One in every seven women experiences depression during pregnancy or in the first year after giving birth. Such postpartum depression can be debilitating. All too often in the United States, however, women living with postpartum depression aren’t diagnosed with it or treated for it. An important piece of the recently passed 21st Century Cures Act aims to change that.
Postpartum depression isn’t just the “baby blues.” It can pose a serious threat to a woman’s life: Maternal suicide exceeds hemorrhage and hypertension as a cause of maternal death. Postpartum and maternal depression can also affect a child’s development. Relatively simple interventions — ranging from support groups and lifestyle changes to medication — can help new mothers or women who have suffered a pregnancy loss get their health back on track. But before that can happen, postpartum depression must first be identified.
The Bringing Postpartum Depression Out of the Shadows Act, part of the 21st Century Cures Act, authorizes the secretary of health and human services to provide federal grants to states to improve their efforts to screen women for postpartum depression and treat those with it at the local level. It is the first federal program that provides funding for both screening and treatment of postpartum depression.
Why do we need this specific emphasis on postpartum depression? For one thing, it often goes undetected. In one study, only 20 percent of women diagnosed with postpartum depression had reported their symptoms to a health care provider. Some women feel as though what they are feeling, from exhaustion to loneliness, are normal experiences of motherhood. They may not realize when their feelings and moods aren’t normal. Other women feel that a stigma is associated with the diagnosis of postpartum depression.
Without adequate screening and diagnosis, it may be a challenge for women to get access to effective treatment.
A successful Massachusetts program could serve as a blueprint for the national effort to identify and treat women with postpartum depression.
The Massachusetts Child Psychiatry Access Project (MCPAP) was launched in 2005 with an eye toward helping children receive psychiatric support and care. In 2014, MCPAP was expanded to MCPAP for Moms by creating a network of obstetric, pediatric, family medicine, and psychiatric providers along with a group of dedicated counselors to be resources for women, their families, and health care providers. Through this network, which also includes specialists who may see women outside of obstetric appointments, clinicians caring for women can identify symptoms of postpartum depression. MCPAP for Moms also creates a continuum of care for women to get timely access to recommended support and treatment.
In the first 18 months of the MCPAP for Moms program, more than 1,100 women were screened and treated for postpartum depression. We believe that the Bringing Postpartum Depression Out of the Shadows Act will allow this successful state program to be scaled nationally and, in doing so, positively affect the well-being of women and their families across the country.
It’s time to truly bring postpartum depression out of the shadows. We are proud that because of the work of advocates for women and children’s health, including those who made MCPAP for Moms a reality in the commonwealth of Massachusetts, more women will receive the depression screening and support they need. Women across the country deserve nothing less.
US Representative Katherine Clark, who represents the 5th District of Massachusetts, is the author of the Bringing Postpartum Depression Out of the Shadows Act. James S. Gessner, MD, is president of the Massachusetts Medical Society. Maryanne C. Bombaugh, MD, is chair of the Massachusetts section of the American Congress of Obstetricians and Gynecologists.