According to a report from the Vermont Department of Health, about 25 percent of people who gave birth in 2020 reported depression, anxiety or other mental health problems during pregnancy or after the baby was born.
The report, which is based on an annual survey of people’s experiences after childbirth, showed an increase from about 20 percent of birth parents in 2014, according to the department. That increase could be the result of the pandemic’s effects on the mental health of everyone in Vermont, said Ilisa Stalberg, health department director for family and children’s health.
A 2020 report from the health department cited survey respondents about their experiences giving birth during the pandemic. Many reported that it affected their overall mental health, ability to access treatment, and connection to their support networks.
But the causes of mental health problems before and after childbirth go far beyond the specific changes caused by the pandemic. Veerle Bergink, director of the women’s mental health program at Mount Sinai Health System in New York City, said postpartum parents experienced a huge life-changing event in addition to physiological triggers.
In a transition from pregnancy to the postpartum period, how every system in your body changes: Your endocrine system, your hormones, you go completely from pregnancy to non-pregnancy, and all of those changes change, Bergink said.
These changes can lead not only to depression but, in rare cases, to serious mental illnesses such as mania or psychosis, he said. Data from the health department showed 12 percent of respondents reported symptoms after giving birth that suggested they were at risk for postpartum depression.
The mental health effects of childbirth can also begin during pregnancy or arise up to a year after giving birth, Stalberg said. Researchers use the term Perinatal Mood and Anxiety Disorders to describe the full spectrum of potential mental health problems.
The leading risk factor for those disorders, which blows out other risk factors, is a prior history of mental illness, Bergink said.
He said they’re also related to socioeconomic status, possibly because low socioeconomic status is linked to other risk factors: financial stress, traumatic life events, less access to healthy food, greater exposure to pollution, and a history of substance abuse. .
The rate of postpartum depression varies significantly by country and region, she said, in part due to differing levels of financial and social support for new parents. It doesn’t help at all that (the US) isn’t generous with parental leave, she said.
Having stressors, like knowing I’m going to go back to work or otherwise not being able to do it financially, is a huge amount of pressure, Bergink said.
According to the health department, two-thirds of parents who told the Vermont survey they were returning to work felt they had too little free time after giving birth. A 2019 department report showed that low-income mothers, in particular, were less likely to get paid leave and took less time off before returning to work.
Bergink said recognizing the reality of anxiety and depression that can come with new parenthood can help prevent or ease postpartum struggles. I think it should be more like the new normal that pregnancy comes with a lot of physical discomforts and that the postpartum period is very intense, she said.
We see in the movies, in society, the happy modern child, he said. This is only part of the reality: it is also very hard work.
Coping mechanisms that are helpful for mental illness in general can help with birth-related mental health as well, such as exercising, eating well and seeing other people, she said. She added that a good support network can help with childcare and make parents feel more supported.
Treating mental health symptoms is also important. Stalberg said parents should reach out to anyone they feel comfortable, from a primary care physician to a therapist, but the state health department also has a birth-specific treatment center called Help Me Grow. The system connects parents to mental health clinicians who are familiar with perinatal mental health conditions.
In 2018, the health department received a five-year grant from the federal government to expand screening for these disorders and provide resources for local organizations and health professionals who work closely with parents, such as obstetricians, Stalberg said.
The department is waiting to see if it will qualify for another round of funding, he said. She’s worried about being able to continue her current job without that money.
The mental health workforce is extremely challenged in Vermont, and so[the number of]people who know how to work with people who are pregnant and in childbirth certainly need to be strengthened as well, she said.
Stalberg said these mental health conditions not only impact the individual experiencing them, but rather significant impacts for infants and children in the future.
Being able to provide early support has long-term wins that we’re quite confident of, and so investing in that seems really important, he said.
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