Maternal Mental Health Conditions and Statistics: An Overview

Mar 27

At the Maternal Mental Health Leadership Alliance, we are committed to curating the latest information in perinatal mental health to help educate healthcare providers, birth workers, and policymakers. Our Topic Fact Sheets Library offers evidence-based fact sheets about maternal mental health and its intersections with different populations. Each fact sheet is researched by our team of public health, public policy, and clinical experts.

PDF VERSION

Maternal Mental Health Overview Fact Sheet
DOWNLOAD

Key Facts: Maternal Mental Health (MMH) Conditions

1 in 5 Mothers are Impacted by Mental Health Conditions

Maternal mental health (MMH) conditions are the MOST COMMON complication of pregnancy and birth, affecting 800,000 families each year in the U.S. [1, 2]

Mental Health Conditions are a Leading Cause of Maternal Deaths

Mental health conditions are a LEADING CAUSE of maternal mortality, accounting for 23% of pregnancy-related deaths. [3]

Most Women are Untreated, Increasing Risk of Negative Impacts

75% of women impacted by maternal mental health conditions REMAIN UNTREATED, increasing the risk of long-term negative impacts on mothers, babies, and families. [4]

$14 Billion: The Cost of Untreated Maternal Mental Health Conditions

The cost of not treating maternal mental health conditions is $32,000 per mother-infant pair, or $14 BILLION each year in the U.S. [5]

Specific Communities are at Increased Risk for Maternal Mental Health Conditions

High-Risk Communities by Race and Ethnicity:

Specific communities have a higher risk of maternal mental health conditions due to structural racism and discrimination, exclusion from research, barriers to accessing support, lack of culturally appropriate care, among other issues. Those impacted include but are not limited to:

American Indian and Alaska Native people [6]
Asian American and Pacific Islander people [7]
Black and African American people [8]
Hispanic and Latino/a/x people [9]
South Asian people [10]

Additional Risk Factors:

The following experiences or events can also increase a woman’s risk for experiencing maternal mental health conditions:

Adverse Childhood Experiences (ACEs) [11]
Current or previous military service as an active duty service member or spouse [12]
Birth trauma [13]
Disabilities [14]
Poverty [15]
Infant in the NICU [16]
Personal or family history of mental health disorders [17]
Intimate partner violence during pregnancy [18]

Terms and Definitions

Various terms are used to describe maternal mental health conditions, including but not limited to:

perinatal mood disorders (PMDs)
perinatal mood and anxiety disorders (PMADs)
maternal mental health (MMH) conditions

Other Terms:

perinatal = From conception through full year postpartum.
antenatal / prenatal = During pregnancy
postpartum / postnatal = First year following pregnancy
postpartum depression / PPD / postpartum = An umbrella term describing mood changes following pregnancy.

Range, Prevalence, and Symptoms of Maternal Mental Health Conditions

Baby Blues [19]

Up to 85% of childbearing individuals.
Normal period of transition.
Typically include emotional sensitivity, weepiness, and / or feeling overwhelmed.
Likely associated with the significant changes in hormones in the immediate postpartum period.
Resolves without treatment within 2-3 weeks following childbirth.

Anxiety Disorders [19, 20]

6-8% of childbearing individuals.
Feeling easily stressed, worried, overwhelmed, tense.
Panic attacks, including shortness of breath, rapid pulse, dizziness, chest or stomach pain.
Fear of going crazy or dying.
Intrusive or scary thoughts; thoughts of harming self or baby.
Fear of going outside.
Sleep disturbances; difficulty falling or staying asleep, even if baby is sleeping.

Obsessive-Compulsive Disorder [19]

4% of childbearing individuals.
Disturbing, repetitive, intrusive thoughts which may include thoughts of harming self or baby; these thoughts cause the individual great distress (i.e. thoughts are ego-dystonic).
Compulsive behaviors, such as checking, in response to intrusive thoughts or in an attempt to make the thoughts stop or go away.

