Maternal mental health is a silent crisis

By Dr. Sabina Khan, originally published by the Orlando Sentinel

In the most recent issue of JAMA Psychiatry, a study spearheaded by Children’s National Hospital has shed light on the frequently disregarded impact of maternal mental illness on the tragic fatalities of new mothers. Emphasizing the need for prompt action, the research team highlights the critical importance of tackling this pressing public health crisis. As an occupational therapy practitioner specializing in maternal health, I see it firsthand.

I have had the privilege of accompanying women as they confront a spectrum of maternal health challenges. From those recuperating from third and fourth-degree tears to those navigating the aftermath of cesarean sections, the most common surgery performed in the U.S., and various forms of pelvic floor dysfunction, I have borne witness to the toll that childbirth exacts on both body and mind. Many of these women not only grapple with physical pain and mobility limitations post-birth but also contend with the burdens of stress, anxiety and depression, compounded by societal stigmas.

Supported by a comprehensive body of peer-reviewed research and health-care policy references, the CDC study emerges amidst a troubling pattern: maternal mortality rates in the United States significantly surpass those of comparable high-income nations, reaching levels up to three times the global average.

An analysis of the data highlights a stark reality — over 80% of maternal deaths in the U.S. are deemed preventable.

According to the CDC, mental health conditions alone account for almost a quarter of these devastating deaths, surpassing even postpartum hemorrhage, a traditionally recognized leading factor in maternal mortality. Black, Asian, Indigenous, and other minority mothers, in particular, contend with maternal mental health conditions at higher rates compared to white mothers, yet they are often less likely to receive treatment.

These disparities are further compounded by barriers such as transportation, child care, cost, and a longstanding distrust of the health-care system. Complicating matters further is the constrained accessibility of comprehensive maternity services across multiple states.

The closure of over 400 maternity facilities nationwide within the last decade has precipitated the plight of nearly 6 million individuals stranded in what are colloquially termed “maternity care deserts,” where access to adequate care is markedly scarce or entirely absent.

Beyond the statistical data lies the profound impact on the daily lives of mothers. Maternal mental health conditions cast a pervasive shadow over even the simplest of tasks, disrupting essential activities- from nurturing newborns to managing household responsibilities. Mothers grapple with a myriad of challenges that extend beyond mere physical strain. We need to support them by understanding exactly how.

Occupational therapy (OT) emerges as an indispensable resource in navigating these multifaceted challenges, offering a holistic approach to maternal mental health care. By meticulously examining the physical, psychological, and social dimensions of well-being, OT practitioners (OTPs) discern the individual needs of each mother and craft tailored interventions to foster recovery and resilience, thereby better equipping mothers for the demanding transition into the fourth trimester.

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We look at physical functionality, emotional well-being, sensory and psychological factors, gaining insight into each mother’s unique challenges and strengths. We explore the social implications of maternal mental health conditions and examine how environmental factors may influence a mother’s ability to engage in daily activities and fulfill her roles.

With an array of tools, OT practitioners provide guidance on stress management techniques, relaxation exercises, and coping strategies, empowering mothers to navigate the emotional demands of motherhood with grace.

Collaborating with families, caregivers, and community resources forges a supportive network that fosters maternal well-being and yields positive outcomes for the mother, child and family unit. A key portal for resources can be found at the American Occupational Therapy Association’s website.

By raising awareness, championing policy reform, and embracing holistic approaches to maternal care, we can lay the foundation for a future in which every mother receives the compassionate, personalized support necessary to flourish.

Dr. Sabina Khan is an assistant professor at the University of St. Augustine for Health Sciences in Miami and a member of the American Occupational Therapy Association (AOTA).