The care gap
The first US inpatient perinatal psychiatry unit opened at UNC in 2011 with 5 beds. A recent count found five such programs nationally and 45 states with none. The first national strategy for maternal mental health was released in May 2024.
This Is Why, Part 5 of 7: The system started building itself very recently
If a mother develops severe depression or psychosis after birth, where does she go?
In much of the world, the answer is a mother-baby unit, where mom and baby are admitted together. Many countries have had these for years. The US had none. (Archives of Women’s Mental Health, 2013)
The first US inpatient psychiatric unit dedicated to pregnant and postpartum women opened at the University of North Carolina in 2011. It has 5 beds. (UNC) Even there, UNC couldn’t keep babies on the unit, because insurance wouldn’t cover infant care while mom was hospitalized. (Ms. Magazine)
A recent count found just five inpatient perinatal psychiatric programs listed nationally, and 45 states with none. (MedicalDaily via inkl)
The national guidance is just as new:
- 2022: the first National Maternal Mental Health Hotline launches. (WSHA)
- 2023: ACOG, the main professional body for OB-GYNs, publishes its first dedicated clinical practice guidelines on screening and treating perinatal mental health conditions. (PubMed) Some recommendations had to be made as “good practice points” because evidence was inadequate or nonexistent.
- May 2024: the federal Task Force on Maternal Mental Health releases the first national strategy for maternal mental health in America. (Policy Center for Maternal Mental Health)
So when a mother is screened once in the hospital and then sent home to figure it out, that isn’t one hospital failing. It’s the predictable result of a system that only began building itself in the last 15 years.
This is why.