Don’t cut lifeline for pregnant women, new mothers

State mental health program provides crucial services

AS AN OBSTETRICIAN/GYNECOLOGIST, I regularly see women suffering from depression in pregnancy and during the year following delivery. The reality is that many women are not caressing their growing bellies or cooing contentedly over their newborns after they give birth. They struggle to varying degrees to take care of themselves and their babies. Sometimes mothers are concerned that they may harm themselves or their infants. Women feel shame and guilt about not being “the perfect mother.” These challenges are very real and hard to acknowledge.

Last summer, Massachusetts threw a lifeline to pregnant and postpartum women and their caregivers by funding a program to aid expectant mothers and new mothers suffering from depression. The Massachusetts Child Psychiatry Access Project for Moms (MCPAP for Moms) provides real-time, expert consultation with psychiatrists and community mental health care coordination to all OB/GYN providers so that mothers with depression can get help.

The Massachusetts chapter of the American College of Obstetricians and Gynecologists was disappointed to learn that the 2016 House budget trimmed the overall MCPAP program request from $3.6 million to $3.1 million and did not include an additional $500,000 to expand MCPAP for Moms services. The Senate budget includes the additional funding. The two versions of the state budget— and the fate of stepped up MCPAP for Moms initiatives—must be reconciled by a House-Senate conference committee.

Up to one in seven women experience depression during pregnancy and in the year after giving birth. Depression during pregnancy is twice as common as diabetes in pregnancy. Unrecognized and untreated depression has immediate and long-term consequences for pregnancy and for new mothers, their children, their families, and our communities. Until recently, most of these women were suffering alone without help, guidance or treatment.

The American College of Obstetricians and Gynecologists encourages providers to screen women for depression and the Bay State has new reporting requirements for depression screening. But screening alone does not improve outcomes. These measures must be paired with appropriate treatment and follow-up.

Since its launch in July 2014, MCPAP for Moms has trained 75 obstetrics practices and has served more than 450 women. Health care providers can call MCPAP for Moms and speak with a psychiatrist who specializes in women’s mental health. Obstetrics providers get help for women by receiving advice from a psychiatrist on current best care practices and medications that are safe for use during pregnancy and when breastfeeding. The program also coordinates ongoing mental health care for these women in their communities.

MCPAP for Moms helps address the serious public health problem of depression among for women in pregnancy and the postpartum period, ensuring that they get appropriate diagnoses, treatment, and follow-up care. This program needs to continue so that pregnant women and new moms with depression get the treatment they need and deserve. The welfare and health of women and families across the entire state will be adversely affected if this program suffers cutbacks. MCPAP for Moms is a real lifeline that represents tax dollars well spent.

Meet the Author

Tiffany A. Moore Simas, MD, is an associate professor of obstetrics/gynecology and pediatrics at the University of Massachusetts Medical School/UMass Memorial Health Care and a fellow of the American College of Obstetricians and Gynecologists.