According to a report by the Vermont Department of Health, about 25% of people who gave birth in 2020 reported depression, anxiety, or other mental health problems during their pregnancy or after their child was born.
The report, based on an annual survey of people’s experiences after childbirth, showed an increase in about 20% of birth parents in 2014, according to the department. That increase could be the result of the pandemic’s impact on the mental health of everyone in Vermont, said Ilisa Stalberg, the Department of Health’s director of family and child health.
A 2020 Department of Health report quoted survey participants about their experiences giving birth during the pandemic. Many reported that it affected their overall mental health, their access to medical care, and their connection to their support networks.
But the causes of mental health problems before and after birth go far beyond the specific changes brought about by the pandemic. Veerle Bergink, director of the women’s mental health program at New York’s Mount Sinai Health System, said that in addition to physiological triggers, parents experienced a “major” life-changing event after childbirth.
“In the transition from pregnancy to postpartum, every system in your body changes: your endocrine system, your hormones, you completely switch from pregnant to not pregnant and all of these changes change,” Bergink said.
These changes can lead not only to depression but, in rare cases, to serious mental illnesses like mania or psychosis, she said. Data from the Department of Health showed that 12% of respondents reported postpartum symptoms that suggested they were at risk for postpartum depression.
The mental health effects of childbirth can also begin during pregnancy or appear up to a year after birth, Stalberg said. Researchers use the term “perinatal mood and anxiety disorders” to describe the full spectrum of potential mental health problems.
The biggest risk factor for these disorders, which “nullifies other risk factors,” is a history of mental illness, Bergink said.
She said they are also related to socioeconomic status, likely because low socioeconomic status is associated with other risk factors: financial stress, traumatic life events, poorer access to healthy food, greater exposure to environmental pollution, and a history of substance abuse.
The rate of postpartum depression varies significantly by country and region, due in part to the different levels of financial and social support available to new parents. “It doesn’t help at all that (the United States) isn’t generous when it comes to parental leave,” she said.
Having stress factors, such as knowing that I’m going to go back to work, otherwise I can’t do it financially, that’s enormous pressure,” said Bergink.
According to the Department of Health, two-thirds of parents who reported returning to work in the Vermont survey felt they had too little free time after giving birth. A 2019 ministry report showed that low-income mothers in particular were less likely to receive paid leave and took less time before returning to work.
Bergink said that acknowledging the reality of anxiety and depression that can accompany new parenthood can help prevent or alleviate postpartum problems. “I think it should rather become the new normal that pregnancy comes with a lot of physical discomfort and the postpartum period is very intense,” she said.
“We see the happy modern baby in movies and in society,” she said. “That’s only part of the reality: It’s also very hard work.”
Coping mechanisms that are helpful with mental illness in general can also be helpful with mental health related to childbirth, such as exercise, healthy eating and socializing, she said. She added that a “good support network” can help with childcare and make parents feel more supported.
Treating psychological symptoms is also important. Stalberg said parents should reach out to everyone they are familiar with, from family doctors to therapists, but the state health department also has a birth-specific treatment center called Help Me Grow. The system connects parents with mental health professionals who are familiar with perinatal mental illness.
In 2018, the health department received a five-year grant from the federal government to expand screening for these disorders and provide resources for local organizations and health care providers who work closely with parents, such as obstetricians, Stalberg said.
The department is waiting to see if it qualifies for another round of funding, she said. She is “concerned” that she will be able to continue the current work without this money.
“Vermont’s mental health workforce is extremely busy, and then there certainly needs to be an increase in the number of people who know how to work with pregnant and laboring people,” she said.
Stalberg said these mental illnesses “not only have an impact on the person affected, but also have a significant impact on infants and children well into the future.”
“Being able to provide support early on leads to long-term successes that we are very confident in, and so we feel it is very important to invest in them,” she said.