The rate of maternal mortality in the United States is worrisomely high. Japan’s maternal mortality rate is 4.3 deaths per 100,000 live births; while [1] the rate in Europe is 6 deaths per 100,000, and the rate in the United States is 18 deaths per 100,000 births. This means that mothers in the U.S. are about three times more likely to die compared to mothers in other high-income countries. In a country of opportunity and wealth, what is causing mothers to die?
What role does maternal mental health play in the mortality rate?
The intersection of maternal mental health and mortality rates presents a complex, multifaceted issue with significant consequences. Maternal mental health encompasses a wide range of emotional and psychological states that women may experience during pregnancy and postpartum. Screening for women at risk for postpartum depression is one way healthcare providers could help. A recent piece by the Association of American Medical Colleges (AAMC) dug into this issue, finding 20% of women suffer from mental health or substance abuse disorder during the time between pregnancy and the first year after birth of the child — referred to by medical professionals as the perinatal period.
According to the CDC, postpartum depression and mental health conditions were the leading cause of maternal deaths (22.7%), with haemorrhage (excessive bleeding) (13.,7%), cardiac conditions (12.8%) and sepsis (9.3%) next most in frequency between 2017 and 2019. Suicide from postpartum depression is the most dangerous condition new mothers face, with disabling anxiety disorders next in ranking. With 1 in 4 maternal deaths caused by postpartum depression and suicide, much more needs to be done to provide perinatal mental health.
What are medical professionals doing to address this problem?
The authors of the AAMC article encourage increased screening. A recently published article in the Journal of the American Medical Association about maternal mortality rate found that most attempts to reduce mortality failed to address mental health. Integration of psychological care into maternal health programs must be done to improve outcomes. Mothers at risk and their physicians should discuss potential medical interventions for the mother, which could include medication, counselling, and group therapy.
The researchers behind the publication call on those behind these initiatives, including lawmakers and practicing physicians, to include mental health needs. The CDC has developed the Pregnancy Risk Assessment Monitoring System (PRAMS) that includes postpartum depression discussions. Education on these matters is essential for policymakers, healthcare providers, and society to make the changes that can save lives.
[1] Health at a Glance: Asia/Pacific 2020 : Measuring Progress Towards Universal Health Coverage