The US is facing a deadly maternal mental health crisis – and it could get worse

Pregnant women and new mothers are facing a deadly mental health crisis in the United States.

Mental health problems, the leading underlying cause of pregnancy-related deaths in the country, are driving an alarming rise in maternal mortality, which increased by about 60 percent between 2019 and 2021, the report said. Center for Disease Control and Prevention (CDC).

According to the CDC, suicides and overdoses account for nearly a quarter of these deaths.

Rates of substance use, depression, anxiety and other serious mental health problems – such as suicidal ideation and postpartum psychosis – appear to be increasing among pregnant women and new mothers.

“I'm very concerned,” said Ludmila De Faria, chair of the American Psychological Association's committee on women's mental health.

The CDC recently released and reported data showing a decline in maternal mortality in 2022 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 if maternal mortality is actually declining.

The agency has not released detailed data on the causes of these deaths, so it remains unclear how many maternal deaths in 2022 were due to mental illness.

It is difficult to gauge the extent to which maternal mental health is deteriorating in the US given the impact of the crisis limited data available.

Although suicide rates appear to be rising among pregnant and postpartum women, Christine Yu Moutier, chief medical officer at the American Foundation for Suicide Prevention, warns that this may be partly due to better data collection on maternal deaths rather than a true increase. .

She especially points out the Maternal Death Prevention Actthat Congress adopted in 2018 as the reason for the data improvement.

But even considering the still limited data on this topic, some studies show that maternal mental health is worsening.

A Research from 2020 found that suicidality, that is, suicidal thoughts or suicide attempts, has increased in the decade before the outbreak of the COVID-19 pandemic.

Researchers at the University of Michigan, who examined suicide rates among pregnant people with private health insurance between 2006 and 2017, found the number of women who thought about suicide or self-harm tripled in those years.

According to De Faria, health experts also believe that rates of mental health conditions such as anxiety and depression among pregnant women have increased as they have become more widespread among the population as a whole.

Since 2020, cases of depression and anxiety have increased by 25 percent globally, the report said World Health Organisation.

In the US, the number of depressions reached a record high last year Gallup poll; 29 percent of American adults in the survey admitted that they had been diagnosed with the disease at some point in their lives – up 10 percentage points from 2015.

The same study found that many more women have had depression than men: About 36 percent of women reported having been diagnosed with depression at some point in their lives, compared to about 20 percent of men.

And that disparity is widening as women see a particularly sharp spike in depression. The research shows that rates among women have increased almost twice as much as among men since 2017.

The number of suicides among young women in the US is also increasing. Deaths by suicide increased by 4 percent from 2021 to 2022 among women ages 25 to 34, according to the most recent CDC data.

Some experts, like Moutier, worry that maternal mental health may have worsened due to reduced access to mental health care.

The US is facing a shortage of mental health providers about 47 percent of Americans, or 158 million people, will live in an area with a mental health workforce shortage this year, according to health policy research group KFF.

In addition, many physicians who treat pregnant or postpartum women, such as general practitioners or obstetrician-gynecologists, do not address mental health, despite professional organizations recommend that they do so.

Angelina Spicer told The Hill that when she visited her gynecologist for a six-week postpartum checkup after her daughter was born eight years ago, the doctor simply made sure “she could have sex again” and never asked how she was doing. living 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 checkup focused on Spicer's weight. The doctor noted that she “looked great” and “just like before the baby,” Spicer recalled.

“I thought: why are we talking about what I look like? 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 undergo mental health screening, according to the Maternal Mental Health Policy Center.

Screening rates are even lower for women with private insurance, the organization found. Only 9 percent of pregnant women and 11 percent of postpartum women with private insurance undergo mental health screening.

Due in part to this lack of screening, while approximately 1 in 8 women will experience postpartum depression in the year after giving birth, approximately half of these cases will remain undiagnosed.a 2019 study found.

Even when cases of depression are discovered, many women do not receive care. An investigation published in 2015 found that only 22 percent of perinatal women who screened positive for depression received treatment.

“The impact this has on women who are not receiving 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] impacts parents, babies, families and our entire society.”

Mood disorders during or immediately after pregnancy can damage a mother's relationship with her baby and partner.

“Emotional problems can hinder a mother's ability to build a strong, nurturing bond with her baby, affecting her ability to provide the responsive care that is crucial for the child's healthy development.” according to a 2023 stallionj.

“Tense emotional states can resonate with the mother's partnership, causing communication breakdowns and emotional distance.”

In addition to treatment, or lack thereof, health experts are also concerned about the changing landscape of reproductive laws after the 2022 Supreme Court decision overturning Roe v. Wade could negatively impact maternal mental health .

After that decision, “what you have is potentially a significant increase in unplanned pregnancies,” De Faria told The Hill.

In the year following the Dobbs v. Jackson Women's Health Organization, states with abortion bans had an average fertility rate that was 2.3 percent higher than states without abortion bans. according to a 2023 analysis.

That increased fertility rate led to about 32,000 more births than expected, according to the analysis. It is not clear how many of those 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 2017 study in Brazil found that women with unplanned pregnancies were 2 1/2 times more likely suffer from depression during pregnancy and the months after delivery compared to women with a planned pregnancy.

While experts worry 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 it,” Caitlin Murphy, a research scientist at the Milken Institute School of Public Health, said of the country's poor maternal mental health and screening rates.

“As soon as information gets out, people start doing something about it.”

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