Untreated mental health disorders among moms inflict a massive toll on families, the economy

Published on
April 30, 2019

On her first night as a mother, Jennifer Kim Lai awoke in the middle of the night to use the bathroom and found her newborn daughter, Elyse, choking on her own vomit.

Still in the hospital, Lai immediately called the nurse, and although the crisis was quickly resolved, it sparked a long year of anxiety for the new mother. “I had a combination of emotions and didn’t know if it was normal or not,” she said.

She didn’t ask anyone for help. “I was always scared that something might happen to her. I cried every night, and felt extremely out of control, like everything was a mistake,” Lai said. But she never told anyone how she felt.

Mood and anxiety disorders affect at least one in seven mothers, and are the most common medical complication during and after childbirth, according to a new study released this week by Mathematica. Left untreated, these conditions can impact the health of both mother and child, and impose a significant economic cost from the loss of maternal productivity and increased use of social services. Not treating the condition costs an average of $32,000 for every mother and child, according to Mathematica. Nationwide, that amounts to $14.2 billion dollars through the first five years of the child's life, or $2.4 billion in California alone.

Melissa, 45, an editor at a legal publishing company in Los Angeles who asked not to use her last name, did not notice her own depression until four months after giving birth. “It is hard to know what’s normal after birth, because of all the hormones and everything you go through as a new mom,” she said. “There could have been signs before, but I hit rock bottom at four months.” 

Melissa described the day she experienced a breakdown. “There was just one day when I was home alone with my daughter, holding her and trying to feed her, when I just started crying and I felt the lowest I’ve ever felt before. I felt paralyzed, like I couldn’t move.”

In September 2018, former California Gov. Jerry Brown signed three bills into law to improve services for maternal mental health. One law requires that obstetricians screen for maternal depression at least once during the pregnancy and once during the postpartum period. Another law requires medicaid health plans and health insurers to develop maternal mental health programs and resources for new mothers. And hospital employees who work with mothers, such as registered nurses and social workers, are required to undergo maternal mental health training, under the third law.

The laws aim to help struggling new mothers get the help that they need in a timely manner. Mothers like Stacia Godown.

“There’s a lack of awareness, and a lack of preventative measures taken,” Godown said, reflecting on her experience with postpartum depression. “Going through my pregnancy, it was never talked about during my doctor’s appointments.”

Three years ago, Godown took her newborn son Finn home from the Children’s Hospital in Orange County after 10 days in the neonatal intensive care unit, where he was battling a blood infection. Despite Godown’s excitement during the pregnancy about having her first baby, once she got home, she felt as if she could not connect with him. “I felt like in the hospital, for those 10 days, I was just on survival mode. And the moment I got home, I told my husband, I didn’t want the baby anymore,” she said. “I thought, I’m never going to bond with Finn, never going to be like other mothers who have that instant love and connection with their babies.” She began spending a lot of time in bed. “When my husband left for work, I would take my son to my mother’s, and head upstairs to the bedroom to sleep. Half an hour before my husband got off work, I would wake up, go downstairs, take Finn home, hand him off to my husband, and go back to sleep,” she said.

Godown finally received a diagnosis of postpartum depression and began treatment when her son was 2 months old, after her mother suggested she talk to her physician. Today, she says, treatment could have helped much sooner.

Advocates hope that with new laws such as those in California, maternal mental health will start to become a routine part of maternity care. Maternal Mental Health Now, an advocacy group based in California, estimates that fewer than one in four moms is screened for postpartum depression. Of those diagnosed with depression, only 50% are receiving any treatment, according to the Mathematica study. 

It took Lai six months before she felt like herself again. She shared her story with the hope that it will erase the stigma and help other moms get the support they need.

“I want new mothers to know that they are allowed to take care of themselves, both physically and mentally,” said Lai. “Don’t feel guilty for wanting to be alone or do things without the baby sometimes. Even if it’s only for an hour, do something that you enjoy that doesn’t involve the baby if you can. Because ultimately, happy, healthy moms make happy, healthy babies.”