One in five new or expectant mothers will experience debilitating anxiety or depression during pregnancy or the first year postpartum. These illnesses – known as perinatal mood and anxiety disorders (PMADs) – are the most common complication of pregnancy and childbirth, more common than other perinatal complications combined (gestational diabetes with hypertension and preecamplsia). All women are screened and monitored for these conditions. Yet, practitioners are not required to ask about a woman’s mental health during pregnancy or after birth.
What do we know about PMADs?
More women experience PMADs each year than the combined number of new cases of tuberculosis, leukemia, multiple sclerosis, Parkinson’s disease, Alzheimer’s disease and epilepsy.
Women who are depressed during pregnancy are more like to have poor prenatal care and increased substance use, leading to increased risk of poor birth outcomes such as preterm labor, premature birth, low birth weight, neonatal intensive-care unit admissions and fetal demise.
Women who are depressed or anxious after having a baby show decreased responsiveness to baby’s cues, leading to greater risk for behavioral, cognitive and emotional delays in children.
The cost of not treating PMADs is $22,000 annually for each mother and baby. In the United States, 800,000 women may experience PMADs each year at a cost of $17 billion in lost wages, unnecessary emergency department and doctor visits and poor health outcomes.
Suicide is the leading cause of death for women in the first year after giving birth, accounting for approximately 20 percent of deaths.