It's one of the most common complications of pregnancy. As many as 1 in 5 new moms in America suffers from perinatal mood and anxiety disorders, and although there is growing awareness of how maternal mental health impacts women and their children, mothers still aren't getting the help they need.
A national survey by Maven, a digital clinic for women, reveals that more than half of new moms aren't getting mental health support during or after pregnancy. Recognizing this problem may be the first step in changing it.
It's not just depression
Kate Ryder, the founder and CEO of Maven, tells Motherly that "the mainstream narrative about maternal mental health is mainly around postpartum depression, but there are many other issues that women face."
Indeed, perinatal anxiety is a huge issue. Of the 700 moms Maven surveyed, only 23% reported suffering from only depression, while most (55%) felt symptoms of both depression and anxiety.
"We wanted to shed light on the topic in general, and illustrate that there are many women today suffering from some form of maternal mental health issue in silence--without a diagnosis, and without support," says Ryder.
The disconnect between moms and OB-GYNs
What Ryder's team learned can be considered alongside the findings recent study published in the Maternal and Child Health Journal. Those researchers surveyed 211 women who had given birth in the previous three years, asking if they'd felt any postpartum mood disorder symptoms and if so, whether they had disclosed these symptoms to a healthcare provider (anyone from a doula to a doctor).
They found 51% of the moms surveyed were experiencing symptoms of mood disorder, but 21% of those moms didn't tell their healthcare providers. "Our study finds that many women who would benefit from treatment are not receiving it, because they don't tell anyone that they're dealing with any challenges," Betty-Shannon Prevatt, the study's lead author says.
The data from Maven suggests that healthcare professionals may need to step up their game when it comes to screening for perinatal and postpartum mood disorders. Although there are guidelines for postpartum depression screening, the American College of Obstetricians and Gynecologists suggests "clinicians screen patients at least once during the perinatal period for depression and anxiety symptoms using a standardized, validated tool. Obstetric providers should be prepared to initiate treatment and refer patients as needed."
Previous research suggests women who are screened may not be forthcoming about their mental health, but 54% of the mothers Maven polled said they were never given the chance, as they were never screened for such issues during pre and postnatal care. Of the women who raised concerns about their mental health to their OB-GYN, 27% were given no concrete next steps to get treatment, To Ryder, this is an indication of a gap in postpartum care.
"OB-GYNs aren't trained in mental health—they're trained in getting a woman through a healthy pregnancy and delivering a healthy child," she tells Motherly. "Further, the system is so fragmented that OB-GYNs don't often know who to refer their patients to if they're having issues—who is in the insurance network of their patient? Who has a specialty in maternal mental health?"
Barriers to therapy
Even when OB-GYNs do know where and how to refer patients to a therapist, the results aren't great. Although 33% of the moms surveyed who initiated conversations about their mental health with their care provider were referred to a therapist, 43% of them never followed through with actually going to the therapist.
Cost and time are barriers to many busy new moms considering traditional therapy, obstacles Ryder hopes Maven and other telehealth services can help more women overcome by offering lower costs and the ability to speak to therapists without leaving the house. As many moms know, sometimes leaving the house with a new baby can be overwhelming, especially if you are also dealing with anxiety.
Technology is helping break down the barriers to therapy, but for the women who don't even know they could benefit from therapy, more still needs to be done. OB-GYNs and health care providers can help, but so can the rest of society. "We need to make it okay for women to talk about their mental health, so that they can have better access to care," says Prevatt.
Ryder believes that a more holistic approach to health could help. "I think the healthcare system needs to treat physical and mental health together. That would result in more effective treatment and help us get ahead of mental health issues before they become acute," she says.
In the meantime, mothers can support each other by talking about maternal mental health and letting each other know the best thing we can do for ourselves, and our kids, is get help when we need it.
[This post was originally published July 1, 2018.]