Substance Use Disorder (SUD) [21]

Often co-morbid.
Most-frequently used substances: tobacco, alcohol, marijuana, cocaine, opioids.
Women are at the highest risk for SUD during reproductive years, especially if access to mental health services is limited.
Most women who use substances often decrease their use during pregnancy. Those who can quit on their own usually do so, which is the distinguishing factor between substance use and SUD.

Depression [19, 20]

14% of childbearing individuals.
Change in appetite, sleep, energy, motivation, concentration.
Negative thinking including guilt, helplessness, hopelessness, worthlessness.
Irritable, angry, rageful.
Lack of interest in the baby.
Low self‐care.
Intrusive or scary thoughts; thoughts of harming self or baby.

Post-Traumatic Stress Disorders [19]

9% of childbearing individuals.
Change in cognition, mood, arousal associated with traumatic events, typically around childbirth.
Avoidance of stimuli associated with the traumatic event.
Feeling constantly keyed up or on guard.
Learn more about birth trauma and PTSD with MMHLA’s Fact Sheet: Birth Trauma and Maternal Mental Health.

Bipolar Disorder [19, 20]

3% of childbearing individuals.
Manic or hypomanic episodes alternate with depressive episodes.
Unusual shifts in mood, energy, activity levels, and ability to carry out day-to-day tasks.
NOTE: Women with bipolar disorder are extremely vulnerable to recurrence during pregnancy and have an increased risk for postpartum depression and psychosis.

Psychosis — MEDICAL EMERGENCY [19, 20]

1-2 women per 1,000 births.
Most significant and least frequent mental health condition occurring during the perinatal period.
Increases the risk of infanticide and/or suicide.
Symptoms include delusions, hallucinations, paranoia, rapid mood swings, cognitive impairment, focus on death, reckless behavior.
Thoughts are ego-syntonic, meaning they do not cause the individual distress.
Onset is sudden, usually within 1-2 weeks following childbirth.
The mother should be under the care of a medical provider or taken to the emergency room for assessment and care.
Learn more with MMHLA’s Fact Sheet: Pregnancy and Postpartum Psychosis.

Timing and Onset of Maternal Mental Health Conditions

40% develop symptoms following childbirth. [22]
33% develop symptoms during pregnancy. [22]
27% enter pregnancy with anxiety or depression. [22]
3-6 months postpartum: Peak onset of maternal mental health conditions. [2]
9-12 months postpartum: Peak incidence of suicide. [23]
3 years postpartum: If untreated, symptoms of maternal mental health conditions can last up to 3 years. [24]

Causes of Maternal Mental Health Conditions

Maternal mental health conditions are caused by a combination of bio-psycho-social factors.

Biological: The dramatic change in hormones during pregnancy and in the immediate postpartum period can have a significant impact on mood. [25]

Psychological: Some individuals struggle with changes in roles, relationships, and responsibilities that come with the transition to parenthood. [26]

Social: The childbearing years often include changes in jobs, homes, and finances that can add stress. External factors, such as isolation during the COVID-19 pandemic, can add to or increase feelings of anxiety or depression. [27]

Consequences of Untreated Maternal Mental Health Conditions

On Mothers

Women with untreated maternal mental health conditions during pregnancy are more likely to: [28, 29]

Have poor prenatal care.
Use substances such as alcohol, tobacco, or drugs.
Experience physical, emotional, or sexual abuse.

Women with untreated maternal mental health conditions postpartum are more likely to: [30]

Be less responsive to their baby’s cues.
Have fewer positive interactions with their baby.
Experience breastfeeding challenges.
Question their competences as mothers.

On Children

Infants born to mothers with untreated maternal mental health conditions are at higher risk for:

Preterm birth, small for gestational size, low birth weight. [29, 31]
Stillbirth. [29]
Longer stay in the neonatal intensive care unit. [32]
Excessive crying. [33]

Untreated maternal mental health conditions in the parent can increase the risk for:

Impaired parent-child interactions. [35]
Behavioral, cognitive, emotional delays in the child. [34]
Adverse childhood experiences. [35]

On Parents

Parents who are depressed or anxious are more likely to: [36, 37]

Make more trips to the emergency department or doctor’s office.
Find it challenging to manage their child’s chronic health conditions.
Not adhere to guidance for safe infant sleep and car seat usage.

