MotherWise in Nicaragua: Evaluating a Culturally Adapted Relationship and Perinatal Mental Health Intervention

Pregnancy and the postpartum period represent a developmental transition not only for individuals, but also for intimate relationships. Changes in roles, finances, physical health, and family expectations can heighten relational strain. In low-resource settings, these stressors often intersect with limited access to perinatal mental health services and increased vulnerability to conflict or relationship violence. Strengthening relational skills during this window may therefore serve as both a preventive and promotive strategy.

In the MRI-funded project MotherWise in Nicaragua: Evaluation of a Culturally Adapted Relationship and Perinatal Mental Health Intervention, Dr. Galena Rhoades (Thriving Families) examines the implementation and outcomes of a culturally adapted relationship education program for pregnant and postpartum women. The intervention, MotherWise, is grounded in evidence-based relationship education and emphasizes communication skills, conflict management, decision-making, and identification of healthy versus unhealthy relational dynamics.

MotherWise has been implemented in Nicaragua since 2021 through a collaboration between Thriving Families and the Health Outreach for Latin America Foundation (HOLA). Multiple cohorts have participated, and preliminary feedback suggests that participants value the program’s focus on clarifying healthy relationship norms and providing practical tools for everyday interactions. The current MRI-supported phase shifts from implementation to systematic evaluation.

The study employs a mixed-methods design to assess both intervention outcomes and contextual fit. Quantitatively, within-participant pre–post analyses examine changes in communication skills, relationship satisfaction, and attitudes toward relationship violence. Qualitatively, Spanish-language focus groups and interviews with participants and facilitators explore perceived impact, cultural alignment, and barriers to engagement. In-person observations provide additional insight into fidelity and delivery conditions.

Emerging qualitative findings highlight increased awareness of mistreatment, enhanced self-reflection, and growing confidence among participants. Facilitator-led linguistic and cultural adaptations appear central to engagement and comprehension. At the same time, structural and relational barriers—such as time constraints, partner resistance, and entrenched gender norms—shape participation and skill application.

By integrating outcome data with implementation insights, this project advances culturally responsive intervention science. Findings will inform refinement of MotherWise in Nicaragua and guide responsible adaptation in other Spanish-speaking, resource-limited contexts. Beyond strengthening individual relationships, the study contributes practical implementation knowledge for communities seeking scalable, relationship-centered supports during the perinatal period.