Preventing Maternal Morbidity and Mortality Through Perinatal Mental Health Care

Emily S Miller1, M Camille Hoffman, Kay Roussos-Ross

  • 1Warren Alpert Medical School of Brown University and the Women & Infants Hospital of Rhode Island, Providence, Rhode Island; the University of Colorado Anschutz School of Medicine, Aurora, Colorado; the University of Florida College of Medicine, Gainesville, Florida; and the University of Massachusetts Chan Medical School and UMass Memorial Health, Worcester, Massachusetts.

Perinatal mental health conditions are among the most common complications of pregnancy and the postpartum period. They are the leading preventable cause of pregnancy-related morbidity and mortality in the United States, largely through suicide, accidental drug overdose, and homicide. When untreated, they are associated with negative short- and long-term outcomes for perinatal individuals, offspring, partners, families, and society. Despite this, perinatal mental health conditions remain underdetected and undertreated. In this narrative review, we highlight resources that increase the capacity for obstetric clinicians to address perinatal mental health. These include clinical guidelines such as the American College of Obstetricians & Gynecologists' Clinical Practice Guidelines and the Alliance on Innovation in Maternal Health's Perinatal Mental Health Conditions Patient Safety Bundle. In addition, we discuss implementation and educational tools to help apply evidence-based guidance into clinical practice, including the Lifeline for Moms Perinatal Mental Health Tool Kit, Addressing Perinatal Mental Health Conditions in Obstetric Settings e-module, Guide for Integrating Mental Health Care Into Obstetric Practice, and Perinatal Mental Health Certification Programs. We also discuss consultation and expert support, including the statewide and regional Perinatal Psychiatry Access Programs. Patient-facing resources discussed include the federally funded maternal mental health hotline and Postpartum Support International's virtual support groups. Finally, opportunities to support obstetric care clinicians in addressing perinatal mental health through reimbursement approaches and policies are also discussed.

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