Recent studies indicate a notable increase in the detection and management of mental health issues during pregnancy and the postpartum period compared to just over a decade ago. However, these advancements have not been uniform across different demographic groups and geographic regions, leaving some individuals vulnerable to untreated symptoms that can endanger both themselves and their newborns.
According to three new papers published in the April issue of Health Affairs by researchers at the University of Michigan, the diagnosis rates of anxiety, depression, and post-traumatic stress disorder (PTSD) during pregnancy and the first year after childbirth have surged among Americans with private insurance from 2008 to 2020. Furthermore, the provision of treatment, including psychotherapy and medication, has also witnessed an uptick within this population.
The studies, conducted by the University of Michigan team focusing on perinatal mental health, encompass various conditions under the umbrella term “perinatal mood and anxiety disorders” (PMAD), including depressive and anxiety disorders occurring throughout pregnancy and the postpartum period.
Key findings from the research conducted on individuals aged 15 to 44 with private insurance from 2008 to 2020 include:
A fourfold increase in the diagnosis of perinatal PTSD, affecting nearly 2% of pregnant or postpartum individuals in 2020. Most of this rise was observed among those also diagnosed with PMAD.
Nearly doubling of PMAD diagnoses, with significant increases noted since 2015. By 2020, 28% of pregnant or postpartum individuals received a PMAD diagnosis.
A more than twofold increase in the rate of suicidal thoughts or acts among pregnant and recently delivered individuals. However, this rate decreased among those diagnosed with PMAD.
A substantial rise in the utilization of psychotherapy among pregnant or postpartum individuals, with a marked increase after 2014.
An increase in antidepressant medication prescriptions during pregnancy and the postpartum period, particularly among those diagnosed with PMAD during pregnancy.
Kara Zivin, Ph.D., a professor at the University of Michigan, emphasized the importance of seeking help for those struggling with mental health issues during pregnancy or the postpartum period, noting the potential consequences of untreated symptoms.
The researchers attribute many of the improvements in diagnosis and treatment to factors such as increased insurance coverage through mental health parity laws and the Affordable Care Act, as well as updated clinical guidelines emphasizing enhanced screening and treatment approaches. Additionally, societal shifts towards greater awareness and acceptance of mental health conditions have likely contributed to these positive trends.
However, disparities persist in diagnosis and care, with differences observed between demographic groups and states. For instance, while there have been notable increases in PMAD diagnosis and antidepressant prescriptions among younger age groups, disparities in diagnosis rates between racial and ethnic groups remain evident.
Moving forward, the researchers plan to continue their investigation into state-level variations and the impact of policy changes on perinatal mental health care. They also highlight the importance of studying the effects of telehealth-based mental health services, especially in areas with limited access to mental health providers.
Ultimately, the strides made in perinatal mental health diagnosis and treatment underscore the broader implications for maternal and child well-being, with the potential to positively impact families for years to come.
