Data from dozens of studies supports the notion that mental health crises are a big factor behind rising rates of maternal deaths during and around pregnancy in the United States.
"We need to bring this to the attention of the public and policymakers to demand action to address the mental health crisis that is contributing to the demise of mothers in America," said Dr. Katherine Wisner, who led the review. She's associate chief of perinatal mental health at Children's National Hospital in Washington, D.C.
"The rate of maternal mortality in the United States is 2-fold to 3-fold greater than that in other high-income countries," her team noted in the study, which was published Feb. 21 in the journal JAMA Psychiatry.
Could mental health issues play a role in many of these tragedies?
To find out, Wisner and her colleagues looked at data from 30 recent studies and 15 historical references.
They found that:
Mental health risks rise during pregnancy. The period in and around a pregnancy is "associated with elevated risk for new-onset or relapse of maternal psychiatric disorders," the researchers reported. For example, 14.5% of pregnant mothers develop depression while pregnant, and another 14.5% battle the illness during the three months after delivery
Many pregnant women face risks for suicide, opioid overdose. The data showed that suicide or opioid overdose together account for nearly a quarter (23%) of maternal deaths occurring within a year of pregnancy
Women often live in "maternity care deserts." Finding help to deal with the mental and physical stressors of pregnancy is getting tougher: Wisner's team found that "nationwide, more than 400 maternity services closed between 2006 and 2020, which left nearly 6 million people with no or limited access to maternity care"
All of the above factors suggest that the majority of U.S. maternal deaths are preventable -- including the approximately 1 in 4 attributed to mental health issues.
However, in a hospital news release, Wisner noted that only 20% of new mothers in America ever get screened for postpartum depression.
"Given that this is a time that many mothers have contact with healthcare professionals, it's critically important that all mothers are screened and offered treatment,"she said. "Mental health is fundamental to health -- of the mother, the child and the entire family."
More information
Find out more about the signs and treatment of postpartum depression at the U.S. Department of Health and Human Services' Office on Women's Health.
SOURCES: Children's National Hospital, news release, Feb. 21, 2024, JAMA Pediatrics, Feb. 21, 2024