Perinatal mental health screening and care among those with pregnancy complications

Perinatal mental health conditions are common and, without effective treatment, can contribute to adverse maternal and child outcomes. In the United States, mental health conditions are a leading cause of maternal morbidity and mortality, contributing to over 20% of pregnancy-related deaths. This expert review aims to assess current literature and provide recommendations regarding mental health care in high-risk patients who experience pregnancy complications. Individuals experiencing pregnancy complications are at increased risk for perinatal mental health conditions, including depression, anxiety, and post-traumatic stress disorder, as compared to those with uncomplicated pregnancies. Despite this increased disease burden, there is limited research on how to support mental health in those experiencing pregnancy complications, a unique population with unmet needs. In this review, we propose multiple ways for obstetric clinicians to enhance their capacity to provide mental health care for high-risk patients facing pregnancy complications, including adapting preventative interventions, improving perinatal mental health education during medical training, expanding perinatal mental health screening, and implementing collaborative care models to expand reach of mental health services during pregnancy and postpartum. Mental health is an essential component of maternal health, and it must be addressed in a systematic, evidence-based manner in order to optimize maternal care and improve outcomes for all patients, especially those high-risk patients experiencing pregnancy complications.