Improving access to behavioral health screenings for pregnant and postpartum women

The number one medical complication of pregnancy and childbirth for mothers is depression and/or anxiety, with one in seven women suffering from a mood disorder during pregnancy and the postpartum period. Further, substance-use disorder remains one of the most pressing public health issues in Rhode Island, and pregnant and postpartum women are not immune. Each of these health issues is treatable, but the key to successful outcomes is proper screening so treatment can begin.

Toward ensuring that pregnant and postpartum women are properly screened, the Health Resources and Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services, has recently awarded the Rhode Island Department of Health a five year, $650,000 per year grant in partnership with the Center for Women's Behavioral Health at Women & Infants Hospital. Together, they will establish a centralized resource to assist health care providers in screening and treating pregnant and postpartum women who have behavioral health conditions.

Margaret M. Howard, PhD, is division director of the Center for Women's Behavioral Health and founder of the Day Hospital at Women & Infants Hospital, the nation's first mother-baby perinatal psychiatric partial hospital program. She has long been an advocate for mental health screening in pregnant and postpartum women and recently received the 2018 Leadership Award from the American Psychological Association's Committee on Women in Psychology.

"Many people, including health care providers who treat pregnant and postpartum women, don't realize how common mood disorders are and that they can affect any woman. Postpartum depression cuts across social, economic, geographic, racial, and ethnic lines," said Dr. Howard. "While there are risk factors for developing postpartum depression, the postpartum period (up to one year after delivery) is the most vulnerable time in any woman's life to come down with a mood or anxiety disorder. This is exactly why screening is so important."

According to the Rhode Island Department of Health, the overarching goal of the grant is to improve the mental health and well-being of pregnant and postpartum women and, thereby, their infants' social and emotional development through increased access to affordable, culturally and linguistically appropriate treatment and recovery support services.

"The period of time just before and after a family welcomes a baby is one of excitement and hope, but it can also be one of the more vulnerable periods in a woman's life. Among the many challenges that women can face are depression during pregnancy, post-partum depression, and substance-use disorder. For each of these issues, broad, comprehensive screenings programs are a key to successful treatment," said Director of Health Nicole Alexander-Scott, MD, MPH. "This partnership will allow us to get vital screening services to women throughout the state and will allow us to focus on critical risk factors, such as experiencing stressful life events, being a teen mom, and having a history of depression. Working together, we can get every woman and family in Rhode Island the supports they need to ensure their health and wellness during every phase of life."

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