- Research this year demonstrated continued trends in poor maternal heath and mental health outcomes during pregnancy and postpartum.
- The COVID-19 pandemic worsened existing disparities in maternal health and mental health for pregnant and new parents.
- While there was national recognition and resources created for maternal health in 2022, barriers for treatment remain.
This post reviews research and other pertinent information that came out on topics related to pregnancy, childbirth, and postpartum in 2022. While there were a few wins in providing recognition and resources for perinatal mental health, there were also several studies and data sets released this year that call attention to the need for us to do so much more in this arena.
Maternal Health and Mental Health Outcomes
This year, the White House proclaimed April 11-April 17 as Black Maternal Health Week to “raise awareness of the state of Black maternal health in the United States by understanding the consequences of systemic discrimination, recognizing the scope of this problem and the need for urgent solutions, amplifying the voices and experiences of Black women, families, and communities, and committing to building a world in which Black women do not have to fear for their safety, their well-being, their dignity, or their lives before, during, and after pregnancy.” As repeated elsewhere in this post, Black mothers continue to experience racial disparities in maternal healthcare. They also experience higher rates of mood and anxiety disorder during pregnancy and postpartum, but lower rates of treatment.
The U.S. continues to have the highest maternal mortality rate among all other developed countries. The Centers for Disease Control and Prevention (CDC) published data in September from 36 states demonstrating that 84 percent of maternal deaths that occurred in the U.S. from 2017-2019 were preventable. Of these deaths, mental health was the leading cause. This included deaths by suicide, substance abuse, and other mental health-associated deaths. Most of these deaths occurred following childbirth (7-365 days postpartum).
While there was an abundance of research related to the pandemic, I will highlight just two noteworthy reports that were released in 2022. The first is a study published in March that showed 1 in 3 new mothers during the early part of the pandemic screened positive for postpartum depression. This is nearly triple pre-pandemic levels—with these rates being around 1 in 7. Of additional concern, 1 in 5 of the participants who screened positive for postpartum depression reported having thoughts of self-harm. However, this aligns with other research that has found rising trends in maternal suicide over the past decade.
The second pandemic-related report that came out this year was from the United States Government Accountability Office (GAO) and described maternal health outcomes. Data from this report demonstrated that COVID-19 contributed to one-quarter of maternal deaths in 2020 and 2021 combined. The report also highlighted that racial disparities persisted during the pandemic. This was seen in maternal death rates as well as preterm and low birth weights for Black women compared to other races and ethnicities.
Screening and Treatment
The first set of data to show rates of mental health screening for pregnant and postpartum patients was released. This data through the Healthcare Effectiveness Data and Information Set revealed that less than 20 percent of women are being assessed for mental health concerns during this critical period. Of those who screened positive for depression, only half received follow-up care. This data reconfirms what small-scale studies previously identified: Medical providers are not engaging in the important task of formally checking if their pregnant and postpartum patients are at risk for mental health concerns nor are they providing referrals for mental health treatment.
The largest study to date was published this year showing no increased risk of neurodevelopmental disorders in children whose mothers took antidepressants while pregnant. This study analyzed data from almost 150,000 children and found that taking antidepressants during pregnancy itself does not increase the risk of children later developing neurodevelopmental disorders, such as autism, ADHD, and other developmental disorders. This is often a concern for pregnant individuals who find themselves weighing the risks and benefits of medication use during pregnancy versus untreated depression. It is hoped this study will help provide some additional information when making this decision and reassurance toward minimizing risks.
Finally, this year we can celebrate the launch of the first National Maternal Mental Health Hotline which provides real-time 24/7 voice and text support in both English and Spanish at 1-833-9-HELP4MOMS. Hotline counselors are staffed with maternal mental health-trained professionals through Postpartum Support International. Anyone in need of support throughout their pregnancy or after childbirth can access real-time support and resources at this number.
Trost SL, Beauregard J, Njie F, et al. Pregnancy-Related Deaths: Data from Maternal Mortality Review Committees in 36 US States, 2017-2019. Atlanta, GA: Centers for Disease Control and Prevention, US Department of Health and Human Services; 2022.
Shuman, C.J., Peahl, A.F., Pareddy, N. et al. Postpartum depression and associated risk factors during the COVID-19 pandemic. BMC Res Notes 15, 102 (2022). https://doi.org/10.1186/s13104-022-05991-8
Suarez EA, Bateman BT, Hernández-Díaz S, Straub L, Wisner KL, Gray KJ, Pennell PB, Lester B, McDougle CJ, Zhu Y, Mogun H, Huybrechts KF. Association of Antidepressant Use During Pregnancy With Risk of Neurodevelopmental Disorders in Children. JAMA Intern Med. 2022 Oct 3. https://doi.org/10.1001/jamainternmed.2022.4268.