USU UWLP Sheds Light on Maternal Mental Health Challenges

It is common for mothers to experience the “baby blues” the first weeks after delivery, feeling anxious, irritable, overwhelmed or weepy. These symptoms often resolve on their own within about two weeks. However, for some women, mental health concerns go beyond the baby blues, such as postpartum depression or anxiety. It is estimated that 1 in 8 women in the U.S. report postpartum depression symptoms.

The Utah Women & Leadership Project recently provided a report that summarizes Utah data on perinatal mood and anxiety disorders, a term that encompasses a range of disorders that can occur during pregnancy and up to one year postpartum. The report reviews relevant information for patients and health care providers and aims to raise awareness so that more women receive appropriate screening and care.

“While PMADs are more likely to occur in women with a history of mental illness, women with no history can also develop PMADS,” said Susan Madsen, UWLP founding director. “Unfortunately, PMADs are often underdiagnosed and undertreated, which we hope can change.”

According to Rachel Denton, licensed social worker and lead report author, untreated PMADs can negatively affect maternal health and increase societal costs including reduced economic output and higher health care costs. They can also affect the mother-infant relationship and the health and development of the child.

“In the most severe form, PMADs are associated with maternal suicide, the second leading cause of death of postpartum women in the U.S.,” she said. “Thus, early screening and treatment of PMADs is extremely critical for the well-being of both mothers and children.”

Utah data from 2021 suggest the rate of postpartum depression symptoms has risen from an estimated 13-15% to 16.2%. Utah’s Department of Health and Human Services published a report based on the 2017-2019 Pregnancy Risk Assessment Monitory System (PRAMS) survey that showed 42.8% of Utah women who delivered a live infant reported depression or anxiety symptoms before pregnancy, during the prenatal period, or during the postpartum period.

Of these women, 45.1% experienced depression or anxiety symptoms before pregnancy, 44.3% experienced depression or anxiety symptoms during the prenatal period, and 14.8% reported symptoms of postpartum depression. Younger mothers reported postpartum depression symptoms more frequently than older mothers did, and research suggests that 1 in 10 fathers also experience symptoms of depression or anxiety in the postpartum period.

Utah data shows that PMAD risk factors include the mother being unmarried, living at or below the federal poverty level, being enrolled in Medicaid, having no college education, receiving WIC services during pregnancy, having an unintended pregnancy, or feeling ambivalence toward pregnancy. Other risk factors include lack of partner support, multiple life stressors, chronic disease, history of physical abuse, and experiencing a difficult or traumatic pregnancy, labor, or delivery.

The American College of Obstetricians and Gynecologists provides the following screening recommendations to assist with PMAD prevention:

• Screen patients at least once during the perinatal period with a validated measurement of mood and emotional well-being.
• Closely monitor, evaluate, and assess women with previous depression, anxiety, suicidal thoughts, or increased risk factors for PMADs.
• Refer patients to appropriate behavioral health resources, initiate medical therapy, or both.
• Ensure systems are in place to confirm follow-up for diagnosis and treatment.

Many organizations, both nationally and locally, work to support maternal mental health in Utah. The Utah Maternal Mental Health Referral Network offers a directory of Utah providers and support groups with specialized training, and several major hospitals in Utah also operate specialized clinics that serve women with PMADs.

In addition, the Utah chapter of Postpartum Support International lists local providers, hotlines, and online support groups and provides educational material, crisis resources, and links to professional training and certification in perinatal mental health.

Also providing support, The Emily Effect is a Utah foundation created to raise awareness about PMADs and organize local resources to support maternal mental health. The foundation has a platform where women can share their stories through videos and “Letters of Light,” written accounts posted on the website.

“Given the high rates of perinatal mood and anxiety disorders, continued research is crucial to inform policy and practice and to help new mothers most at risk,” said Sadie Wilde, assistant professor at USU and a report author. “Through evidence-based policy adjustments, Utah can improve PMADs screening rates and access to quality care.”

Madsen said there are many who can play a role in supporting mothers who experience PMADS and help ensure positive outcomes for them.

“Policymakers, providers, friends and extended family can help, and women and their partners can speak up and share their challenges,” she said. “And it is particularly important that we work to reduce the stigma surrounding maternal mental health to create safety for mothers experiencing PMADs.”

Report authors also include Madison Harmer, UWLP graduate research assistant.

To see the full report with references, click here. For further information on UWLP programs and projects, visit utwomen.org.