5 Important Changes in Maternal Mental Health Care

But even though they’re common, perinatal mental health issues have often been under-recognized in health policy, research, and care.

“For so many years, maternal mental health topics were either not studied or not taken seriously," says Baroud.

Fortunately, that’s beginning to change, and major recent advances are helping pregnant and postpartum people care for their mental health.

Here’s some important work that’s being done to address mental health for pregnant and postpartum people, and what it all means for you.

1. New Guidelines for Mental Health Screening and Treatment

In 2023, the American College of Obstetricians and Gynecologists (ACOG) updated their guidelines on screening and diagnosis of mental health conditions during pregnancy and postpartum. These guidelines state that all pregnancy patients should be screened for depression and anxiety at specific times. These include at the first prenatal visit, later in pregnancy, and at postpartum visits.

ACOG also changed their treatment guidelines to include updated recommendations on the safety and usefulness of medications used for mental health conditions.

In the past, screening often fell through the cracks, with some providers assuming someone else had taken care of it. “Having some guidelines on what the expectations are and who needs and should be screening eliminates the assumptions,” says Allie Stefanelli, a licensed psychotherapist, clinical social worker, and founder of Riverview Psychotherapy in Natick, Massachusetts. This helps ensure everyone is screened and given the support they may need.

The guidelines for timing matter, too, because a person’s mental health can shift over time, Stefanelli adds.

Perinatal mood and anxiety disorders are very treatable mental health issues, especially when they’re caught early, Baroud says. So early and frequent screening is an advantage for you. “The earlier that we can get ahead of things, the better.”

She adds, “Don’t be afraid of being screened. It’s great that you are being asked these questions, and I would say to answer them as honestly as you can, because the hope is that you would then be given some resources [if you need them].”

2. FDA Approval of Medications for Maternal Mental Health

In the past, treating postpartum depression involved a hit-or-miss experimentation with different antidepressants. Treatment could take months to make a difference, if it worked at all.

In 2019, however, the Food and Drug Administration (FDA) approved the first medication specifically for postpartum depression, called brexanolone (Zulresso). The drug is given as an infused injection, and was shown in clinical trials to improve symptoms within 30 days.

In 2023 the FDA approved the first oral drug for postpartum depression, called zuranolone (Zurzuvae). It’s designed to work quickly and to be taken for just a few weeks, and you can take it at home rather than needing to go to a healthcare facility for an infusion.

The availability of these medications is helping people recognize that postpartum mood disorders as real, serious conditions, and that effective treatments exist. “They take out the mystery or stigma around maternal mental health,” Baroud says.

The hope is that condition-specific medications help highlight that mental health issues are not your fault. They’re caused by a change in brain chemistry, which medication can help treat.

3. Launch of the Task Force on Maternal Mental Health

In September 2023, the federal government launched a new group called the Task Force on Maternal Mental Health. It’s co-led by the Office on Women’s Health and the Substance Abuse and Mental Health Services Administration. The goal is to identify and make recommendations for support (like research, care, and even the way we communicate about mental health) that addresses maternal mental health conditions and co-occurring substance use disorders.

Launching this task force signals a move toward showing it’s the broader system’s responsibility to support pregnant and postpartum people. “There are structures in place in our society that put more weight and more burden on the birthing person to work things out by yourself, and that’s just not helpful,” Baroud says. “So by having this task force, we’re acknowledging that there needs to be systemic change to improve the quality of care.”

4. The National Maternal Mental Health Hotline

Mother’s Day 2023 was the beginning of the National Maternal Mental Health Hotline, which is available in English and Spanish. Now, you can talk about your mental health through a free, confidential phone hotline. You can also call for referrals to local providers, telehealth providers, and/or support groups, and get phone or text access to professional counselors.

As a free service, the hotline helps make mental health care available to all pregnant people and new parents, regardless of income, where you live, or other factors that can sometimes make care difficult to access.

With the hotline, you just have to pick up the phone, rather than traveling somewhere, sending emails, or doing research yourself, Stefanelli notes. “Being a mom is incredibly challenging. And so anything that lowers the barrier to accessing support is paramount,” Stefanelli says.

5. The Momnibus Act

The Black Maternal Health Momnibus Act—commonly called the Momnibus—is made up of 13 bills that strive to improve health outcomes for Black and Indigenous mothers.

“We know that for Black and brown birthing people, the statistics are significantly worse,” Baroud says. For example, research says that Black birthing parents experience perinatal mental health issues at twice the rate of birthing parents in general. And Black women are three times more likely than white women to die during the first year postpartum from all causes.

The Momnibus Act helps fund and drive research addressing the root causes that lead to worse outcomes like these. And research evidence will help experts build or invest in programs that are shown to be helpful, Stefanelli explains.

Among others, several important initiatives include:

• Making quality maternal health care (including mental health care) more accessible
• Helping postpartum people with substance use disorders
• Improving maternal mental health care for veterans

These advances make big strides in helping pregnant and postpartum people get the mental health support they deserve to thrive.

“Women’s mental health matters,” Baroud says. “These are real issues, and they deserve analysis and treatment.”