It is no secret that the United States is in the midst of a maternal health crisis, with one in five pregnant or postpartum women diagnosed with a perinatal mood and anxiety disorder (PMAD) and maternal mortality rates two to three times higher than those in other high income countries. A recent literature review led by Dr. Katherine Wisner, Associate Chief of Perinatal Mental Health at Children’s National Hospital in Washington, D.C, examined a possible relationship between maternal mental health and the high rate of maternal mortality in the United States. Dr. Wisner and her team examined data from 30 recent studies and 15 historical references. Researchers found that approximately one in four maternal deaths is attributed to mental health concerns, leading them to conclude the majority of these deaths are preventable.
Researchers went on to note that more could be done to identify and treat PMADs during pregnancy; indeed 14.5 percent of pregnant mothers develop depression during their pregnancy and another 14.5 percent continue to struggle with symptoms three months after delivery. Women with a history of mental illness are at an increased risk of developing symptoms. Still, Wisner notes that only 20 percent of new mothers are ever screened for postpartum depression.
Researchers further highlight that pregnant and postpartum women are at an increased risk for suicide and opioid overdose– suicide and opioid overdose account for 23 percent of maternal deaths that occur within one year of pregnancy.
Further, Wisner’s team found that women often live in “maternity care deserts,” where finding care and support to deal with the mental and physical stressors of pregnancy is increasingly difficult. Per Winser, “nationwide, more than 400 maternity services closed between 2006 and 2020, which left nearly 6 million people with no or limited access to maternity care.” Black women and people of color are disproportionately impacted by maternity care deserts. The vast majority of maternity care deserts are in the rural South; more than half of the nation’s Black population lives in the South. Indeed, Black women have the highest maternal mortality rate in the United States of 69.9 per 100,000 live births– almost three times the rate for white women in the United States.
Wisner’s team ultimately calls for concrete programmatic and policy changes to reduce perinatal stress and trauma, standardize care and data collection, increase access to reproductive psychiatry curricula among subscribers, reduce maternity care deserts, and support the integration of perinatal and behavioral health care. The researchers further call for paid parental leave as a public health policy, not simply an economic one. They conclude that “fortifying the social foundation strengthens the prospects for the health of families for our current and future generations.”
One in four pregnant and postpartum women struggle with perinatal mood and anxiety disorders. To learn more and/or seek treatment, visit our page on perinatal mood and anxiety disorders.