Publications - Perinatal Emotional Concerns

Men’s brains change when they become dads, by Lindsey Bever, The Washington Post, Jun 14 2024.

“Studies have shown that when women become pregnant and after they give birth, physical changes occur in their brains that, some researchers suspect, may help prepare women for motherhood. And now research shows that new fathers go through similar changes. The brain changes that men experience may support “the ability to form a bond with the baby and connect sensitively to the baby because that’s important for our species’ survival,” said Darby Saxbe, a professor of psychology at the University of Southern California who has been studying structural brain changes. ”

Maternal mental health conditions drive climbing death rate in US, research says, by Mira Cheng, CNN, Feb 23 2024.

“Maternal mental illness is the leading cause of pregnancy-related deaths in the US, according to a new evidence review, but national initiatives developed to combat the issue often fail to prioritize mental health. The maternal mortality rate in the US is two- to threefold greater than in other high-income countries, and it has only increased in recent years, according to the review, which was published Wednesday in the journal JAMA Psychiatry. More than 80% of pregnancy-related deaths in the US are preventable, the US Centers for Disease Control and Prevention says. The new review examined 30 recent studies and 15 historical references to highlight the underrecognized contribution of mental illness to maternal mortality. The researchers determined that mental health disorders such as suicide and opioid overdose are responsible for nearly 1 in 4 maternal deaths in the US. That’s almost double the rate of maternal death from postpartum hemorrhage, the second leading cause of pregnancy-related death, according to the reports from three dozen maternal morbidity and mortality review committees, state-based organizations that review maternal deaths. ”

Life in the Throes of Postpartum Depression, by Catherine Pearson, The New York Times, Jun 23 2023.

“The condition, which can arise at any point during the first year postpartum — and is distinct from the relatively short-lived “baby blues” most women experience soon after delivery — is now recognized as one of the most common complications of childbirth. It affects one in eight new moms, and mental health struggles are a leading cause of pregnancy-related death in the United States, primarily from suicide and drug overdose.  There are more treatment options for postpartum depression now than ever before, including the first medication designed specifically to treat it. But factors like stigma and inadequate screening keep many mothers from getting help. The Centers for Disease Control and Prevention estimates that about 20 percent of women were not asked about depression during a prenatal visit, and more than half of women with postpartum depression continue to go untreated. ”

Maternity’s Most Dangerous Time: After New Mothers Come Home, by Roni Caryn Rabin, The New York Times, May 28 2023.

“Most people think of labor and birth as the most dangerous part of pregnancy. But new scientific research is challenging this assumption, finding that substantial risks persist for a full year after birth itself. The deadliest time for mothers is actually after the baby is born. And for each woman who dies, an estimated 50 to 100 women experience severe complications that may leave them with lifelong health problems. The numbers are growing as more American women become heavier, and hypertension and diabetes become more common. More women are also postponing childbearing until later in life, so they are more likely to start pregnancy with chronic medical conditions that can lead to complications. The new figures come amid a troubling rise in deaths of pregnant women and new mothers in the United States, which has the highest maternal mortality rate in the industrialized world. The figures soared during the pandemic, to 32.9 deaths for every 100,000 live births in 2021, up from 20.1 per 100,000 in 2019. Rates for Black and Native American women are two to three times higher than those for white women. But those figures reflect a traditional definition of maternal mortality, deaths that occur during gestation or up to six weeks after birth. A fuller extent of the problem came to light in September, when the Centers for Disease Control and Prevention took a more expansive look at mothers’ deaths, analyzing them for a full year after childbirth and including deaths resulting from mental health conditions. The leading causes of maternal mortality among white and Hispanic women are mental health conditions that lead to suicide or fatal overdoses. Among Asian women, the leading cause is hemorrhage. ”

10 ways to get mental health help during a therapist shortage, by Lindsey Bever, The Washington Post, Oct 29 2022.

“Anxiety and depression have been on the rise in the United States since the start of the pandemic. This has led to a crisis in mental health that has been worsened by the shortage of mental health counselors.  A significant number of mental health professionals are not accepting new clients. Others have long waiting lists.  The Washington Post asked mental health professionals what advice they would give people who are struggling to find a therapist. About 300 experts from across the country responded with advice on getting an appointment — and tips on what people can do in the meantime to try to help themselves. Here are their recommendations. ”

With homicide a leading cause of maternal death, doctors urged to screen pregnant women for domestic violence, by Jacqueline Howard, CNN, Oct 20 2022.

“Two researchers are urging health-care providers to educate and screen pregnant women about intimate partner violence, as women in the United States are more likely to be murdered during pregnancy or postpartum than to die of common obstetric causes such as high blood pressure, hemorrhage or sepsis.  Other research suggests that they are also at higher risk of homicide than women who are not pregnant.  Pregnancy-related homicides are often linked to domestic violence and firearms – but they are preventable, Rebecca Lawn and Karestan Koenen of the Harvard T.H. Chan School of Public Health wrote in an editorial published Wednesday in the medical journal BMJ. ”

It’s Science: Preschool play protects your child’s mental health later in life, by Kristen Fischer, Motherly, Jul 5 2022.

