May is Maternal Mental Health Month and Perinatal Mood and Anxiety Disorders Awareness Month in the State of Michigan which means it’s the perfect time to shine a light on mental health conditions during pregnancy and postpartum—a period also known as the perinatal period. It’s especially important to raise awareness about these mental health conditions because, taken together, they represent the leading reason for maternal complications and deaths during the perinatal period. These deaths are preventable.
At the U-M Perinatal Mental Health Services and Policy Program, we conduct multiple studies funded by the National Institutes of Health that examine the impacts of federal and state behavioral health policy changes on health and economic outcomes among childbearing individuals and infants. Here are five things we’ve learned and that you may not know about perinatal mental health.
1. Mental health conditions during pregnancy and after birth are common.
Each year, one in five people struggle with mental health conditions such as depression and anxiety during pregnancy and after birth, and this rate may be rising. In a new study, our team found that the rate of perinatal mood and anxiety diagnoses nearly doubled in people with private insurance from 2008 to 2020, with 28% of pregnant or postpartum individuals receiving a perinatal mood and anxiety diagnosis by 2020.
2. Postpartum depression is only one part of maternal mental health.
When people think about mental health conditions related to pregnancy, they often think about postpartum depression. But postpartum depression is only part of the story. To begin with, depression can also happen during pregnancy, not just after birth. Depression itself represents only one of multiple conditions a pregnant or postpartum individual might face.
Anxiety during the perinatal period may be as common or more common than depression. Other conditions such as post-traumatic stress disorder, which can be related to pregnancy or birth or not related, can also occur. When studying post-traumatic stress disorder during the perinatal period, our team recently found that the rate of perinatal post-traumatic stress disorder diagnoses quadrupled from 2008 to 2020 in perinatal people with private insurance, with nearly 2% of those pregnant or postpartum receiving a post-traumatic stress disorder diagnosis by 2020. Other less common mental health conditions affecting pregnant and postpartum individuals include bipolar disorder, attention-deficit/hyperactivity disorder, and psychosis.
3. Some people are at more risk for these conditions than others.
Perinatal mental health conditions affect some people more than others. Broadly speaking, researchers have long found racial disparities in maternal health, including in maternal deaths. For example, Black and American Indian and Alaska Native people experience higher rates of pregnancy-related deaths when compared with White people. Our team’s findings also point to racial disparities when it comes to perinatal mental health conditions. For example, in our study focused on the rate of perinatal mood and anxiety disorders mentioned above, we found that Black individuals had the largest increase (55%) in perinatal mood and anxiety diagnoses from 2008 to 2020.
4. Few people with perinatal mental health conditions get help...
Though these mental health conditions are common among perinatal people in the United States, these conditions often go undiagnosed and untreated. A well-known study shows that for people with postpartum depression, only about 30% were identified by clinicians, about 15% received treatment, and less than 5% achieved remission. This critical gap in health care negatively impacts not only perinatal people but also babies and families.
5. But evidence-based treatment is available.
The good news is that treatment is available. Many professional organizations have guidelines for evidence-based treatment for perinatal mental health conditions. These guidelines may include the use of psychotherapy and mental health medications like antidepressants. We found encouraging signs in our recent study: rates of psychotherapy and mental health medication use during pregnancy and after birth increased from 2008 to 2020 in perinatal people with private insurance.
If you or someone you know is living with a mental health condition during pregnancy or postpartum, we encourage you to seek support. Organizations like Postpartum Support International offer many ways to connect you or someone you know to maternal mental health services.
Watch this CBS News video featuring Kara Zivin, Ph.D.
Read this infographic to see the latest research findings related to maternal mental health
