Greater Mental Health Support Is Still Needed During Pregnancy

When a person becomes pregnant, concerns about the baby take center stage. Parents start to purchase cribs and car seats, get bottles and pacifiers, and schedule prenatal appointments. With the focus on the baby and moms’ physical health, there is little, if any, thought about how mom is doing mentally. A new study published this year shines a light on the lack of attention given to moms’ mental health during pregnancy, a vitally important topic.

“Pregnancy impacts the woman’s entire being. Early and appropriate access to mental health services can significantly reduce the negative health impacts for both mother and infant,” states Gwenneth Simmonds, PhD, CNM in Atlanta, Georgia.

Approximately one in five mothers experience mental health issues during pregnancy. Many don’t have a roadmap to mental wellness to help during this time. While women now use their own self-care methods to deal with mental health struggles during pregnancy, more support could be offered to take better care of both mom and baby during and after pregnancy.

Study Details

Researchers gathered information about the mental health problems women experienced during pregnancy from self-reported questionnaires. Participants came from a hospital in Wales and included expectant women and midwives.

Those who reported symptoms of depression and anxiety in early pregnancy, but were not receiving mental health services, were then asked additional questions regarding their mental health challenges. There were 20 participants for the interview portion of the study.

Findings showed that nine women reported having mental health disorders late in pregnancy. Additionally, 15 women had symptoms of mild to moderate depression, and 15 women had symptoms of mild to moderate anxiety. While the study sampling was small, it paints a bigger picture—that pregnant people don’t receive the mental health care they need during this vulnerable time.

“[The] current level of support is inadequate. All pregnant women should be screened early for possible mental health issues and follow-up care provided to those identified to be at risk,” advises Dr. Simmonds.

Previous research has shown that when women battle mental health problems during pregnancy, it can impact their baby’s neurological development and fetal heart rate. Prenatal stress and depression can also lead to socioemotional development issues and behavioral problems in children.

The current study findings highlight the strong prevalence of mental health issues in pregnant mothers, and the fact that not enough is done about it within the medical community.

How Women Have Managed

Hormonal changes, financial difficulties, relationship problems, uncertainty about the future, and numerous other circumstances can cause stress, anxiety, or depression for a pregnant person. Support and help with processing these emotions are important for expecting parents. Unfortunately, a number of barriers hinder adequate mental health care.

“Some possible barriers to care include shame [and] embarrassment on the part of the mother, failure of the [obstetrician] provider to recognize the need for mental health services, lack of transportation, and in the US lack of access [to mental health care],” notes Dr. Simmonds.

Even if a woman does have access to mental health care, she often has to find it on her own. The search process itself can be a deterrent.

“You have to seek it out yourself, you have to decide that you need it, then you have to find a practitioner that you’re comfortable with,” notes Rachael Benjamin, LCSW, Director, Tribeca Maternity. “You have to seek them out either through a clinic system or a social support network, or community or private practice, but you have to find it. Most [obstetricians] do not have a ready list available, so that’s a barrier,” Benjamin adds.

The barriers, coupled with the lack of a streamlined process to provide mental health services, have led women to seek help in other capacities. Support groups and family members provide comfort and support. Books and online blogs have also helped bridge the gap in mental health care. These self-care solutions have been a band-aid on a larger problem. Experts say greater awareness and action in the medical community is needed.

[Obstetricians] and midwives should be asking how someone is actually emotionally feeling. ‘Are you feeling anxious about this? How’s your mood these days?’ Benjamin explains. “I think practitioners, therapists, or [obstetricians] should try to connect with each other and build community together so there’s a referral system in place,” she suggests.

Pregnant individuals need better education on the impact of depression, anxiety, and stress during pregnancy. They should be given information on mental health care available to them, and how to access it. And they should not feel ashamed of what they are feeling.

Future Outlook

Recognizing and treating prenatal depression and anxiety is beneficial for mom and baby alike. Although it doesn’t guarantee the absence of mental health challenges in the future, it can create a good foundation of coping strategies. Acknowledgement now could mean a better outcome later.

“Adequate prenatal recognition and management can significantly reduce the negative impact of postpartum depression as these women would be receiving the mental health care that they need,” Dr. Simmonds notes.

People who are expecting and their children can only benefit from more importance being placed on mental health care. If incorporated as a part of prenatal checkups, it can be advantageous to everyone.

“Society needs to view mental health as just another form of necessary health care. Currently the stigma attached keeps many people who need the care from seeking the services. Family, providers, and the community can help women recognize they have a problem and encourage them to seek appropriate intervention,” Dr. Simmonds concludes.