September is here, and with it comes the National Suicide Prevention Month – a time when we shine a critically important spotlight on mental health and work to raise awareness about preventing suicide. Suicidality affects people from all walks of life and at various points of their lives. As this article will show, tragically it can also be a part of the transition to parenthood. Although recent years have brought a more robust push for recognition of mental health challenges associated with pregnancy and postpartum, this has not resulted in comprehensive nation-wide measures aimed at addressing suicidality and mental health conditions during the perinatal period. The consequences have been dire.
Consider the following startling facts:
Perinatal mood and anxiety disorders (PMADs) are among the most common pregnancy complications, impacting up to 1 in 5 women (WHO, 2018).
Suicide is a leading cause of maternal mortality in the United States in the first postpartum year: in fact, 20% of deaths in the postpartum period are due to suicide (Campbell et al., 2021).
Black women are twice as likely to experience PMADs but half as likely to receive treatment (Taylor and Gamble, 2017).
Up to 75% of birthing people experiencing PMADs do not receive treatment (Byatt et al., 2015).
As these statistics reveal, we are facing an urgent maternal mental health crisis in our country.
Detecting and treating perinatal mental health issues promptly is crucial for several reasons. Early intervention aims to prevent the progression of symptoms and reduce the risk of severe outcomes, including suicide. The wellbeing of the birthing parent, their partner, and their baby is at stake. Untreated mental health conditions often become chronic. Further, they can impair a mother’s ability to bond with her baby, potentially affecting the infant’s emotional and cognitive development (Gavin et al., 2005). Depression experienced by the mother increases the risk of mental health complications for her partner (Goodman, 2004; Paulson and Bazemore, 2010).
There is hope: Timely treatment of perinatal depression and anxiety has been shown to vastly improve outcomes for the entire family (Howard et al., 2014). By prioritizing mental health care in the perinatal period, we support not only individual families but the health and stability of communities as a whole.
This call to action is also supported by the fact that we have treatments that actually work: Interventions such as psychotherapy, medication, and support groups are effective in addressing symptoms and providing the necessary support during this critical period.
As we know, there is a long way from awareness and advocacy to legislation and impact on one’s lived experience. This said, 2024 has thus far been marked by important progress on the national level. In May 2024, The Department of Health and Human Services released two critical documents created by its Task Force on Maternal Mental Health: the official Report to Congress and the National Strategy to Improve Maternal Mental Health Care. These documents presented an overview of the current maternal mental health care systems, policies, and practices in the United States, and offered a comprehensive strategy for addressing the many barriers to detection and care. No matter how arduous or difficult, it is a path we need to walk.
The vision is there, and to make it into reality, we all need to view ourselves as agents of change.
Here are some ways you can make a difference:
- Educate yourself about the maternal health crisis in the United States. You can start by reading the documents listed above.
- Learn about perinatal mental health and share the information with others. Fact sheets created by the Maternal Mental Health Leadership Alliance (MMHLA) are an excellent place to start.
- Consider joining Postpartum Support International (PSI) whose mission is to “promote awareness, prevention and treatment of mental health issues related to childbearing in every country worldwide.”
- Follow and participate in the advocacy work of MMHLA, a “nonprofit organization dedicated to promoting the mental health of mothers and childbearing people in the United States with a focus on national policy and health equity.”
- Help new parents in your community!
- Fight the mental health stigma wherever you see it. Talk about mental health.
- Hold your state and federal legislators accountable. To learn more about passed and pending legislation in your state, visit the Policy Center for Maternal Mental Health website.
- Make sure you know about National Suicide Prevention Hotline, National Maternal Mental Health Hotline, and PSI’s HelpLine. Numbers and more information can be found here.
- If you are struggling with your mental health, take to heart PSI’s mantra and get the help you deserve: “You are not alone. You are not to blame. With help, you will be well.”
Suicide Prevention Month is a vital reminder of our collective responsibility to address mental health challenges that have a profound and devastating effect on our families, children, and entire communities. Mental health matters at every stage of life, including during pregnancy and the postpartum period.
References:
American College of Obstetricians and Gynecologists (ACOG). (2018). Postpartum depression. Retrieved August 22, 2024, from https://www.acog.org
Byatt, N., Levin, L. L., Ziedonis, D., Moore Simas, T. A., & Allison, J. (2015). Enhancing participation in depression care in outpatient perinatal care settings: A systematic review. Obstetrics and Gynecology, 126(5), 1048–1058. https://doi.org/10.1097/AOG.0000000000001067
Campbell, J., Matoff-Stepp, S., Velez, M. L., Cox, H. H., & Laughon, K. (2021). Pregnancy-associated deaths from homicide, suicide, and drug overdose: Review of research and the intersection with intimate partner violence. Journal of Women’s Health, 30(2), 236–244. https://doi.org/10.1089/jwh.2020.8875
Gavin, N. I., Gaynes, B. N., Lohr, K. N., Meltzer-Brody, S., Gartlehner, G., & Vest, J. R. (2005). Perinatal depression: A systematic review of prevalence and incidence. Obstetrics & Gynecology, 106(5), 1071-1083. https://doi.org/10.1097/01.AOG.0000183597.31630.db
Goodman, J. H. (2004). Paternal postpartum depression, its relationship to maternal postpartum depression, and implications for family health. Journal of Advanced Nursing, 45(1), 26–35. https://doi.org/10.1046/j.1365-2648.2003.02857.x
Howard, L. M., Molyneaux, E., Dennis, C. L., Rochat, T., Stein, A., & Milgrom, J. (2014). Non-psychotic mental disorders in the perinatal period. The Lancet Psychiatry, 1(6), 451-459. https://doi.org/10.1016/S0140-6736(14)61276-9
Khan, K. S., Wojdyla, D., Say, L., Gülmezoglu, A. M., & Van Look, P. F. (2022). WHO analysis of causes of maternal death: A systematic review. The Lancet, 367(9516), 1066-1074. https://doi.org/10.1016/S0140-6736(06)68397-9
Paulson, J. F., & Bazemore, S. D. (2010). Prenatal and postpartum depression in fathers and its association with maternal depression: A meta-analysis. JAMA, 303(19), 1961–1969. https://doi.org/10.1001/jama.2010.605
Taylor, J., & Gamble, C. (2017, November). Suffering in silence: Mood disorders among pregnant and postpartum women of color. American Progress. Retrieved August 22, 2024, from https://www.americanprogress.org/article/suffering-in-silence/
World Health Organization. (2021). Maternal mental health. Retrieved August 20, 2024, from https://www.who.int/mental_health/maternal-child/maternal_mental_health/en/
