Pregnant women and new mothers face a deadly mental health crisis in the United States.
Mental health conditions, the leading underlying cause of pregnancy-related deaths in the country, are driving an alarming rise in maternal mortality rates, which increased by about 60 percent between 2019 and 2021, according to the Centers for Disease Control and Prevention (CDC).
Suicides and overdoses account for nearly a quarter of these deaths, according to the CDC.
Rates of substance use, depression, anxiety and other serious mental health conditions – such as suicidal ideation and postpartum psychosis – appear to be rising among pregnant women and new mothers.
“I’m very worried,” said Ludmila De Faria, chair of the American Psychological Association’s committee on women’s mental health.
The CDC recently released data showing that maternal deaths declined in 2022 and reported that 817 women died due to maternal causes that year. While the decline in deaths is a step in the right direction, doctors warn that more data is needed to see whether maternal mortality is actually declining.
The agency has not released detailed data on the causes of these deaths, so it is not yet clear how many maternal deaths in 2022 resulted from mental health problems.
It is difficult to assess the extent to which maternal mental health is worsening in the US, given the limited data available.
Although suicide rates appear to be rising among pregnant and postpartum women, for example, Christine Yu Moutier, chief medical officer at the American Foundation for Suicide Prevention, warns that this may be due, in part, to better collection of data on maternal mortality, not a real increase. .
She points especially to the Maternal Deaths Prevention Lawwhich Congress approved in 2018, as a reason for improving data.
But even considering the still limited data on the subject, some research suggests that maternal mental health is deteriorating.
One 2020 study found that suicidality, that is, suicidal thoughts or suicide attempts, increased in the decade before the start of the COVID-19 pandemic.
Researchers at the University of Michigan, examining suicide rates among pregnant women with private health insurance between 2006 and 2017, discovered the number of women who thought about suicide or self-harm tripled during these years.
Health experts also believe that rates of mental health problems such as anxiety and depression have increased among pregnant women because they have become more widespread in the population as a whole, according to De Faria.
Since 2020, global rates of depression and anxiety have increased by 25%, according to the World Health Organization.
In the US, depression rates reached an all-time high last year, according to a study Gallup Poll; 29 percent of American adults admitted in the survey that they had been diagnosed with the disease at some point in their lives – 10 percentage points higher than in 2015.
The same survey found that many more women suffered from depression than men: about 36% of women reported being diagnosed with depression at some point in their lives, compared to about 20% of men.
And that disparity is growing as women experience a particularly sharp increase in depression. Rates have increased nearly twice as much among women as men since 2017, research shows.
Suicide rates among young women in the US are also rising. Deaths by suicide increased by 4 percent from 2021 to 2022 among women ages 25 to 34, according to the latest CDC data.
Some experts, like Moutier, worry that maternal mental health may have worsened due to decreased access to mental health care.
The US is facing a shortage of mental health providers, with about 47 percent of Americans, or 158 million people, who lived in areas with mental health workforce shortages this year, according to the health policy research group KFF.
Additionally, many doctors who treat pregnant or postpartum women, such as primary care physicians or obstetrician-gynecologists, do not check mental health despite professional organizations recommending that they do so.
Angelina Spicer told The Hill that when she visited her gynecologist for a six-week postpartum exam after her daughter was born eight years ago, the doctor just made sure “she was free to have sex again” and never asked how she was dealing with life with the new baby.
Spicer, a stand-up comedian, experienced severe anxiety and depression after the birth of her daughter.
But she said the conversation with her doctor during the exam centered on Spicer’s weight. The doctor commented how she “looked amazing” and “just like she did before the baby,” Spicer recalls.
“I was like, why are we talking about my appearance? And why doesn’t anyone ask me why I feel like I’m drowning?” she said.
Less than 20 percent of pregnant and postpartum women with Medicaid receive mental health screenings, according to the Policy Center for Maternal Mental Health.
Screening rates are even lower for women with private insurance, the organization found. Only 9% of pregnant women and 11% of postpartum women with private insurance undergo mental health screenings.
Partly because of this lack of screening, although about 1 in 8 women will experience postpartum depression in the year after giving birth, about half of these cases will go undiagnosed.a 2019 study found.
Even when cases of depression are detected, many women do not receive care. A study published in 2015 found that only 22 percent of perinatal women who tested positive for depression received treatment.
“The impact this has on women who don’t receive treatment and the impact on families is enormous,” said Elizabeth Cherot, president and CEO of March of Dimes.
“Think about how, if left untreated, how [poor maternal mental health] it affects parents, babies, families and our entire society.”
Mood disorders during or shortly after pregnancy can harm a mother’s relationship with her baby and partner.
“Emotional distress can impair a mother’s ability to form a strong, loving bond with her baby, impairing her ability to provide responsive care, which is crucial to the baby’s healthy development,” according to a 2023 stallionYes.
“Tense emotional states can have repercussions on the mother’s partnership, causing failures in communication and emotional distancing.”
Beyond the realm of treatment, or lack thereof, health experts are also concerned about the changing landscape of reproductive laws following the 2022 Supreme Court ruling that overturned Roe v. Wade. Wade may have a negative impact on maternal mental health.
Following this decision, “what we have is a potentially significant increase in the number of unplanned pregnancies,” De Faria told The Hill.
The year following the Women’s Health Organization decision Dobbs v. Jackson, states with abortion bans had an average fertility rate 2.3% higher than states without them, according to a 2023 analysis.
This increase in the fertility rate led to about 32,000 more births than expected, according to the analysis. It is unclear how many of these pregnancies were planned.
Having an unplanned pregnancy can be “a huge stressor” for someone with or without a pre-existing psychiatric illness, De Faria said.
Numerous studies show a link between unplanned pregnancies and higher rates of perinatal depression.
A study carried out in Brazil in 2017 found that women with unplanned pregnancies were 2 1/2 times more likely suffer from depression during pregnancy and in the postpartum months compared to women with planned pregnancies.
While experts have concerns about the future of maternal mental health, they also agree that there may be some light in the darkness.
“What gives me hope is the attention that has been focused on this,” Caitlin Murphy, a researcher at the Milken Institute School of Public Health, said of the country’s low maternal mental health and screening rates.
“Once the information gets out, people start doing something about it.”
This story originally appeared on thehill.com read the full story
