In late January, the United States Preventive Services Task Force released its final recommendation statement for adult depression screening. In a significant shift from the 2009 recommendations, this update includes the first call for screening women for depression, specifically during pregnancy and after giving birth.
These changes in screening recommendations show national recognition of the growing body of evidence of the widespread prevalence of maternal depression, as well as the two-generation impact of untreated maternal depression on both women and their children. Importantly, these new recommendations also acknowledge depression can begin during pregnancy as well as during the postpartum period. If untreated, this can have a devastating impact on women and their children. Most notably, untreated maternal depression can affect maternal mental and physical health, parenting behaviors, birth outcomes, early childhood development and school readiness.
Maternal depression currently affects approximately 13 percent of pregnant women and mothers in the United States. Prevalence rates are substantially greater for low-income women and women of color. Twenty-five percent of low-income women are living with material depression, and it affects 25 percent of women of color compared to 12 percent of white women. Low-income women and women of color, especially Black and Latina women, are also the least likely to receive adequate or any treatment. The disproportionate impact of maternal depression indicates that in addition to being an issue of maternal and child health more broadly, maternal depression is also an issue of health equity.
The final recommendation statement from the U.S. Preventive Services Task Force renews the call to action for the federal government and the states to screen and provide appropriate treatment and follow-up for maternal depression. However, significant barriers remain for health systems and patients. These barriers include:
- Lack of available health insurance coverage—many states have yet to close the coverage gap for low-income people, which unduly affects low-income women, women of color, and immigrant women
- A workforce shortage of mental health providers and lack of training for primary care physicians and obstetrician-gynecologists to complete screening and follow-up
- Lack of access to compassionate, culturally and linguistically appropriate care across multiple settings
- Social stigma surrounding depression and other mental health disorders
This message also serves as a reminder to advocates of maternal and child health across the nation to stay focused on expanding access to two-generation approaches to treatment for families affected by maternal depression. As we celebrate Black History Month, we also are reminded of our duty to reduce disparities in maternal depression care for Black women, other women of color, and their children. We will continue to provide resources and support to advocates pursuing this work.
Please be on the look out for a series of case studies of best policy practices for addressing maternal depression coming soon!
Taylor Frazier, Children’s Health Intern