Pregnancy in the Margins: A Review of the Literature and Introduction of An Attachment-Based Ecotherapy Intervention for Marginalized Expecting Couples

Abstract

The experience of pregnancy within the U.S. healthcare system is life threatening for pregnant people in the margins. Minority populations, including Black and Native American people, people of color, cultural and ethnic minorities, LGBTQ+ people, migrants and refugees, and the socioeconomically marginalized all face serious disparities in pregnancy, childbirth and postnatal health care outcomes. This study sought to understand how ecotherapy for marginalized expecting couples can support attachment repair, foster family resilience to mitigate the stresses of marginalized pregnancy and create a protective benefit for navigating maternal health care. A literature review provides critical synthesis of three areas of discourse, perinatal mental health and maternal health care, attachment theory and attachment-based intervention, and ecopsychology and ecotherapy. An attachment-based ecotherapy intervention is introduced, and recommendations are made for future study. The study aims to stimulate new discourse on how ecotherapy can be incorporated in the field of marriage, couple, and family therapy to offer expanded clinical support for marginalized expecting couples.