Perinatal Health and Mood Disorders

Pregnancy as stress test for brain:

• Self-esteem
• Poverty
• Racism
• Health
• Genetics

Intersectionality increases risk:

• Race
• Gender
• Economic

Prevention:

• Therapy
• Mindfulness
• Medical treatment
• Education
• Biological mechanisms

Gaps:

• Biological risk factors
• Interventions

Challenges to Reproductive Journey

Barriers and stigmas must be addressed:

• Infertility
• Pregnancy loss
• Premature birth
• Equitable care is a must

Perinatal mood anxiety disorders:

• Can last years
• Range of mood disorder beyond postpartum depression

Maternal suicide:

• Hidden cause of maternal death in the U.S.
• COVID-19 made this worse

Care Cascade for Perinatal Depression

Only 3-5% reach remission.

Solutions:

• Work together
• Education and training
• Focus on health equity

Pregnancy Homicide and Violent Death

• Exceeds any obstetric cause of death
• Gun violence
• Partner violence
• About half postpartum

All cases are preventable:

• Policy
• Community prevention
• Identification

Access to Clinical Trials

Gaps:

• Maternal outcomes
• Dosing

• Fetal safety
• Pregnant people excluded from trials

Ethical foundations:

• Protection
• Respect
• Access

Communication of findings must be clear.

Discussion

Causes and prevention of violence:

• Removing guns
• Having structures for escape
• Addressing equity and racism

Impact of abortion restrictions:

• Pregnant person has a heartbeat too
• Stress from lack of autonomy
• Need to focus on both pregnant person and baby

Questions

Hand off between care settings?

• Increase capacity
• Phone support
• Maintain setting
• Cross discipline communication

Screening in BIPOC population:

• Question for connection to care

Access to care for everyone:

• Insufficient across the board
• Group provision
• Support for OB/GYN