Exploring Maternal Grandmother Support in the Perinatal Period: Implications for Postpartum Mental Health
The early postpartum period is a well-documented inflection point for mental health risk, yet one of the most commonly cited protective factors—social support—often remains underspecified in empirical work. Who provides support, what form that support takes, and under what relational conditions it operates are questions that are frequently flattened in favor of broad, partner-centric models. An MRI-funded project led by Dr. Sarah Curci (University of Denver) seeks to address one such gap by examining a largely understudied but highly influential figure in the perinatal support system: the maternal grandmother.
Titled Exploring Maternal Grandmother Support in the Perinatal Period: Impacts on Postpartum Mental Health, the study reframes social support not as a diffuse background variable, but as a relationship-embedded process that can be both protective and, in some contexts, psychologically costly. While maternal grandmothers are often central sources of caregiving, cultural continuity, and practical assistance—particularly in low-resourced families—their role has rarely been examined as a distinct contributor to postpartum adjustment.
The project is embedded within an ongoing longitudinal study of approximately 900 pregnant individuals receiving prenatal care at Denver Health, a Federally Qualified Healthcare Center and safety-net hospital serving predominantly low-income and underserved communities. Participants are screened during prenatal visits, consented in English or Spanish, and randomized to the ROSE postpartum depression prevention program, delivered in either in-person or virtual group formats. This parent trial, led by Dr. Galena Rhoades, Dr. Elysia Davis, and Dr. Nicholas Perry (University of Denver), provides a robust infrastructure for examining how specific relational supports operate within real-world prevention contexts.
Conceptually, the study challenges the assumption that “more support is better.” Instead, it operationalizes support as a set of functional domains—emotional, instrumental, informational, and culturally grounded—and asks how these domains interact with relationship quality, proximity, and frequency of contact to shape postpartum mood and adjustment. The guiding question is deliberately relational and conditional: when maternal grandmothers are involved, what changes, for whom, and why?
The project has four primary aims: (1) to test associations between maternal grandmother support and postpartum depressive symptoms; (2) to examine whether relationship quality and geographic or relational proximity moderate these associations; (3) to characterize the specific types of support maternal grandmothers provide during the early postpartum period; and (4) to explore how birthing parents perceive these experiences as influencing mental health, parenting self-efficacy, and overall adjustment.
Methodologically, the study employs a mixed-methods design layered onto an established longitudinal framework. Maternal-grandmother-specific survey measures are administered during pregnancy and at six weeks postpartum, alongside assessments of depressive symptoms, perceived availability of different support functions, relationship quality, contact frequency, proximity, and broader social network characteristics. Quantitative analyses use multiple regression analyses to estimate associations and test interactions, accounting for key sociodemographic factors. Qualitative data are drawn from in-depth, 60-minute Zoom interviews with a subset of participants within six months postpartum and analyzed using applied thematic analysis that integrates theory-driven and inductive coding, with reliability checks throughout.
The translational focus of the project centers on making relational science usable in clinical and community settings. Planned next steps include refining grandmother-specific assessment tools that can be integrated into perinatal care without increasing clinical burden; developing guidance applicable to both in-person and virtual support contexts; incorporating family-system conversations into early postpartum visits; and identifying implementation supports that help providers respond when grandmother involvement is strained, ambivalent, or conflictual. Findings will be disseminated through peer-reviewed publications and academic conferences, alongside accessible digital infographics designed for clinicians, researchers, and the broader public.
Ultimately, this work situates postpartum mental health within the family system rather than the individual alone. By specifying who provides support, how that support functions, and under what relational conditions it promotes or undermines well-being, the study moves the field toward more precise—and more realistic—models of perinatal care.