Perinatal Mental Health Issues Costing Our Economy

By Barry Waldman

Perinatal Mental Health Issues Are Costing Our Economy and We Hardly Know It

The most exalted, revered, transformational event in most people’s lives is the birth of their children. It is so life-changing that one in eight new mothers struggles with post-partum depression and another one in eight suffers some other mental health issue, like drug use and domestic violence.

Photo by Omar Lopez on Unsplash

Yet in this country, at least, we pay scant attention to the mental health of the people involved in the momentous entry into the world of a new human being. Only 15% of women suffering from a maternal mental health disorder receive treatment.

The financial cost of perinatal mental health

Perinatal mental health issues reverberate throughout a community. It is estimated that post-partum depression alone costs the nation $14.2 billion — $32,000 per mother-baby pair – in lower workplace productivity, increased reliance on public benefits and higher health care costs for treating maternal and child health issues. That does not include the knock-on effects on children as they become adolescents, teenagers and adults.

“We know that when women experience health issues they have less healthy pregnancies,” said Dr. Connie Guille, a reproductive psychiatrist and founder and director of the Women’s Reproductive Behavioral Health Division at MUSC.

“Their diet and exercise are not great and they are at much greater risk for pre-term birth and low birth weight, which can lead to poor child development. Studies that follow children of these women find they have much greater risk for developmental delays, academic problems, behavioral problems and depression in adolescence,” she added.

Making perinatal mental health a healthcare priority

Hospitals around the nation are beginning to pay attention. Indeed, so are governments and employers.

Three years ago, the Birth Center of Denver implemented a program of screening the mental health of pregnant women and found the incidence of depression was much higher than previously reported. Over a couple of years, they managed to screen every woman who entered the facility and direct those who needed it to treatment.

Northwestern Medicine healthcare system implemented a similar program and found that 40% of the women were experiencing some mental health issue, with nearly half of them requiring some level of treatment.

In South Carolina, the department of health’s Birth Outcomes Initiative (BOI) made perinatal mental health a priority issue and made screening a billable service by providers in 2016. Training was initiated at Ob/Gyn offices around the state, but it was a one-time effort and its impact has waned. The BOI is planning to reinvigorate the program.

Perinatal Mental Health at MUSC

MUSC attempts to screen every pregnant and post-partum woman who comes through their women’s health services and offers immediate access to confidential telemedicine services. That often leads to evidence-based therapy like cognitive behavior therapy and effective medications for those with moderate to severe symptoms

“When women are untreated for their mental health problems, 50% of them still suffer 12 months after delivery,” Dr. Guille notes. “When treated, they generally recover within 6-8 weeks.”

Carter Mello gave birth at MUSC into the teeth of Covid last year. It made a wild ride even wilder. But she was heartened by the caring concern she experienced for her mental well-being.

“Every visit they asked me the questions to screen me for depression, before and after my baby was born,” she said. “I was also relieved to know virtual therapy visits were available should I need them from the convenience of home.”


Employers have a role to play

Mental health issues come with a healthy dose of stigma and judgment, a double whammy layered on top of the transformation in family dynamics that birth entails. For many mothers, Dr. Guille says, there is the added misconception that the Department of Social Services will get involved, deem them unfit and take their baby away.

The Lowcountry Graduate Center recognizes the powerful economic brake that maternal mental health issues present to our region. Employers bear the cost of absenteeism, reduced productivity and turnover. The masters program in social work offered at the LGC prepares clinicians who treat, among others, women suffering depression, drug use and domestic violence.

Dr. Guille says the issue is so important, and unrecognized, that employers who employ significant numbers of women of child-bearing age would be well-advised to provide a specialty service for this population.

A sign at the Fourth Trimester Collective sums up what happens to new mothers: “You’re about to meet someone entirely new. And it’s not your baby. It’s going to be you.”