Maternal Mental Health Complications

Maternal mental health complications, including postpartum depression and psychosis, can have a significant impact on both the mother and child's well-being. Factors such as stigma, culture, trauma, and lack of support systems can exacerbate these conditions. Early detection and intervention are crucial to prevent adverse outcomes like preterm birth, low birth weight, and behavioral issues in children. Untreated prenatal and postpartum mental health disorders can lead to a range of challenges, highlighting the importance of a holistic approach to maternal care.

• Maternal mental health
• Postpartum depression
• Prenatal mental disorders
• Early detection
• Maternal well-being

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1. Maternal Mental Health Complications

2. Prevalence 20% and up to 48% in some populations Considerations: Stigma Culture Racism Trauma Poverty Support System Education Level Diagnostic Imprecision #1 complication of pregnancy while more common than gestational diabetes, pre-eclampsia, and preterm delivery, postpartum depression has received much less attention in contemporary medical literature, training, and clinical practice. Kathryn A. Leopold, MD, Lauren B. Zoschnick, MD

3. Spectrum of Maternal MH Complications

4. Postpartum Psychosis Bipolar Disorder Depression/Anxiety Perinatal OCD/PTSD overwhelmed anxiety disorder mood/psychotic disorder distractibility, can t think straight ego dystonic increased energy intrusive, repetitive thoughts decreased need for sleep guilt/shame inappropriate humor worthlessness flashbacks, nightmares paranoia hopelessness shame disorganized thoughts compulsions/behaviors to reduce anxiety change in appetite bizarre behavior insomnia hallucinations, delusions avoidance behaviors irritability, anger, rage germ phobia excessive worries/fears persistent increased arousal unexplained physical symptoms often presents with PPD suicidal ideation M. Sparago, MD POEM

5. Early Detection Is Key Universal Screening without further assessment, diagnosis, and systematic follow up does not improve treatment entry or outcomes ~Miller et al. 2009

6. Impact: Untreated Prenatal MH Disorders 4x risk of preterm birth Low birth weight Relapse MH complications Increased self-medication/ substance abuse Increased risk of being a victim of violence Poor nutrition/weight gain Behavioral complications in children POEM-MHAFC

7. Impact: Untreated Postpartum MH Disorders Infant Attachment difficulties Failure to thrive Child Symptoms of depression - lack of pleasure Failure to meet milestones Behavioral difficulties & cognitive deficits Physical abuse, neglect Worsening health problems Partner Higher parenting stress Higher depression rates

8. Components of Recovery Medical Intervention Peer Support Intervention Behavioral Intervention

9. Journey of a POEM Client OB/GYN Social worker Home-visiting nurse/CHW Pediatrician Other medical practitioner Mental health professional/provider Postpartum Support International o Self-refer via web form o Self-refer via support line, email, or text o Direct referral from provider via fax or web form o Provider referral via support line, email, or text Referral Received Referral to mental health professional/provider In-person support group information Online support group connection Mentorship Community and MHAFC resources POEM Staff Contacts Mom o Call/contact mom five (5) times o Reach mom, offer appropriate resources o Check in with mom weekly unless otherwise noted o Ensure mom is connecting with referred resources/providers o Connect with a mentor for additional support o Offer ongoing staff support until mom s is connected/engaged with support and/or services Check In/ Follow Up o Mom is only closed when: POEM staff/mentor knows she has connected with support and/or she voices that she will reach out if needing support POEM staff determines that mom is doing well enough to discontinue regular check-ins She stops returning contacts (several attempts) Closure

10. POEM Equity Initiative Expand referral network of mental health providers of color

11. POEM Program Outcomes POEM Participants treatment entry Treatment entry - screening alone* 8 22 17 75 78 Verified Unverified Declined Treated Untreated *Byatt et al. Obstetrics and Gynecology.2015

12. (614) 315-8989 Talk/Text Line poem@mhafc.org www.mhafc.org