Maternal Mental Health - Awareness and Statistics
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When I chose the name “Shout Your Worth” for this website, I was so happy with it. I felt like it embodied exactly what I promised to always do for Luke, and what I know other parents have promised to do for their kids as well. As I was talking to a friend about the site, how it was coming together, and why I chose the name, I realized that “Shout Your Worth” wasn’t just for Luke — it was for me too. That is when I decided that in conjunction with talking about Down syndrome, I would also talk about maternal mental health and make sure those moms who suffer with postpartum mental disorders know that they too have worth, are important, and they are not alone.
So, I’m taking a brief break on writing about Luke and Down syndrome, to write about something equally important and just as stigmatized — maternal mental health. Maternal mental health disorders can occur during pregnancy and the postpartum period. They include conditions such as postpartum anxiety, depression, obsessive-compulsiveness, and psychosis. I would venture to say the two we hear about the most are postpartum anxiety (PPA) and postpartum depression (PPD) — yet none of those conditions are things we often hear about, talk about, or acknowledge. Yet statistics from postpartumdepresion.org show that at a minimum — 70-80% of women experience what is known as the “baby blues”. A recent study is cited as saying that 1-7 women may experience PPD in the year following their child’s birth, while the rate of clinical PPD is reported as being between 10-20% and that is in the United States alone.
In my opinion, those statistics are just the tip of the iceberg. We see them and we know what they are, but there is something far larger that is lingering beneath. Those statistics don’t consider women who go undiagnosed or don’t meet the criteria to be diagnosed with a clinical maternal mental health disorder. These statistics are especially low when you consider the fact that women are often only screened for postpartum depression one time, at the six week postpartum checkup, yet a study on postpartum depression indicates women are most at risk for developing PPD between 2 and 6 months after delivery, during times when screening is not common.
Mood disorders occurring during pregnancy are associated with an increase in pregnancy related complications, and put women at higher risk of developing a postpartum mood disorder. According to America’s Health Rankings at the UnitedHealth Foundation postpartum depression “is one of the most common medical complications during the postpartum period”, posing health risks not only to the mother but also to the baby, including delayed bonding during crucial stages of infant development. As far as the health risk to the mother, it is well documented (here, here, and here) that suicide due to postpartum depression is a leading cause of death among new mothers.
What you also don’t see from the snapshots of the statistics above are the disparities between white women and women of color. This article reports that those women who screened positive for being at risk for postpartum depression “were more likely to be younger, African American, publicly insured, single, and less well educated.” Another study found that, when compared to their white counter parts, black and Latina women sought help for their postpartum mood disorder at significantly lower rates. They are also far less likely to receive any type of follow up treatment or continued care, and among women who did receive treatment via antidepressants, black and Latina women were less likely to refill prescriptions for these medications compared to white women.
To add to all of this, it wasn’t even until 2016 that routine postpartum depression screening was endorsed in the United States, and not until as recently as 2018 that the American Academy of Pediatrics endorsed screening of mothers for mood disorders at the child’s well visits until 6 months of age. You can read an overview of how we can make postpartum depression screening more effective here, or read a more in depth analysis from the Maternal and Child Health Journal.
The statistics and the data behind them are so very frightening to me. We have glaring evidence that women are suffering and dying from mental health struggles, a disproportionate number of them being women of color, yet there is so little that is being done. Continue on to post two for my opinion on why this is happening and for my story with postpartum mental health struggles.
Curious to dig deeper and read more? Here are links to further studies on maternal mental health disorders and the disparities between the treatment of white women and women of color:
"Efficacy and Safety of Screening for Postpartum Depression"
“Screening for and treating postpartum depression and psychosis: A cost-effectiveness analysis”
"Racial and Ethnic Disparities in Postpartum Depression Care Among Low-Income Women"
"Perinatal Mood and Anxiety Disorders in Latina Moms"
"PMADs - Such as PPD and Anxiety - in African American Moms"