May is recognized as Mental Health Awareness Month. Mental health is considered one of the main complications of pregnancy and the postpartum period.
Dr. Zobeida Diaz, division director of women’s behavioral health at Women & Infants Hospital, spoke with Providence Business News about the mental health challenges that women face during pregnancy and postpartum.
PBN: How prevalent are mental health issues among pregnant and postpartum women?
DIAZ: Mood and anxiety disorders are prevalent mental health concerns during pregnancy and the postpartum period, affecting approximately 10%-13% of women globally. In developing countries, the rates are even higher.
In the United States, about 1 in 5 pregnant or postpartum women experience mood or anxiety disorders, and postpartum depression is now considered the most common complication of childbirth. Although a leading cause of morbidity and mortality among childbearing women, postpartum depression remains under-recognized and under-treated.
PBN: Why are pregnant and postpartum women at risk of mental health illness?
DIAZ: Pregnant and postpartum women are at risk of mental health illness due to a combination of biological, psychological and social factors. The biological factors include dramatic shifts in hormone levels, which can impact mood; a family history of mental health disorders; and potential medical complications that can occur during pregnancy, labor/delivery and postpartum.
Stressors like sleep deprivation, lack of support and traumatic birth experiences also contribute to the risk. Postpartum women also face significant adjustments in relationships, responsibilities and self-identity that come with parenthood.
PBN: What kind of mental illnesses do pregnant and postpartum women usually face?
DIAZ: Mood and anxiety disorders are the most common psychiatric disorders experienced in pregnancy and the postpartum period. In the U.S., it is estimated that approximately 17% of women in the peripartum period will experience depression. The rates for anxiety disorders are even higher, at approximately 21%. Substance use disorders are rapidly increasing in prevalence, with tobacco, alcohol and marijuana being the most common, followed closely by opioids and cocaine.
PBN: What are the risk factors for developing mental health illnesses during pregnancy or after childbirth?
DIAZ: Risk factors that are associated with mental health illnesses during pregnancy or the postpartum period include a prior history of mental health conditions; environmental stressors, such as intimate partner violence; limited/poor supports; an unplanned/undesired pregnancy; current or historical stressful life events (trauma, poverty, losses); and a family history of mental health illnesses.
PBN: What resources are available for those facing pregnancy-related mental health illnesses?
DIAZ: In Rhode Island, we are fortunate to have a variety of resources that are available for those facing pregnancy-related mental health conditions, and medical and mental health providers have options when placing referrals.
In 2000, Women & Infants Hospital established the first mother-baby partial hospital program in the country. Since its inception, postpartum women, as well as pregnant women, have benefited from the intensive therapy, psychiatric medication management and case management support that are provided in the program. A mother-baby perinatal anxiety and OCD [obsessive-compulsive disorder]-intensive outpatient program was also created in 2021 to focus specifically on the treatment of anxiety disorders.
Outpatient behavioral health services are also available at the Center for Women’s Behavioral Health at Women & Infants Hospital. For urgent resource and referral help, tele-consultative services are also available through the Rhode Island Maternal Psychiatry Resource Network (RI MomsPRN).
Katie Castellani is a PBN staff writer. You may contact her at Castellani@PBN.com.
