Traditionally, during Maternal Mental Health Awareness Month, we hear statistics about how many women suffer from the “baby blues,” a period of depression that can occur right after birth. For example, 13 to 19 percent of people who give birth experience postpartum depression, and this number doubles to 38 percent for people of color. Yet we rarely consider how this depression is a consequence of the interplay of social, structural, and biological factors across lives and generations. This year, we must also consider how the dual crises of the COVID-19 global pandemic and a national reckoning on racial injustice have exacerbated inequities in maternal mental health.
This Maternal Mental Health Awareness Month, we ask researchers and health care providers to actively engage and integrate birthing people in understanding and addressing these complexities. As part of this inclusion, we must not assume that every person giving birth identifies as a mother, because many—such as transgender men, some nonbinary people, and surrogates—don’t.
Researchers often erroneously believe they must approach research only from their professional perspective to maintain objectivity. However, to ask the right questions, understand the answers, and offer meaningful solutions, it is imperative that we collectively use a restorative justice framework and include people with lived experiences in every stage of our research. In addition, we must be careful not to re-traumatize these people or bring in their voices simply to teach those with privilege; rather, we need to act as allies and do our best to pursue research that helps them heal. To guide this research, we strongly encourage the use of social epidemiology theories so that we are intentional in understanding and acting on the social, structural, and contextual factors that cause unequal distribution of health and disease.
We also recommend researchers further investigate how the pandemic is compounding feelings of loneliness, isolation, anxiety, and uncertainty for pregnant, birthing, and postpartum people. Pre-pandemic research showed that people who are Black or Hispanic and have limited incomes receive significantly less mental health care for depression and follow-up care after giving birth. Compounding this unequal access and treatment, hospitals, birthing centers, and health providers have been restricting the number of individuals who can accompany a birthing person to appointments or relying on telehealth appointments. Moreover, typical neighborhood, community, and social supports for new parents may not be as readily available. These factors will likely have significant long-term effects on the mental health of the birthing person and their children that researchers should document and address. They also raise the following questions about how our structures and systems, exacerbated by COVID-19, serve birthing people now and how they will serve them after the pandemic:
- How does irregular and inadequate access to phones and the Internet impact people’s access to telehealth services, including mental health consultations, individual and group therapy, and support groups?
- How can lack of privacy at home influence the effectiveness of telehealth services for mental health?
- How do race, age, ethnicity, and gender identity affect a birthing person’s experience with health and mental health services?
- How does trauma influence how birthing people interact with health and mental health systems, particularly the heightened trauma many are currently experiencing?
It is time to recognize the unique mental health needs of pregnant, birthing, and postpartum people worldwide. To learn more about how we are working to provide clarity about the factors that influence mental health, the impact of untreated maternal mental health conditions, and how we are helping our partners improve access to reproductive and mental health services around the world, we invite you to visit the following resources:
- Learn about our active involvement in groundbreaking mobilization and research activities, such as the Black Mamas Matter Alliance, which seeks to advance Black maternal health, rights, and justice through advocacy, research, power building, and work to change culture, and Bridging the Chasm, which aims to redress structural barriers in women’s health care by working with cross-sector collaborators, such as policymakers, educators, and the media.
- Explore NYC Standards for Respectful Care at Birth and its five-year Sexual and Reproductive Justice campaign, which we helped inform with qualitative research.
- Learn about the Birth Equity Action Network, which builds on the evaluation informed by HealthConnect One’s Birth Equity Leadership Academy.
- Learn more about the world’s first maternal health development impact bond to improve maternal health outcomes in India.
- Discover how community health workers in low- and middle-income countries are using mobile health tools to improve the reach and quality of health information and services.
- Learn about the Home Visiting Evidence of Effectiveness (HomVEE) review of the effectiveness of home visiting programs.
- Read about the Centers for Medicare & Medicaid Services’ Maternal and Infant Health Initiative and a state Medicaid agency learning collaborative dedicated to improving postpartum care.
- Gain an understanding of how community-based organizations in Massachusetts support activities to educate Latinas about the importance of breast and cervical cancer screening.
- Learn more about insights we provided to the Missouri Foundation for Health to improve access to comprehensive contraception among people in Missouri, especially in rural areas.