Thriving Beyond

Mental health is a significant contributor to women’s health and wellbeing, especially during pregnancy. Mental health wellbeing has severe implications for both the mother and the baby. The COVID-19 pandemic has imposed significant challenges contributing to the worsened state of maternal mental health in the United States.

In a study of 11 developed countries, the United States ranks the highest in health care expenditure and the lowest in life expectancy. The same study reported that the United States has the highest suicide rates, 13.9 deaths per 100,000. In addition, the United States has the highest maternal mortality rates among wealthy nations. The Centers for Disease Control National Center for Health Statistics reported that the average rate of maternal deaths was 17.4 per 100,00 live birth and this rate is twice as pronounced among Black women.

In New York State, 1 in 5 moms will experience a perinatal mood and anxiety disorder. Perinatal mood and anxiety disorders, including postpartum depression, is the number one medical complication in pregnancy and childbirth. Suicide is a leading cause of maternal death within the first year after childbirth. Maternal death by suicide is more common than deaths by postpartum hemorrhage or hypertensive disorders.

Changes in maternal care and obstetric practices due to the pandemic are likely to result in changes in psychosocial and obstetric outcomes. Almost all aspects of pregnancy, childbirth and postpartum care have changed to some extent. These changes, a few among many others, include a shift in prenatal care to telehealth platforms, removal of partners and support persons from delivery rooms during birth, consideration of alternative birthing plans in fear of infection, and reduced post-delivery stay. Such changes are likely to cause lasting impacts on mothers’ mental health and wellbeing.

Recent and ongoing studies are documenting the impacts of the pandemic on maternal mental health. Early findings from the COPE study reported that 75% of pregnant women indicated changes in their prenatal care, and 90% of those who had given birth reported changes in their postnatal care. The study showed that 78% of mothers reported an increase in stress, and of those women, 17% reported access to mental healthcare as a source of stress. Another study among pregnant and postpartum women found that 33% of women had clinically elevated symptoms of depression during COVID-19, and loneliness was a risk factor for increased depressive symptoms.

With this information and much more circulating in the literature, an integrative, collective, and strategic effort is needed to address the maternal mental health crisis in the United States and globally. During May, Maternal Mental Health Awareness Month, several organizations have launched campaigns and social media movements to raise awareness. However, this should not be the only time the issue of maternal mental health is addressed. The conversation surrounding maternal mental health needs to be amplified every day. The mental health and wellbeing of mothers and their babies need to be grounded in maternity care. The COVID-19 pandemic brought to light many challenges. However, it also allows us to address our maternity care systems’ weaknesses and create innovative solutions to improve maternal mental health beyond the pandemic. It is time stories are told of mothers thriving, not just surviving.