gap in perinatal mental health research and have important implications for future research, policy, and interventions.

Download

Share

COinS
 

© Copyright 2026 Tess Alexandra Carlson