“Preschoolers who learn to play well with others have better mental health as they age, according to a recent study. The research looked at “peer play ability,” an indicator of how well kids play with each other.  The report provides the first clear evidence that peer play ability “has a protective effect on mental health,” the authors said in a statement. The study appeared in Child Psychiatry and Human Development.  Three-year-olds who had better peer play ability consistently had fewer signs of poor mental health when they were 7 years old. That is, their parents and teachers reported fewer emotional issues and conduct problems, they were less likely to get into spats with other kids, and they had lower hyperactivity.  ”

How men hurt and grieve over miscarriage, too, by Matt Villano, CNN, Jul 15 2021.

“What scientists do know: About 10% to 20% of known pregnancies end in miscarriage, at least according to the Mayo Clinic. Many obstetricians and other experts say this number likely is even higher, since many miscarriages occur so early in a woman's pregnancy that some women don't realize they are pregnant at all.  Typically, because women are the ones carrying the fetus, miscarriages are perceived to be biopsychosocial in nature — that is, they affect moms biologically, psychologically and socially.  But fathers experience acute loss as well, said Kate Kripke, founder and director of the Postpartum Wellness Center in Boulder, Colorado. Theirs is psychosocial, without the biology. ”

America is failing Black moms during the pandemic, by Anna North, Vox, Aug 10 2020.

“Long before the pandemic hit, Black pregnant and birthing people around the country were reporting that doctors disregarded their concerns, ignored their wishes, and put them at risk. Out of 10 similarly wealthy countries, the US had the highest number of maternal deaths per capita in 2018. Black women are disproportionately impacted, dying in childbirth at three to four times the rate of white women. Now, birthing people and their advocates say the Covid-19 crisis is only exacerbating the discrimination that Black patients and other patients of color already face from providers — one of the main drivers behind their higher rates of maternal mortality.  ”

Pregnant during a pandemic, by Dr. Sanjay Gupta, CNN , Mar 30 2020.

“Imagine the challenge of expecting a child without knowing what to expect. CNN Chief Medical Correspondent Dr. Sanjay Gupta shares the stories of three women who are due to give birth in the coming weeks and answers key questions about pregnancy in the midst of the Covid-19 pandemic. ”

1 in 5 Mothers Gets Postpartum Depression. New York City Plans to Help., by Jeffery C. Mays, New York Times, Feb 5 2020.

“Every first-time parent in New York City will soon be eligible to receive as many as six home visits from professionals as part of a $43 million early childhood effort that Ms. McCray will announce on Wednesday. The New Family Home Visits initiative, which will initially begin as a $9 million effort in Brooklyn before spreading to the rest of the city by 2024, will offer expanded access to at-home screenings for anxiety and postpartum depression, and connect mothers to relevant mental-health services. ”

Fathers should be screened for postpartum blues, too, by Vishwadha Chander, Reuters, Dec 26 2019.

“Screening fathers for postpartum depression is as important as screening mothers, researchers argue, and current guidelines don’t go far enough in urging doctors to identify new fathers who may be suffering. ”

New Postpartum Depression Drug Could Be Hard To Access For Moms Most In Need, by Rhitu Chatterjee, NPR, Mar 21 2019.

“One in nine women in the United States suffer from depression after childbirth. For some women, postpartum depression is so bad that they struggle to care for their children and may even consider or attempt suicide. [...] Depression during pregnancy and soon after childbirth can be debilitating and can even lead to hospitalization for some women. It can prevent a mother from taking care of her baby, which in turn affects the mother-child bonding, the baby's development and emotional well-being. Postpartum depression even increases an infant's risk of having depression later in life. [...] This week, the Food and Drug Administration approved a new drug that can help, the first drug approved specifically for postpartum depression. While researchers and clinicians are excited about the drug's potential, some foresee obstacles to making it available to women who need it the most. ”

To Prevent Pregnancy-Related Depression, At-Risk Women Advised To Get Counseling, by Patti Neighmond, NPR, Feb 12 2019.

“Doctors can and should do more to prevent depression among pregnant women and new mothers by referring them to counseling. That's the recommendation of the U.S. Preventive Services Task Force, an influential panel of clinicians and researchers that makes recommendations for patient care. [...] Depression during pregnancy and in the year after childbirth is surprisingly common. It's estimated that 1 in 7 pregnant women will suffer depression while pregnant or following childbirth. ”

Even with insurance, getting mental health treatment is a struggle in Mass., study says, by Liz Kowalczyk, Boston Globe, Dec 11 2018.

“Massachusetts residents who need health care are colliding with a hard reality: Having medical insurance doesn’t guarantee you can get treatment, particularly for psychiatric problems. More than half of adults who sought mental health or addiction treatment in recent months had difficulty getting that care, according to a survey of 2,201 residents by the Blue Cross Blue Shield of Massachusetts Foundation in Boston...The obstacle wasn’t a lack of insurance; the vast majority of patients were insured. Rather, the problem was that providers either did not accept their insurance or their practices were closed to new patients. ”