A new analysis involving 2,700 pregnant and postpartum women and people across the U.S. reveals a disproportionate lack of mental health screenings for Latina, Indigenous and Black mothers and birthing people.
Perinatal mood and anxiety disorders are the most common complications experienced during pregnancy, and the most underdiagnosed. The new study, published in the journal Health Equity, examined gaps in the provision of comprehensive mental health services for childbearing people, especially among racialized populations.
“For many families, pregnancy and postpartum care are a gateway to lifelong health,” says lead author Dr. Tanya Taiwo, a research fellow at the Birth Place Lab within the UBC faculty of medicine’s midwifery program. “Perinatal care providers play a pivotal role in supporting the psychosocial health of the expectant parent and child through the perinatal experience. By screening and, when indicated, connecting pregnant and postpartum women and people to mental health counseling, perinatal care providers can save lives, enhance health and set families up for lasting wellness.”
The repercussions of failing to screen pregnant women and people for mood and anxiety disorders can significantly and adversely affect the health of parent and child. According to the CDC, mental health conditions are a leading cause of pregnancy-related death.
Mood disorders such as depression can result in neurodevelopmental delays, behavioral problems, attachment disorders and more. Anxiety in pregnancy is associated with premature birth and adverse implications for fetal neurodevelopment. More than half of survey respondents reported structural barriers to optimal mental health during pregnancy. Additional findings from the study include:
- Latina women are least likely to be screened for postpartum mood and anxiety disorders.
- Indigenous women are three times more likely than white women to have unmet needs for perinatal treatment for depression or access to mental health counseling.
- Black women are more than twice as likely as white women to have unmet needs for perinatal treatment for depression or mental health counseling.
- Women and pregnant people with midwife care providers were significantly more likely to report screening for perinatal mood and anxiety disorders.
“Making reforms to our health care system can be accomplished and the findings of this study offer an attainable way forward that requires awareness from health care providers, regular screenings for perinatal patients with better attention for people of colour, and lowering the bar of access to care to help babies — some of the most vulnerable members of our society,” says Dr. Taiwo, who is also an assistant professor in the department of midwifery at Bastyr University in Kenmore, Washington.
The study suggests a low-barrier approach for health care systems to screen pregnant people of colour more effectively for perinatal anxiety and mood disorders. This includes increasing incentives for adherence to national screening guidelines, reimbursing for perinatal mental health screening and treatment programs, expanding culture-centred midwife-led birth centres, and hiring and increasing access to community mental health workers.
“Perinatal care providers can play a pivotal role in supporting physical and psychosocial wellness throughout the childbearing cycle,” said Dr. Taiwo. “Yet our research found significant unmet needs for psychosocial support services, with glaring disparities in care for Indigenous and Black women and childbearing people. Our findings call for a reproductive justice approach to effective health care reform.”
The findings stem from the Giving Voice to Mothers Study, which was published in the journal Reproductive Health in 2019. This patient-designed survey captured participants’ experiences of engaging with perinatal services, including access, respectful care and health systems responsiveness across the U.S.