Women's Mental Health
Tiffany Moore Simas, MD, MPH, MEd, FACOG
Chair of Dept Ob/Gyn; Professor of Ob/Gyn, Pediatrics, Psychiatry, Pop & Quant Health Sciences
University of Massachusetts Medical School/UMassMemorial Health
Pregnant and postpartum women are dying at unprecedented rates due to mental health and substance use disorders. Maternal suicide is on par with and often exceeds hypertensive crisis, postpartum hemorrhage, and thromboembolic disease as a cause of maternal mortality. As front-line providers for pregnant and postpartum women, obstetric providers are in an ideal position to support maternal mental health. Recognizing this ideal setting and that we cannot address maternal mortality without addressing mental health, professional societies, policy makers, and governmental organizations are recognizing it and acting on it.
Despite consistent recommendations for universal screening, the subsequent care of women is lagging-behind these changing care standards. Obstetric providers are challenged and often ill-equipped to detect, assess and manage perinatal mental health and substance use disorders. Another major challenge is the woeful lack of access to adequate mental health care for pregnant and postpartum women. Care of women will continue to lag without purposeful efforts aimed at innovating mental health care delivery in obstetric settings. There is emerging evidence for models that support front-line obstetric providers address perinatal mood and anxiety disorders.
In this symposium we will: 1) summarize current rates of perinatal mental health conditions and gaps in care, 2) summarize national efforts to build the capacity of frontline medical providers to address perinatal mental health and substance use disorders, and 3) provide strategies for how CL psychiatrists can help obstetric providers address perinatal mental health and substance use disorders.
Structure of the session:
Introduction – Dr. Byatt (5 minutes)
Dr. Straub will provide an overview of epidemiology related to perinatal mental health conditions, and effects on maternal and infant health and maternal mortality (15 minutes).
Dr. Moore Simas will review current professional expectations regarding the integration of obstetric and behavioral health in the United States, barriers to following those recommendations and opportunities for CL psychiatrists to seal gaps in care (15 minutes).
Dr. Callaghan will describe her experience and lessons learned while developing and implementing a multidisciplinary clinic for pregnant women with substance use disorders, which has required close consultation with CL psychiatrists in both the inpatient and outpatient setting (15 minutes).
Dr. Byatt will describe national efforts aimed to build front line provider capacity to address perinatal mental health and substance use disorders (15 minutes).
Dr. Stewart will describe the effects of Intimate Partner Violence on reproductive issues, including pregnancy, and describe an international curriculum for mental health and Ob/Gynn providers that is in wide-spread international use (15 minutes).
Summary and Q and A – Dr. Stewart (10 minutes)
Implications: Integrating care for perinatal mental health and substance disorders into obstetric care carries the potential to reduce maternal mortality and improve the overall health of mother and families. As nations gear up to address the maternal mortality crisis, efforts will fail, and we will not optimally impact the health of our nation’s mothers, children, and families if we do not harness this opportunity.