Mental health disorders on the rise in pregnant, post-partum women
Significant strides have been made in women’s mental health care, specifically when it comes to pregnant and post-partum women.
Initiatives have been launched in policy and funding and more in-depth research was conducted. Amidst these efforts was the development of the first oral medication targeting postpartum depression.
However, more can be done.
Nancy Byatt, D.O., M.S., MBA, DFAPA, FACLP is a perinatal scientist, professor of psychiatry at UMass Chan Medical School, and executive director of its Lifeline for Families and the Lifeline for Moms Program.
She said mental health disorders are on the rise in pregnant and postpartum women. Based on her research as well as her own experience, there are multiple factors involved.
For one, pregnancy and postpartum are challenging times biologically and hormonally and certain individuals can be more at risk because of those hormone shifts. For example, bipolar disorder can be a big risk during this time.
Secondly, whether starting a family or expanding one, there is trauma through relationships with parents or a partner. And when a baby comes, emotions from the past can get triggered.
That is particularly true if the mother does not have a good support system.
Thirdly, Byatt said the issue must be looked at through a public policy lens, noting there are unmet social needs including the fact that it is expensive to raise a child.
A lack of medical leave policies in the U.S. is a factor. For those who do have leave, it is often unpaid. Other stressors include childcare needs for additional children and lack of access to mental healthcare.
“It’s a challenge to get mental health care in the U.S.,” she said. “We do not have enough licensed professionals. We have not created the workforce we need. We have been in a mental health crisis for a long time and now it’s an emergency.”
Byatt believes there is a disconnect in medicine. Clinicians are not valuing how people are feeling. She said the American College of Obstetricians and Gynecologists is working hard to change this situation by focusing on what is often called the “fourth trimester.”
But she said there is such pressure to see patients quickly, it is challenging to fit in caring about mental health. She also noted that women’s healthcare should not only target the young.
“All of women’s reproductive phases in their lives…they all can be associated with mood and anxiety disorders,” Byatt said. “Ideally, we should be screening and assessing mental health regardless of whether a woman is gestating or not. Women’s health is important.”
In a New York Times Op-Ed, Surgeon General Vivek Murthy issued an advisory to call attention to the stress and mental health concerns of parents and caregivers. He cited a study by the American Psychological Association that showed 48 percent of parents felt overwhelming, daily stress compared to 26 percent of other adults.
Stressors identified by parents included everything from financial struggles to not getting enough sleep to social media, screen time and more.
“The stress and mental health challenges faced by parents aren’t always visible, but they can take a steep toll,” Murthy said. “It’s time to recognize they constitute a serious public health concern for our country. Parents who feel pushed to the brink deserve more platitudes. They need tangible support.”
The Surgeon General’s advisory came on the heels of a study published in the journal, “Archives of Women’s Mental Health.” That study showed a disproportionate amount of labor spent on raising children was shouldered solely by mothers.
Household tasks were mainly skewed toward women as well as cognitive labor—planning tasks, delegating responsibilities, and anticipating needs. The cognitive labor was found to cause higher rates of women’s depression, stress, and burnout, and it affected their overall mental health and relationship functioning.
The National Institutes of Health also announced its support of research and policy change for women’s health, specifically the prevention, diagnosis, and treatment of postpartum depression.
And, the Federal Drug Administration (FDA) approved Zurzuvae, which treats the symptoms of postpartum depression. After multiple clinical trials, the drug could improve postpartum depression in as little as three days.
Further, the Centers for Disease Control indicated that healthcare providers are missing the opportunity to catch mental health issues during a prenatal visit. Only about one in five pregnant women were asked about symptoms of depression during a prenatal visit and about one in eight were asked during a postpartum visit.