Date of Conferral

7-16-2026

Date of Award

July 2026

Degree

Ph.D.

School

Nursing

Advisor

Cara Krulewitch

Abstract

Maternal mortality (MM) continues to be a public health concern in the state of Arizona. There is little to no research investigating the relationship between MM and mental health conditions co-occurring with contributing factors among women who have died in Arizona while pregnant or within 1 year of the end of a pregnancy. The purposes of this quantitative study, guided by the three delays model (3DM), were to examine (a) MM and mental health conditions as the primary underlying cause of death; (b) MM and mental health conditions surrounding death; and (c) significant contributing factors (i.e., discrimination, knowledge, lack of access/financial resources, and substance use disorder (SUD)) to the prediction of mental health conditions surrounding death. Secondary data from 351 deceased women were analyzed using frequency distribution and binary logistic regression. Findings of the study demonstrate that 29.6% of women died due to a primary underlying cause of mental health conditions, and 38.1% of women had mental health conditions surrounding death. Results further indicate that discrimination, lack of access/financial resources, and SUD were significant predictors (p < .05); however, knowledge was not a statistically significant predictor. Future research recommendations include large-scale quantitative research studies that assist in gaining a better understanding of whether additional contributing factors predict the outcome of mental health conditions surrounding death for other MM populations. This study provides evidence that nursing, organizational, and societal initiatives can have positive social change implications for women who have mental health conditions and co-occurring contributing factors during the perinatal period.

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