Perinatal depression (defined as depression during pregnancy and the immediate postpartum period) happens to so many mothers, 1 in 7 of us, in fact. It can make pregnancy and early motherhood even harder than it needs to be and rob new mothers of a joyful time they were looking forward to.
And now, the U.S. Preventive Services Task Force (USPSTF) says there is a way to prevent perinatal depression in the moms who are most at risk. This week the USPSTF published guidelines calling on health care providers to identify at-risk women and connect them with cognitive behavioral therapy and interpersonal therapy.
These counseling interventions are effective in preventing perinatal depression, the USPSTF found, and, as The New York Times reports, the new guidelines mean the kinds of therapies that can prevent moms from becoming depressed with be covered under the Affordable Care Act.
Therapy can change and save lives, but it's often unaffordable. Now, more mothers will have access to it when they need it most.
Any mom can develop perinatal depression, but certain women are more at risk. Those with a personal or family history of depression and those dealing with stressful circumstances like poverty, divorce, young or solo motherhood are at an increased risk. Past abuse or trauma, gestational diabetes, and experiencing an unplanned or complicated pregnancy also increase a mother's risk for depression during and after pregnancy.
Untreated, perinatal depression can have terrible outcomes for women, babies and families. A proactive approach—getting at-risk moms into therapy before depression hits—could actually prevent the disease and its personal and social consequences.
"We can prevent this devastating illness and it's about time that we did," Karina Davidson, a clinical psychologist and researcher who helped write the recommendations told NPR.
But it won't be easy to do that, says Harvard Medical School psychiatrist Marlene P. Freeman. In an editorial published alongside the USPSTF recommendations, Freeman points out that proactive intervention is a challenging task for the current health system. "Clinicians who provide obstetrical care may not have the expertise or time during clinical visits to perform assessments and tailor referrals to women who are identified," Freeman writes. "Availability and access to care present potential hurdles, and stigma presents another potential barrier for some women to seek and accept mental health care," she continues.
The system and our society are not currently set up to help get moms into cognitive behavioral therapy and interpersonal therapy, but maybe the adoption of these guidelines can change that over time.
Perinatal depression often goes untreated because mothers don't know how or when to ask for help. According to a 2017 study published in the Maternal and Child Health Journal, one in five new moms experiencing postpartum mood disorders doesn't disclose her symptoms to healthcare providers.
That's why the American Academy of Pediatrics released its own depression guidelines in late 2018, urging pediatricians "incorporate recognition and management of perinatal depression into pediatric practice."
If health care providers do what both the USPSTF and the AAP suggest, American mothers could have doctors looking out for their mental health at every stage of the perinatal journey.
You might also like:
- Postpartum depression and anxiety are more common than you may think—here are the resources you need
- Prenatal depression is the most under-diagnosed pregnancy complication in the U.S.
- More than half of new moms aren't getting the mental health support they need