We’ve witnessed tremendous courage in the face of mental health challenges on the part of elite athletes recently. Simone Biles withdrawing from the women’s team all-around gymnastics event in Tokyo last month — as the competition was ongoing — because she feared her mental state would lead to physical injury during a difficult routine. Naomi Osaka pulling out of the French Open and Wimbledon because she wanted to focus on her mental health. Olympians Raven Saunders, Simone Manuel, Ginny Fuchs and Noah Lyles have spoken out about mental health, too.
These brave athletes — and others, like Meghan, the Duchess of Sussex — are speaking out on a topic that, in the past, was shrouded in silence. Their insistence we listen now is critical: According to a poll by Harris conducted on behalf of March of Dimes earlier this year, 4 in 10 people — and nearly half of 18- to 44-year-old women and mothers — said their mental health has declined during the COVID-19 crisis.
Yet for most people, superstar athlete or not, recognizing a mental health issue, let alone taking action to get help or treatment — even staying home from work for a mental health day — is a challenge. This is especially true for vulnerable populations, including postpartum mothers and their babies, who, according to the Harris/March of Dimes poll, are not adequately supported by mental health resources. As a nation, we must take this moment of heightened mental health awareness and reduced stigma and use it to finally address the barriers that keep pregnant people and new moms from getting the mental health care they need.
Mental illness affects up to 20% of pregnant women, and mental health issues are among the most common complications of pregnancy and childbirth. About a third of women experience anxiety during pregnancy. Approximately 1 in 8 women experiences postpartum depression. And evidence suggests that rates of maternal mental health disorders increased during the pandemic.
Though stigma has decreased somewhat in recent years, it continues to persist alongside systemic barriers. When Simone Biles experienced the “twisties” hurtling through the air, she had health care professionals nearby to help. But for too many pregnant people in America, mental health care is out of reach. The reality they face includes lack of access to and insurance coverage for mental health care, lack of screening in doctor’s offices, and poor coordination of care among primary care physicians, who could catch emerging issues, and mental health specialists, who can treat them.
At an even more basic level, pregnant women — and, even more so, the people around them — very likely don’t recognize the signs of mental health problems, unlike Simone Biles, her coaches, the gymnastic team’s medical staff, and her teammates.
The Harris/March of Dimes poll found men are less likely than women to be aware of multiple signs of poor maternal mental health — such as postpartum psychosis, baby blues, and exhaustion — though women’s awareness was also relatively low. More than half of fathers and younger men surveyed did not believe that the mental health of a mom affects that of her newborn child, though some studies have found that to be the case. Without their partners in their corner, pregnant people and new moms may suffer in silence.
Like a Simon Biles triple double, the solution, on its face, is easy, but the complex execution will take dedication. Most maternal mental health disorders can be treated — they simply need to be identified and diagnosed. To get to the point where pregnant and postpartum women’s symptoms are recognized, we must ensure that women have access to insurance that covers mental health care. To ensure people with public insurance have access to care throughout pregnancy and the postpartum period, we must extend Medicaid coverage to one year after birth. Doing so will ensure more women have access to mental health screenings that are incorporated into prenatal visits, well-child visits and postpartum check-ups. Screening at least once before or after birth can help doctors identify maternal depression. Pregnant people will also benefit if the provider who screens and refers them for mental health issues coordinates with the mental health provider. Providers need sufficient reimbursement for screening, diagnosis and treatment.
In addition, we must boost providers’ and the public’s awareness of the signs and symptoms of the mood and anxiety disorders that are not just a “normal” part of pregnancy but rather a warning of an underlying issue or illness. Finally, we need to track maternal mental health disorders and collect data on maternal mental health screening initiatives and treatment outcomes. This will help us improve our understanding of maternal mental health and create new solutions that will help moms stay healthy throughout their pregnancies and the first year of a baby’s life.
One important step toward these changes will be for Congress to pass the Black Maternal Health Momnibus Act of 2021, whose Moms Matter Act includes funding to invest in community-based maternal mental health care, raise awareness and build the maternal mental health workforce.
With the support of her team, Simone Biles returned to compete in the individual balance beam, earning bronze. Olympic athletes aren’t the only ones who feel immense stress in their daily lives — pandemic or not — or who struggle with anxiety, depression and other mental health conditions. Their moment in the spotlight could be game changing for moms across America, too. As Olympic sprinter and mom Allyson Felix has said, “We have to do better by our mothers.”
Stacey D. Stewart is president and CEO of March of Dimes, a nonprofit organization that supports mothers and babies' health through research, advocacy and education. Lisa Blunt Rochester represents Delaware in the U.S. House of Representatives.