Women experiencing maternal mental health conditions might say...

“Having a baby was a mistake.”
“I’m such a bad mother, my baby and family would be better off without me.”
“I’m exhausted but can’t sleep, even when the baby sleeps.”
“I feel like I’m drowning.”
“I’m afraid to be alone with my baby.”
“I want to run away.”
“I’m not bonding with my baby.”
“I was so embarrassed to say that I have postpartum depression out loud. It felt dirty, like it was a contagious disease.”

DID YOU KNOW?

The number one predictor for experiencing a maternal mental health condition is a personal or family history of mental health disorders.

Racial and Cultural Considerations

Increased Risk: Women of color are 3-4 times more likely to experience complications during pregnancy and childbirth and die from these complications than white women. [38]

Intergenerational Trauma: Black women enter pregnancy and childbirth suffering the impacts of intergenerational trauma, including the knowledge that many obstetric and gynecologic procedures were tested on Black women without their consent and without pain medication. [39]

Institutional Racism: Institutional racism in health care settings contributes to Black women receiving lower quality of care – such as giving birth in lower-quality hospitals – as well as being subject to dangerous, demeaning, or humiliating treatment. [38, 39]

Impact on Non-Birthing Parents

Fathers, Partners, Adoptive Parents At-Risk: Non-birthing parents – including fathers, partners, adoptive parents – are also at risk for experiencing mental health conditions related to pregnancy and parenting. [40, 41]

1 in 10 Fathers: As many as 1 in 10 fathers experience postpartum depression, with maternal depression being the #1 predictor of paternal depression. [40]

Grief and Loss: Parents involved in adoption – both the birthing parents and the adopting parents – can also experience strong emotions, including grief and loss. [41]

Barriers to Accessing Care

Feelings of shame, stigma, guilt. [42]
Expense and/or lack of access to healthcare. [42]
Social biases in the healthcare system. [15, 42]
Logistical challenges, such as lack of transportation or childcare. [15]
Distrust of the healthcare system. [42]
Fear that child protective services or immigration agencies will become involved. [43, 44]
Fear of being considered a “bad mom.” [42]
Racial, cultural, and religious beliefs. [42]

DID YOU KNOW?

Women of color and women of low income are MORE LIKELY to experience maternal mental health conditions and LESS LIKELY to be able to access care. [15, 42]

Treatment for Maternal Mental Health Conditions

Most maternal mental health conditions are temporary and treatable. Almost all women who experience maternal mental health conditions can recover with a combination of:

Time off from work to rest and recover. [45]
Self-care, including proper nutrition and sleep, along with light exercise and time for oneself. [46, 47, 48, 49, 50]
Relaxation and mindfulness techniques, which have been shown to be helpful with stress, anxiety, and depression in pregnant and postpartum people. [51]
Social support from peers, friends, and family.
Professional support from doulas, lactation consultants, and counselors / therapists.
Medications that are safe and effective during pregnancy or while breastfeeding.

LEARN MORE

Download MMHLA’s Fact Sheet: Components of Mental Health and Wellness for Pregnancy and Postpartum.

FREE Support for Pregnant and Postpartum Parents

National Maternal Mental Health Hotline
For individuals who are not in crisis but need real-time support and assistance for maternal mental health conditions.
**1-833-TLC-MAMA (1-833-852-6262)**
24 / 7 / 365 response within 5 minutes
Voice, text, and chat
English and Spanish
60+ languages available via translator
LEARN MORE

Postpartum Support International Helpline

For individuals who are not in crisis but need resources and referrals for maternal mental health conditions.

1-800-944-4773
FREE
30+ online support groups
Volunteer coordinators in all 50 states
Specialized coordinators for specific needs
Online directory of mental health providers