A new report shows that Maryland is in the top 10 states when it comes to policies that support mental health among new mothers and pregnant people.
But the state only received a C-, according to a nationwide report card from the policy think tank called Policy Center for Maternal Mental Health. According to the report card, 40 states either received a D or an F, and the highest graded state was California with a B-.
While Maryland may be one of the leading states in programs that assist with maternal mental health, the overall consensus from the organization is that the United States is “failing mothers” in mental health support.
“What that suggests is that we are both leaders in the country but also there’s more to go in terms of everything we need to do,” according to Maryland’s deputy secretary for public health services, Dr. Nilesh Kalyanaraman.
Concerns and interest in improving mental health has been growing over several years, particularly over the COVID pandemic as many American’s struggled mentally with social isolation for safety reasons.
But new mothers can experience a host of mental health concerns that add unique challenges during pregnancy or after delivering a child.
There were 68,285 babies born in Maryland in 2021, the most recent data from the The Centers for Disease Control and Prevention.
According to Kalyanaraman, about one in five women will be affected by mental health conditions, which can complicate bonding with the new baby or with family members.
“Most common being depression and anxiety disorders, but there are others as well, some of the more serious mental health conditions,” he said.
“It affects the woman, in terms of feeling sad or depressed… but it can also affect the relationship with the baby or with other members of the family,” Kalyanaraman continued. “Difficulty bonding with the baby is a concern. Feeling that you’re out of control or ‘crazy…’ Feelings that you maybe shouldn’t have become a mother — worrying you might hurt your baby or yourself as more severe manifestations. So there’s both impacts on the woman herself and also the relationship between the baby and the family.”
Another concern for new mothers can be postpartum depression, when some mothers experience severe depression which can possibly last for months or longer, according to the Mayo Clinic. Severe cases can lead to postpartum psychosis “may lead to life-threatening thoughts or behaviors and requires immediate treatment,” the Mayo Clinic says.
The Centers for Disease Control and Prevention notes that 1 in 8 live births will result in symptoms of postpartum depression for the mother. In 2020, about 13.4% out of 995 of Maryland mothers self-reported postpartum depressive symptoms that year.
Issues like substance abuse can also be a challenge for some mothers, Kalyanaraman noted, which may also impact the health of the pregnancy. In fact, the Maryland Department of Health recently received a federal grant of $800,000 to create a pilot program that helps address the issue of substance abuse among pregnant and postpartum women.
But policies on how to handle maternal mental health concerns vary across the United States.
The Policy Center for Maternal Mental Health released the state’s grades in order to highlight how access to maternal health care can impact mental health, taking into account insurance coverage in the state, Medicaid expansion, and state programs aimed to take on and improve maternal mental health.
States like Maryland that expanded Medicaid coverage helped improve their grades in the report card, because more low-income mothers can have access to health care during their pregnancy and after the delivery.
Maryland also has a task force specifically designed to focus on the issue of maternal mental health, which contributed to the state’s score. Maryland also has several state programs to assist in maternal mental health, such in home visiting services, where new mothers can receive support and learn parenting skills before and after birth.
Still, Maryland received a C-, along with New Jersey, Rhode Island, and Wisconsin. Only five states received a C: Arizona, Colorado, Illinois, Pennsylvania, and Massachusetts. According to the analysis, these states had stronger policies on mental health screenings.
California received the highest grade with a B-, with Medicaid expansion, stronger mental health screening policies and state programs, according to the report card.
Seven states scored a D for maternal mental health, and another seven earned a D-. The remaining 15 states received a flat F. In a recent report, CNN noted that many states receiving a grade of a ‘D’ or lower also have severely restricted abortion access or banned abortion in the state.
Kalyanaraman noted that while Maryland does have maternal mental health screening services, there is room for improvement.
He said that the Department of Health is pushing to ensure that there is more prenatal and postpartum risk screening to identify which mothers may need additional mental health support based on their experiences and other outside factors. Then, they can connect them to resources that may help.
“Some of the triggers (for mental health concerns) are issues like the physical and emotional demand of childbearing, but also the material demands of being pregnant and then having an infant in the house. For instance, access to food, if you don’t have that reliably, does increase stress.”
Investing in the mental health and well-being among new mothers and pregnant people can help lead to a better start for a young child and ease the stress off parents. But there are additional measures that can be taken across the United States and within Maryland.
“We have, as a country, made large strides in addressing mental health overall. I think back to ten or even five years ago, we’ve made a lot of progress,” Kalyanaraman said.
“That doesn’t me we don’t have more to do. But we are moving in the right direction. Certainly as a state, Maryland, but also other states as well are pushing forward,” he added.
The Maryland Department of Health urges that Marylanders who are struggling a possible maternal mental health condition to seek help by contacting a health professional or Maryland’s helpline by calling 211.