Why We Must Support Maternal Mental Health
Having a new baby is the happiest time in a woman’s life, right?
One in five new or expectant mothers will experience debilitating anxiety or depression during pregnancy or the first year postpartum. These illnesses – known as perinatal mood and anxiety disorders (PMADs) – are the most common complication of pregnancy and childbirth, more common than other perinatal complications combined (gestational diabetes with hypertension and preecamplsia). All women are screened and monitored for these conditions. Yet, practitioners are not required to ask about a woman’s mental health during pregnancy or after birth.
What do we know about PMADs?
- More women experience PMADs each year than the combined number of new cases of tuberculosis, leukemia, multiple sclerosis, Parkinson’s disease, Alzheimer’s disease and epilepsy.
- Women who are depressed during pregnancy are more like to have poor prenatal care and increased substance use, leading to increased risk of poor birth outcomes such as preterm labor, premature birth, low birth weight, neonatal intensive-care unit admissions and fetal demise.
- Women who are depressed or anxious after having a baby show decreased responsiveness to baby’s cues, leading to greater risk for behavioral, cognitive and emotional delays in children.
- The cost of not treating PMADs is $22,000 annually for each mother and baby. In the United States, 800,000 women may experience PMADs each year at a cost of $17 billion in lost wages, unnecessary emergency department and doctor visits and poor health outcomes.
- Suicide is the leading cause of death for women in the first year after giving birth, accounting for approximately 20 percent of deaths.
How can we help women overcome PMADs?
First, we need to talk about PMADs. Thirty years ago, people whispered about breast cancer. Today, the breast cancer pink ribbon is ubiquitous. The same needs to happen with PMADs. Obstetric, pediatric and family physicians should discuss PMADs with women and their families. And, all women should be screened for PMADs — from conception through the baby’s first birthday.
Second, every hospital should have a dedicated maternal mental health program, including a coordinator to help women navigate care, support groups and mental health providers who can provide services as necessary.
Third, funding needs to be available to help treat women who have PMADs. Congress is currently pursuing legislation that would provide $5 million a year to treat PMADs.
That is a mere drop in the bucket.
Is there any good news?
The time to address PMADs has come.
In the last two years, the following national organizations have called for addressing PMADs: American Congress of Obstetricians and Gynecologists, American Academy of Pediatrics, American Council of Family Physicians, March of Dimes, National Institutes of Health and the U.S. Preventive Service Task Force.
Public awareness is growing. Mainstream media — The New York Times, The Washington Post, The Wall Street Journal — report on PMADs with increased nuance and understanding. A full-length movie documentary about PMADs was released in 2015, celebrities like Hayden Panettierre have bravely acknowledged their struggles with PMADs and May has been designated Maternal Mental Health Awareness Month.
Fortunately, PMADs are relatively easy to diagnose and treat. Women recover and, we know, healthy mothers lead to healthy families.
To learn more about PMADs, visit:
Adrienne Griffen is founder and executive director of Postpartum Support Virginia, whose mission is to help women overcome other perinatal mood and anxiety disorders. In 2015, PSVa helped 245 women through 16 FREE peer-led support groups. In 2016, the National Council honored Adrienne with an Award of Excellence.