KANSAS CITY, Mo. – Kansas City area resident Megan Reed, mother to a 7-month-old, said she was reading through old journal entries she had written while postpartum.

What should have been a joyous time, was anything but.  

“I was reading back through that last night and at the end of every journal entry, it had said, ‘I am struggling,’” she said.

Three months after giving birth to her first child, Reed said she started feeling suicidal.

She immediately called her physician, who recommended she be admitted for treatment.

“I immediately thought, ‘This is why moms don’t ask for help because they’re afraid of being deemed unfit to take care of their child, they’re afraid of their child being taken away from them because of a hormonal thing that is often outside of your control,’” Reed said.

A new collaborative study released by maternal mortality review committees in multiple US states found that four in five pregnancy-related deaths between 2017 and 2019 were preventable.

Twenty-three percent of pregnancy-related deaths during this time were caused by mental health conditions, such as suicide, as well as overdose and drug poisoning related to substance use disorder, the study suggests.

Ashlie Otto, maternal mortality coordinator at the Missouri Department of Health and Senior Services, said the results of the study are unsurprising. 

“I think, largely, perinatal mood and anxiety disorders have always been out there, they just not largely had a lot of attention and there’s a lot of stigma around them,” Otto said. “So, I think that the more we can highlight them and really normalize them as a medical condition, then the more folks will feel comfortable coming out and getting help for those conditions and hopefully, we don’t continue to see these numbers.”

Dr. Sarah Pearl, obstetrics and gynecology physician at Saint Luke’s Women’s Health East in Lees Summit, said the findings emphasize how important it is for medical providers to take their time and invest in each patient.

“We need to take the time as providers to get back to the basics, the basics of spending time with people, getting to know them and building that trust so that they know that they can come to us with any need they have and we’ve got them,” she said.

Rooting for mental health resources

Reed said postpartum depression is different from the depression she experienced earlier in life because it’s difficult to care for a baby when you don’t even feel motivated to take care of yourself. 

“There’s this extra level of shame and guilt for not being this happy, excited mom,” she said. “You have your baby and you love your baby, and at the same time, you absolutely hate yourself.”

She said she thought she was well-equipped to take it on, but soon realized she needed help.

“Postpartum depression was something I never thought would happen to me because I had struggled with depression in my normal life in previous years and I thought I could handle it,” Reed said.

Pearl said it’s disheartening to see that mothers are struggling.

“For me, just personally, as an OBGYN provider, this study brings light to, “Which patients do I need to spend an extra minute telling them in the office, ‘You are not alone,’” she said.

Reed said she wishes she had received more resources from her medical provider on how to cope with postpartum depression during her pregnancy. 

She said she was one of the lucky ones, but to no credit to her physician, who failed to provide her with any mental health referrals or recommendations until it was almost too late.

“I felt like I was sort of fending for myself but I was fortunate to be in a community of women willing to help and understand the landscape of what the brain does chemically and hormonally when you have a baby,” she said.

Otto said very few health care facilities have psychiatrists on site who specialize in perinatal mood and anxiety disorders, something she’s hopeful the study will encourage.

She said the Missouri Perinatal Collaborative, a network of teams working to improve quality of care for mothers and babies, is actively training local health care providers on how to provide better mental health support and rehabilitation for pregnant women. 

“If we can help support those individuals to be healthier and get them to more of that well-woman visit and transition them into those interconception periods, then you would anticipate having a healthier birth the next time around, if that’s the case,” she said.

For more information on mental health resources for pregnant women, visit the Missouri Department of Health & Senior Services website.