May is National Maternal Mental Health Month

Clarissa Gooding-Aytch, MPH, MSW

Pregnancy can be an exciting time in a woman’s life but can bring many challenges. In the current COVID-19 pandemic, these challenges can be exacerbated and may result in mental health concerns.

Perinatal depression is a condition which occurs during or after pregnancy, and can present with mild to severe symptoms. You may be wondering, isn’t that Postpartum Depression? Well, yes…but not quite. Perinatal Depression includes Postpartum Depression, but many women experience depression during their pregnancy, which is Prenatal Depression. So, Perinatal Depression encompasses both Prenatal and Postpartum Depression.

Despite Perinatal Depression being a very common mood disorder among birthing and postpartum persons, it is, unfortunately, still very stigmatized. Due to this significant stigmatization, there is an incredible under reporting of mental health symptoms and among pregnant and postpartum persons. In 2018, only 12.5% of birthing people reported having depression during their pregnancy. However, more than 25% of these birthing people reported feeling postpartum depression. Thankfully, the overwhelming majority of these birthing people also report that their healthcare provider asked them about their mental wellbeing during their postpartum visit. Unfortunately, these birthing people did not have the same experience in the 12 months before they conceived, missing the mark to address mental wellbeing as a part of preconception health.[1]

The mind-body connection can have a profound effect on an individual’s health at every stage of their life[2]. There have been a number of studies that have examined possible links between mental wellbeing prior to pregnancy and undesirable pregnancy outcomes like preterm birth and low birth weight. Not surprisingly, researchers found that there are associations between mental wellbeing prior to pregnancy and birth outcomes[3]. For over a decade, the NC Division of Public Health has identified mental wellbeing as a priority area for optimal preconception health care in its NC Preconception Health Strategic Plan[4].

So, as we enter Maternal Mental Health Month, let’s consider the health of individuals before they become pregnant as well as promote awareness of perinatal depression and its signs and symptoms. These signs and symptoms can include:

1. Persistent sad, anxious, or empty mood

2. Feelings of guilt, hopelessness,

3. Trouble bonding or forming emotional attachment with new baby

4. Persistent doubts about ability to care for new baby

5. Thoughts about death, suicide, harming oneself or the baby

It’s important to note that treatment exists for perinatal depression. For more information, please visit the National Institute of Mental Health at nimh.nih.gov and type in perinatal depression. Also, make it a point to talk to your healthcare provider and normalize discussions of mental wellbeing with your friends and family.

[1] NC PRAMS, 2018 [2] Littrell J. (2008). The mind-body connection: not just a theory anymore. Social work in health care, 46(4), 17–37. https://doi.org/10.1300/j010v46n04_02 [3] Witt, W. P., Wisk, L. E., Cheng, E. R., Hampton, J. M., & Hagen, E. W. (2012). Preconception mental health predicts pregnancy complications and adverse birth outcomes: a national population-based study. Maternal and child health journal, 16(7), 1525–1541. https://doi.org/10.1007/s10995-011-0916-4 [4] NC Department of Health and Human Services, Division of Public Health, Women & Children’s Health Branch