Reducing psychiatric illness in the perinatal period: A review and commentary

Abstract

This brief overview highlights the global crisis of perinatal psychiatric illness (PPI). PPI is a major contributor to many adverse pregnancy, childbirth, and childhood development outcomes. It contributes to billions of dollars in spending worldwide each year and has a significant impact on the individual, their family, and their community. It is also highly preventable. Current recommendations for intervention and management of PPI are limited and vary considerably from country to country. Furthermore, there are several significant challenges asso-ciated with implementation of these recommendations. These challenges are magnified in number and consequence among women of color and/or minority populations, who experience persistent and negative health disparities during pregnancy and the postpartum period. This paper aims to provide a broad overview of the current state of recommendations and implementation challenges for PPI and layout a framework for overcoming these challenges. An equity-informed model of care that provides universal intervention for pregnant women may be one solution to address the preventable consequences of PPI on child and maternal health. Uniquely, this model emphasizes the importance of managing and eliminating known barriers to traditional health care models. Culturally and contextually specific challenges must be overcome to fully realize the impact of improved management of PPI.

Keywords: Perinatal psychiatric illness, Postpartum depression, Equity-oriented care, Minority populations, Maternal mortality, Pregnancy

Core Tip: Perinatal psychiatric illness is a major contributor to maternal mortality and morbidity rates, especially among women of color. This paper explores the ways in which current standard of practice is failing to address these disparities and offers an alternative framework for consideration.