Understanding Perinatal Mental Health: The Leading Cause of Maternal Death in the U.S. and What You Need to Know

“I look at my baby and I don’t feel a thing,” a new mother shares, holding her 3-week-old infant. “I feel so much guilt… sometimes I don’t want to be here at all.” Sadly, she’s not alone. This feeling is part of a larger issue: perinatal mental health struggles.

About 1 in 5 women face mental health challenges during pregnancy or after childbirth. The Centers for Disease Control and Prevention reports that conditions like anxiety and depression are now the leading cause of maternal deaths in the U.S. These mental health issues can lead to tragic outcomes, including suicide. Infants are affected too, with risks like lower breastfeeding rates and developmental delays.

Even with a better understanding of this crisis, many women struggle to get the help they need. The expansion of Medicaid postpartum coverage to a full year in 2021 was a step forward, yet challenges remain, particularly in mental health access, which varies by state. A study found that nearly 65% of pregnant women experiencing depression didn’t receive a diagnosis, and half of those didn’t get treatment. Barriers like cost, stigma, and personal reluctance to seek help play a big role. Furthermore, 84% of pregnant women live in areas lacking mental health providers, highlighting an urgent need for better resources.

The American College of Obstetricians and Gynecologists (ACOG) advises that all pregnant women should be screened for depression and anxiety. Yet, many don’t get screened. Data from the Pregnancy Risk Assessment Monitoring System (PRAMS) shows that 1 in 5 women weren’t asked about depression during check-ups before giving birth. Another study revealed that many healthcare providers feel uncertain about how to deal with perinatal mental health issues, often due to insufficient training. The ACGME doesn’t require specific training in mental health for OB/GYN residents, making this gap even wider.

To tackle this public health issue, we must implement universal screening for mental health issues during and after pregnancy. Coordinated care among obstetricians, primary care physicians, and mental health professionals is essential. Proper training for OB/GYN residents on mental health should also be a priority. Additionally, telehealth services can help reach marginalized areas that need mental health care. Educating communities about these issues can reduce stigma and encourage compassionate, patient-centered support.

The fact that mental health conditions are the top cause of maternal deaths in the U.S. demands immediate attention. This pressing issue requires a shift in how we view mental health during and after pregnancy. It should be integral to the overall care that mothers receive. For a healthier future, we need action from healthcare systems, policymakers, and training organizations to ensure no mother suffers from a preventable mental health issue.

Sheila Noon is a medical student.

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