It is no secret that there has been a stigma around mental health, and we as a society are just beginning to break through that stigma. Unfortunately, there is an even bigger stigma around maternal mental health. The words “postpartum” and “depression” get thrown around, but the seriousness of maternal mental health is rarely discussed among the general public. It is time we carefully consider the gravity of the issue of maternal mental health.
Suicide is the leading cause of maternal death up until a year after childbirth.1 One in five women experience anxiety or depression either during or after pregnancy, and up to 80% of women experience normal baby blues following childbirth.2 Depression and anxiety are the leading mental health issues among pregnant women, but pregnancy-related post-traumatic stress disorder (PTSD) and postpartum psychosis are also common. Unfortunately, up to 75% of mental health issues go undiagnosed in mothers.3 In addition, the issue of maternal mental health is further complicated by the racial disparity that exists within maternal health. According to the Centers for Disease Control and Prevention (CDC), for example, Black women are three times more likely to die from pregnancy-related causes than White women.4
So how do we better protect the women who are bringing new life into the world? There have been many policies and programs in the past few years trying to combat the care gaps in maternal health overall as well as maternal mental health specifically. Improving the overall care of mothers will hopefully reduce the amount of mental health issues that go undiagnosed. To that end, the American Rescue Plan Act of 2021 gave states the option to extend postpartum Medicaid coverage to 12 months, up from the traditional 60 days.5 Also, the Maternal Healthy Quality and Improvement Act (S. 1675) is a bill that requires the Department of Health and Human Services to give grants to improve maternal health. Essentially, this bill provides funding to help reduce maternal deaths and train health care professionals in this area.6 Improving the education of both moms on the warning signs of postpartum mental health issues and health care professionals on recognizing the signs will hopefully reduce preventable causes of maternal deaths.
To address the issue of racial disparities in maternal health, the Black Maternal Health Momnibus Act of 2021 looks at the social determinants of health and provides implicit bias training to medical professionals to improve care for Black mothers.6 Additionally, there have been several resolutions introduced in the US Congress to bring awareness to Black maternal health specifically. For example, “Black Maternal Health Week” has been brought up on several occasions. The purpose of this week is to bring attention to maternal health and the importance of reducing preventable morbidity and mortality among Black women.7
Advancements in maternal health are slow, especially when mental health is involved. Despite the slow process, there is progress. Bringing awareness to the issue is the first step. It is important for women to know that they are not alone. Mothers who are affected should seek care as early as possible given that 100% of the maternal health diagnoses respond to early treatment.3
Charity Underwood, MD
Dr. Underwood is a resident physician at Loma Linda University. She is currently a transitional year resident going into Occupational Medicine. She attended medical school at Loma Linda University. Prior to medical school, she attended Walla Walla University where she received her Bachelor of Science in biology.