One questionnaire, then Google it

Postpartum mental health care is hard to find in the US because medicine spent decades excluding women from research, removed postpartum illness from psychiatry’s manual, and approved its first postpartum depression drug only in 2019. Specialized services and a national strategy came even later.

This Is Why, Part 1 of 7

A client of mine recently called her local hospitals. She asked a simple question: what do you do to support women during pregnancy and after birth?

The answer was the same everywhere. They give a screening questionnaire, the Edinburgh Postnatal Depression Scale, right after delivery. That’s it.

If something feels “off” weeks later, she was told to look it up online. And when she did, there was almost nowhere local to go.

This isn’t one hospital dropping the ball. Perinatal mood and anxiety disorders affect about one in five pregnant and postpartum people. They are among the most common complications of pregnancy, and among the most underdiagnosed.

So why is the care so thin? Because medicine spent decades not studying women, not naming postpartum illness, and not building treatments or services for it. Some of the key milestones happened in my lifetime. Some happened in the last two years.

Over the next six posts, I’ll walk through that history, with sources, one gap at a time:

1. The research gap: women left out of drug studies
2. The diagnosis gap: psychiatry’s manual and postpartum illness
3. The treatment gap: the first postpartum medications
4. The care gap: specialized programs and national plans
5. The stakes: what happens when care doesn’t exist
6. What we do now

This is why.