Stories

How the world views postpartum depression is changing—and 2024 may be an inflection point

Having a baby is a momentous and joyful occasion. The storybook version of the major life milestone is full of picture-perfect moments: infants cooing contentedly in a new mother's arms and gentle smiles exchanged in the soft morning light.

But for many new mothers, the reality is much more complicated. There are, of course, the expected shifts in routine, including sleepless nights and endless diaper changes. But there are also more nebulous elements like navigating emotional turbulence and embracing a new identity—one that involves integrating the profound responsibilities of motherhood with their previous sense of self.

For some women, these challenges go beyond the usual adjustments and struggles. Postpartum depression (PPD) is a less-talked-about but all-too-common experience of new motherhood. For centuries the condition was largely overlooked—despite it impacting women the world over.1

 

PPD's Past and Present

PPD presents differently in every woman who experiences it, but it shares some common characteristics: persistent feelings of sadness or irritability, mood swings, bouts of anxiety, and consistent or severe fatigue.When symptoms last longer than a couple of weeks, they might indicate something more serious than the standard "baby blues"—the normal emotional adjustment period for a mother following a baby's birth. PPD may also impact appetite, sleep, and ability to concentrate. It can leave new mothers feeling overwhelmed or hopeless, and it can have a significant impact on their wellbeing.3

PPD is common. In the United States, nearly one in eight women report symptoms in the first year after having a child.2 Despite the condition's prevalence, most women with PPD don't get the critical care and support they need. Some estimates put the number of diagnosed women who receive any treatment as low as 15.8%.4 This is often due to social stigma, lack of awareness of treatment options,5 and difficulty accessing mental health services.6

These impediments can have dire consequences. In the U.S., the Centers for Disease Control (CDC) notes that 80% of pregnancy-related deaths are considered preventable. More than half of all pregnancy-related deaths (53%) occur between seven days and a year after pregnancy. And nearly one-quarter (23%) of pregnancy-related deaths are due to underlying mental health conditions.7

Thankfully, increasing awareness and advocacy efforts are gradually eroding the barriers to treating PPD and other maternal mental health conditions. Institutional reforms are laying the groundwork for a more supportive healthcare environment, and regular mental health screenings are becoming more commonplace. The American College of Obstetricians and Gynecologists (ACOG) now recommends that obstetric care providers screen patients at least once during the perinatal period—during active pregnancy or in the first year after delivery—for depression and anxiety. If a woman is screened during her pregnancy, the ACOG recommends she be screened again in the postpartum period during a comprehensive exam.8

Meanwhile, technological advancements and policy changes are making it easier for mothers to access support.

 

Looking to a Brighter Future

The complexity of the maternal mental health crisis necessitates a collaborative, multidimensional strategy. No single entity can tackle this issue in isolation. Dismantling barriers to care, advancing research, and implementing policies that prioritize maternal mental health will require a concerted effort by healthcare providers, researchers, digital health experts, payers, and policymakers working in tandem.

Healthcare providers, for example, play a crucial role in the early identification and intervention of PPD, offering a first line of defense. Health systems prioritizing accessibility can help ensure mothers receive comprehensive care for both physical and mental health needs. Researchers contribute by expanding the global understanding of PPD, exploring innovative treatments, and evaluating the effectiveness of various support mechanisms. Meanwhile, digital health experts can leverage technology to bridge gaps in care, offer remote counseling and virtual healthcare experiences, and introduce new mothers to support groups and educational resources.

Additionally, payers and policymakers represent vital components of the broader effort to address maternal mental health. Insurance companies, or payers, must reconsider barriers such as prior authorizations that can delay timely care. Governments and policymakers must scrutinize and amend restrictive state policies—including Medicaid policies—to facilitate easier access to essential services.

As a leader in healthcare innovation, Biogen is committed to exploring cutting-edge treatments and supporting research initiatives to uncover comprehensive approaches to maternal care. By partnering with healthcare professionals, advocacy groups, and research institutions, Biogen strives for a future in which no mother must navigate the challenges of PPD alone.

It's time to paint a more accurate and complete picture of motherhood—one that acknowledges the breadth of the maternal experience and destigmatizes common experiences like PPD. Through continued advocacy, innovation, and collaboration, we can ensure that maternal mental health is no longer a crisis but a priority.

References
  1. Abdollahi, F., et al. Postnatal Depression and Its Associated Factors in Women From Different Cultures. Iranian Journal of Psychiatry and Behavioral Sciences. 2011 Autumn-Winter; 5(2): 5–11. 
  2. Talking Postpartum Depression. U.S. Office on Women’s Health. January 2024.
  3. Perinatal Depression, How is Postpartum Depression Different from “Baby Blues”?. National Institute of Mental Health. 2023.
  4. Cox EQ, et al. J Clin Psychiatry. 2016;77(9):1189-1200.
  5.  Iturralde, E., et al. Engagement in perinatal depression treatment: a qualitative study of barriers across and within racial/ethnic groups, BMC Pregnancy Childbirth. 2021 Jul 16;21(1):512. doi: 10.1186/s12884-021-03969-1.
  6. Bell, L., et al. Barriers and Facilitators to the Use of Mental Health Services by Women With Elevated Symptoms of Depression and Their Partners. Issues Mental Health Nursing. 2016 Sep;37(9):651-659. doi: 10.1080/01612840.2016.1180724.
  7. Trost, S., et al. Pregnancy-Related Deaths: Data from Maternal Mortality Review Committees in 36 US States, 2017–2019. U.S. Centers for Disease Control and Prevention.
  8. Screening and Diagnosis of Mental Health Conditions During Pregnancy and Postpartum. The American College of Obstetricians and Gynecologists, Clinical Practice Guideline Number 4. June 2023.