Spotlight on Maternal Mental Health

Mental health conditions are the most common complications during pregnancy and the postpartum period. The Centers for Disease Control and Prevention (CDC) identifies mental health issues, including depression, anxiety, suicide, and substance use disorders, as the leading underlying cause of maternal mortality. Most of these deaths are preventable. This crisis in maternal mental health disproportionately impacts individuals from marginalized communities, including Black and Indigenous people and individuals with disabilities, experiencing economic hardship, or living in rural areas.

Concerns with Maternal Mental Health

Despite the prevalence of maternal mental health conditions, they are often undiagnosed and untreated. For example, the U.S. Preventive Services Task Force recommends screening for depression during pregnancy and the postpartum period, but screening rates vary widely across states and U.S. jurisdictions. Untreated mental health issues can negatively affect both the mother and child’s physical and emotional health and overall well-being. Around 70% of new parents wish they had known more about postpartum mental health before giving birth, yet it is often overlooked in discussions about maternal health in the U.S.

COVID-19’s Effects

The COVID-19 pandemic exacerbated challenges to accessing maternal health care, particularly for marginalized and underserved communities. In 2021, maternal deaths rose to the highest level in 6 decades. About one-quarter of the maternal deaths in 2020 and 2021 were related to COVID-19, either due to coronavirus infections or the broader impact of the pandemic on health care. Maternal mortality rates have since fallen, but they remain significantly higher than in other high-income countries.

The COVID-19 pandemic also contributed to higher levels of maternal mental health conditions, reflecting factors such as increased isolation and disruptions to health care, childcare, and other critical services. The Health Resources and Services Administration’s (HRSA’s) National Maternal Mental Health Hotline reported a rise in calls and texts from May 2022 to April 2023, signaling the continued impact of COVID-19 on maternal mental health.

Westat’s Work

Westat partners with federal agencies such as HRSA, CDC, and the Centers for Medicare & Medicaid Services (CMS), to address various maternal mental health issues. For HRSA, Westat is evaluating the national Healthy Start program, which invests in communities to improve health outcomes before, during, and after pregnancy. For the CDC, we support groups such as Maternal Mortality Review Committees, health care providers, and public health agencies to raise awareness and improve data collection on the causes of maternal mortality. For CMS, we are evaluating the Maternal Opioid Misuse (MOM) Model, which aims to provide integrated, person-centered care for pregnant and postpartum Medicaid beneficiaries with opioid use disorder.

The White House Blueprint for Addressing the Maternal Health Crisis (PDF) has outlined priorities to improve maternal health outcomes in the U.S., including mental health. Westat’s high-quality research and evaluation in maternal health aligns with the Blueprint’s goals. We recognize the complexities of maternal mortality and morbidity, particularly in disproportionately impacted populations. Our goal is to mitigate maternal health complications, reduce maternal deaths, and ultimately identify strategies to enhance maternal mental health and well-being.