Pregnancy and the postpartum period are ripe with emotional change. You may feel energetic, exhausted, joyful, excited, sad, or worried – sometimes all in the same hour. Shifting emotions can be normal due to your new schedule and adjusting to life with a little one. But sometimes these feelings can take a toll on your life and affect the health of your children.
Studies have shown that up to 20% of women live with mental health conditions during pregnancy and the postpartum period, ranging from depression and anxiety and obsessive-compulsive disorder to post-traumatic stress, bipolar disorder, and substance use. In fact, nearly 50,000 Texas women who gave birth in 2019 were affected by mental health conditions.
Approximately 75% of women who have mental health symptoms during pregnancy and the postpartum period do not get treatment. There are many reasons for this – and one of the most prominent is a shortage of mental health professionals who are knowledgeable in treating pregnant and postpartum women.
Untreated maternal depression and anxiety can disrupt sleep, negatively impact mood, and increase the risk of heart conditions such as high blood pressure. Research also shows that children of parents with untreated depression develop social problems and may have three times the risk of developing major depressive disorder and increased rates of anxiety and substance use disorder.
Getting more mothers treatment can help – a 2022 study, for example, found that treating caregiver depression significantly improved their children’s asthma outcomes.
As a psychiatrist (Dr. Doty) and Ob/Gyn (Dr. Elwell Silver), we see this problem firsthand. While we can’t certify enough mental health professionals today to address every patient’s needs, we are participating in a new state pilot program, PeriPAN, that’s working to fill the gap.
PeriPAN’s origin story
The Texas Child Mental Health Care Consortium (TCMHCC) was created by the 86th Texas Legislature to address mental health challenges and the child and teen mental health care system by leveraging the expertise and capacity of health-related higher education institutions.
One of TCMHCC’s five initiatives is the Child Psychiatry Access Network (CPAN). Primary care providers can access CPAN for help with the behavioral health care of pediatric patients. In 2021, the Texas Legislature approved federal funding from the American Rescue Plan Act to expand several of TCMHCC’s initiatives. CPAN has been expanded to include maternal health – pregnant or postpartum, up to one year – through the PeriPAN pilot program.
PeriPAN offers Ob/Gyns, midwives, pediatricians, family doctors, and mental health providers across Texas free phone consultations with psychiatrists who have experience treating pregnant and postpartum patients. While patients are not involved in these one-on-one sessions, they directly benefit because their doctors are getting expert answers about mental health symptoms and, if treatment is appropriate, it can start sooner.
How PeriPAN works
PeriPAN gives providers a safe resource to call when patients need mental health care beyond their expertise. For example, an Ob/Gyn with a pregnant patient, a pediatrician whose patient’s mother needs care, or a psychiatrist seeing a patient with pregnancy-related symptoms.
Our health care providers are skilled in recognizing mental health symptoms and making certain diagnoses; they may just need help with the nuances of treatment. So, instead of a patient having to wait for a mental health appointment, their Ob/Gyn or family doctor can call the PeriPAN hotline where an expert can help:
- Diagnose a mental health condition
- Recommend safe, effective medication
- Provide resource information for therapy or other services
- Provide training and education for maternal mental health care
The provider-to-provider hotline is staffed Monday-Friday from 8 a.m. to 5 p.m. with experts in social work or counseling who can guide your health care provider to resources and services for new or soon-to-be mothers, such as local mental health professionals, and support groups.
For clinical treatment questions, your health care provider will be transferred to the psychiatrist on call. Faculty psychiatrists from UT Southwestern who specialize in women's mental health serve nine counties around Dallas. The consultations can help your doctor get you started on safe, effective treatment right away.
Why it’s important to talk with your doctor about mental health
Women tend to prioritize the health and wellness of loved ones over their own. But just as taking care of yourself physically is important, so is caring for your mental health. Don’t be afraid to reach out – even if you think whatever you’re feeling isn’t that big a deal. Women with untreated mental health conditions are more likely to:
- Have poor physical health and nutrition
- Use substances such as alcohol, tobacco, or drugs
- Experience physical, emotional, or sexual abuse
- Be unemployed
- Die by suicide
Related reading: ‘Baby blues’ or postpartum depression?
Prioritizing your mental health also can affect your unborn baby. Children born to mothers with untreated mental health conditions are at higher risk for:
- Low birth weight
- Preterm birth
- Excessive crying
- Behavioral, cognitive, or emotional delays
If you have a history with a mental health condition, keep taking your medication and contact your Ob/Gyn. In some cases, stopping the medication may harm your health. Your doctor and a mental health professional can discuss potential medication changes you may need to make during pregnancy or while breastfeeding.
Related reading: Should I stop taking medication when I’m pregnant?
We know that taking care of your mental health is a commitment. We can help you navigate the challenges during and after pregnancy. Behind the scenes, we’re actively working together to speed up the process of connecting you to the resources and mental health care that you need.
In an ideal world, we would have enough mental health professionals that everyone who needed to see one could right away. But we’re not there yet. Until we are, PeriPAN can make the psychiatrists we do have trained to address maternal mental health concerns available to help their colleagues in other specialties – as well as the women they care for.