The U.S. is failing mothers, according to a new study. In the Inaugural Maternal Mental Health State Report Card 2023, the U.S. scored a D when assessed against maternal mental health care provision factors. Combine this with the global economic crisis and recent changes to abortion legislation, and the risk to maternal mental health is more significant than ever.
The nonprofit Policy Center for Maternal Mental Health study and researchers at George Washington University analyzed three elements: provider and program, screening and screening reimbursement, and insurance coverage and payment. As a result, 40 states were graded D and F. Only 10 states scored grades C and above, with the highest score (B-) awarded to California.
The importance of high-quality mental health care for new and expectant mothers has been widely studied. Feeling anxious and overwhelmed is common, with as many as 1 in 8 mothers experiencing some form of mental health concern during or after pregnancy. Dr. Jesse Hanson, Clinical Psychologist and MentalHealth.com’s Medical Content Director, explains, “pregnancy, birth, and early motherhood are extremely stressful and taxing processes for mothers. Providing support to them is of utmost importance for their health, as well as the health of their babies, and ultimately for our future, as those babies will grow up to influence communities and societies."
Mental health treatment and support are available for those who need it, although the standard and availability of care vary between states giving medical professionals cause for concern. Untreated maternal mental health conditions can pose significant risks. It can lead to low birth weight and cognitive and developmental difficulties for the child. For untreated mothers, there are risks of developing long-term mental health complaints, hypertension, and maternal suicide.
The failings in maternal mental health care are not new; in 2021, the National Partnership for Women and Families reported that the mental health of mothers in the U.S. was in crisis. At the time, the COVID-19 pandemic was deemed an influencing factor. Two years later, an additional factor gives medical professionals more cause for concern.
In 2022, the Supreme Court overturned Roe. v. Wade, allowing individual states to ban or severely restrict abortions. Since then, abortions have been banned in many states, and others have banned abortions after a gestational age ranging between 6 and 18 weeks. This situation continues to evolve, with North Carolina banning abortions past 12 weeks gestation from 1st July this year.
Prior to the landmark decision of the court, many campaigners, including the American Psychological Association (APA), reported substantial evidence that those denied abortion had higher levels of anxiety and lower life satisfaction than those that had received an abortion.
Hanson is concerned, “regardless of individual views on abortion, when the choice is taken away, it negatively impacts collective maternal mental health. Women are forced to face the challenges of motherhood and maternal mental health when they don’t feel ready. Ultimately, this yields more traumatic experiences for mothers and their babies.”
Concerningly, of the 15 F-grade states where maternal mental health care provision is severely lacking, more than half have banned or restricted access to abortion within the last year. Texas is one such state. In 2021 a report stated that 13.2% of Texan women are affected by an untreated maternal mental health condition. With a ban on abortions, this number is likely to rise, and Texas does not have sufficient mental health care provisions to manage this increase.
Improving early diagnosis of maternal mental health care conditions is vital. Despite many experts, including the APA, calling on obstetric practices to perform proactive mental health screening, many are not. The Policy Centre Report Cards identified only 5 states where obstetrician-gynecologists are required to conduct mental health assessments.
Hanson believes the solution is “a systemic shift around mental health care.” Federal and state governments must be pressured to increase maternal mental health care provision, especially in light of the impact of the changes in abortion law. Hanson states, “if more professionals are trained in Pre and Peri-natal psychology (PPN), that will improve maternal mental health standards at a national or global level.”
Education is also crucial. Raising awareness will help to remove the stigma and ensure that those affected will notice the signs and seek help quickly. Dr. Hanson concludes, “as a culture, we need to be reminded that motherhood is one of the most important jobs, if not the most important, in our society.”
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