Raising Awareness of Maternal Mental Health

Mental health conditions represent the most common complications that women experience during pregnancy and the postpartum period. Pre-pandemic data from the Centers for Disease Control and Prevention (CDC) indicate issues related to mental health, such as depression, anxiety, death by suicide, and substance use disorders, are the most frequent underlying causes of maternal mortality.

In commemoration of Maternal Mental Health Awareness Month in May, Westat’s Katherine Flaherty, ScD, an Associate Director for Public Health, explains why there is an urgent need for more research on maternal mental health.

Q. What are some concerns associated with maternal mental health?

A. A variety of mental health issues can affect maternal health. Prenatal and postpartum depression is common, and screening for depression during these phases is critical but not universally practiced. If postpartum depression is left untreated, it can impact the mother’s health and may cause sleeping, eating, and behavioral problems for the baby. Recent research also suggests that children whose mothers had more positive mental health during pregnancy were less likely to develop mental and behavioral disorders.

Q. How has COVID-19 affected this population?

A. The COVID-19 pandemic has had severe adverse consequences on maternal health.  Postpartum mental health issues increased during the pandemic. There was also a spike in maternal death rates in 2021 compared to the year prior, with rates for Black women significantly higher than for White and Hispanic women. The COVID-19 pandemic challenged health systems, limiting women’s access to health care. Some groups of pregnant and postpartum people were more severely impacted due to inequitable opportunities to receive or access health care.

Q. How does Westat envision addressing the health needs of pregnant and postpartum people? 

A. Westat is currently working with federal agencies such as the Health Resources Services Administration (HRSA), Centers for Medicare & Medicaid Services (CMS) and CDC on a variety of maternal health issues. For HRSA, Westat is evaluating the national Healthy Start program in which grantees coordinate prenatal and postpartum visits for participants and provide a number of other health care services, including screening and referral for depression, substance use, and interpersonal violence. For CMS, with our colleagues at Westat Insight, we are evaluating the Maternal Opioid Misuse Model on pregnant and postpartum Medicaid beneficiaries with opioid use disorder and on their infants.

We are also working with the CDC Maternal Mortality Prevention Team on the Enhancing Reviews and Surveillance to Eliminate Maternal Mortality Initiative (ERASE). The project’s goal is to identify root causes of maternal deaths and develop recommendations to reduce the deaths through multidisciplinary teams of clinical, public health, and community organizations.

The White House Blueprint for Addressing the Maternal Health Crisis (PDF) has outlined priorities to improve maternal health outcomes in the U.S., and mental health is embedded in these priorities. Westat’s high-quality research and evaluation in maternal health supports the thorough examination of the complex issues of maternal mortality and morbidity, focusing in particular on disproportionately impacted populations. The aim of our research efforts is to assist in mitigating maternal health complications and stemming the rise in maternal deaths.