Perinatal depression is a significant issue affecting up to 20% of women in the United States during pregnancy or the postpartum period. Despite this high prevalence, many women go untreated due to a lack of widely deployed screening systems for mental illness in mothers. Experts believe this has led to increased rates of mental illness, suicide, and drug overdoses, making them the leading causes of death in the first year after a woman gives birth. Root causes include racial and socioeconomic disparities in maternal care, lack of support systems, shortages of mental health professionals, and insufficient reimbursement for services, among others.
In response to the maternal mental health crisis, the Maternal Mental Health Task Force recently recommended creating maternity care centers as hubs of integrated care and birthing facilities, particularly in rural communities that have become maternity care deserts. These centers would help address disparities in care and provide support for new mothers. Programs like the Massachusetts Child Psychiatry Access Program for Moms have been successful in helping doctors recognize and assist mothers with mood disorders before harm is done, but many programs across the country are struggling due to limited resources.
Training and equipping midwives and doulas has been one approach to helping struggling mothers in states like Montana, where rates of maternal depression are higher than the national average. The state had the sixth-highest maternal mortality rate in 2019 and has implemented a program to train doulas, particularly in tribal communities, to counter systemic barriers and improve community health. Several states, including California, Florida, and Rhode Island, have Medicaid coverage for doula care, recognizing the importance of this support for maternal mental health.
As efforts to expand maternal mental health programs continue, the federal task force has proposed funding consultation programs similar to successful models like the Massachusetts program. The goal is to train more mental health providers and place them in high-need areas, as well as certify a more diverse workforce of community mental health workers, patient navigators, doulas, and peer support specialists. A voluntary curriculum in reproductive psychiatry aims to improve skills for treating perinatal women with mental illness, addressing the lack of training in this area for many mental health practitioners.
While progress has been made in raising awareness and implementing programs to support maternal mental health, there is still much work to be done. The maternal mental health crisis is a complex issue that requires a multifaceted approach, including addressing disparities in care, training healthcare providers, and ensuring equitable access to mental health services for mothers. By recognizing the importance of maternal mental health and investing resources in programs to support new mothers, strides can be made in improving outcomes and reducing the rates of mental illness, suicide, and drug overdoses among women during and after pregnancy.
