Rapid rise seen in mental health diagnosis and care during and after pregnancy

April 4, 2024
From depression and anxiety to PTSD, pre-pandemic decade saw increased diagnosis and treatment during perinatal period in those with private insurance.

Mental health issues during pregnancy or the first year of parenthood have a much greater chance of getting detected and treated now than just over a decade ago, a trio of new studies suggests.

But the rise in diagnosis and care hasn’t happened equally across different groups and states, leaving some pregnant or postpartum individuals more likely to suffer through treatable symptoms that can put themselves and their newborn at risk.

In general, the studies show rises in diagnoses of anxiety, depression and post-traumatic stress disorder during pregnancy and the first year after giving birth in Americans with private insurance from 2008 to 2020. Treatment – both with psychotherapy and medications – also rose in this population.

The findings, published in three papers in the April issue of the journal Health Affairs, come from a team at the University of Michigan who study mental health in the perinatal period.

Their analysis groups multiple conditions diagnosed during this period under the label PMAD, short for perinatal mood and anxiety disorders. In general, PMAD includes depressive and anxiety disorders that occur any time during pregnancy and the postpartum year.

Key findings from 2008 to 2020 in privately insured people aged 15 to 44:

  • The rate of perinatal PTSD diagnosis quadrupled, to nearly 2% of all those pregnant or postpartum in 2020. Most of the rise was among those also diagnosed with PMAD; PTSD is considered an anxiety disorder in reaction to trauma.
  • The rate of PMAD diagnoses nearly doubled, with the greatest increases seen since 2015. By 2020, 28% of those pregnant or postpartum received a PMAD diagnosis.
  • The rate of suicidal thoughts or acts among pregnant and recently delivered people more than doubled overall, based on information reported to insurance companies. But the rate dropped among all those who had received a PMAD diagnosis.
  • The rate at which patients who were pregnant or postpartum received psychotherapy – any form of talk therapy paid for by their private insurance – more than doubled. The rate of psychotherapy among those diagnosed with a PMAD condition increased 16% across the entire study period, with a clear increase after 2014.
  • The rate of antidepressant medication prescriptions during pregnancy and the postpartum period rose overall, but the rate rose fastest among those diagnosed with a PMAD during pregnancy. The rate of antidepressant prescribing rose especially sharply after multiple guidelines for clinicians treating PMAD came out in 2015 and 2016. By 2020, just under half of those diagnosed with a PMAD received a prescription for an antidepressant.

University of Michigan release