The perinatal period—pregnancy through the first year after birth—is one of the most vulnerable times in a woman’s life. Yet, nearly 1 in 4 women are affected by mental health disorders during this time [Miller & LaRusso, 2011]. Conditions such as depression, anxiety, and PTSD are not only common, but often untreated, with serious consequences for both mothers and children [Howard & Khalifeh, 2020].
Despite this, perinatal mental health is chronically underfunded, under-researched, and misunderstood—especially for women of color, low-income mothers, and those facing systemic medical bias.
The Barriers Are Real—and Widespread
Many women never receive adequate screening or care. A review of postpartum depression (PPD) risk factors found that 85% of women with symptoms do not seek professional help [Hutchens & Kearney, 2020]. Even among those diagnosed, only a small percentage engage in treatment. Why? A lack of trained providers, inconsistent screening practices, and persistent stigma around mental health all play a role.
Systemic Bias in Women’s Health
Too often, “women’s health” has been narrowly defined as sexual and reproductive health, ignoring other conditions that affect women differently than men. Shockingly, women report 52% more adverse drug reactions than men, and experience 36% higher fatality rates from them [McKinsey Health Institute, 2024].
Until recently, clinical trials regularly excluded women, resulting in medications being 3.5 times more likely to be withdrawn for safety reasons when used by women. Conditions like endometriosis and polycystic ovarian syndrome continue to receive less attention than male-centered illnesses, despite affecting millions.
Race, Ethnicity, and Access to Care
A study of over 330,000 women found that Black and Hispanic mothers were more likely to experience postpartum depression, but less likely to receive prescription treatment than their white counterparts [Pollack et al., 2022]. Black women, in particular, face significantly higher barriers to timely and appropriate care.
These disparities extend beyond treatment to the care experience itself. One in five women report mistreatment during maternity care, with that number rising to 1 in 3 for Black, Hispanic, and multiracial women [Mohamoud et al., 2023]. Many report feeling ignored, disrespected, or even unsafe when trying to advocate for themselves or their babies.
Socioeconomic Status: A Critical Factor
Low-income mothers face additional barriers—like lack of transportation, childcare, or safe housing—that make attending appointments nearly impossible. Many experience trauma, intimate partner violence, or cultural stigma that further complicates screening and treatment [Boyd et al., 2023].
A woman’s environment—including her access to community support—has a massive influence on whether she receives help or continues to suffer in silence.
The Financial Cost of Doing Nothing
The economic burden of untreated perinatal mental health conditions in the U.S. is estimated at $14 billion annually—roughly $32,000 per mother-child pair [Hutchens & Kearney, 2020]. The costs are higher for mothers, but nearly half also stem from adverse child outcomes.
Globally, women spend 25% more of their lives in poor health than men. Addressing this gap could unlock $1 trillion in annual global GDP by 2040, while improving the health and well-being of millions [McKinsey Health Institute, 2024].
The Gender Discrimination Link
In 2020, researchers confirmed a direct connection between perceived gender discrimination in maternity care and depressive symptoms [Stepanikova, 2020]. Biological and hormonal differences also contribute to women being diagnosed with depression at twice the rate of men [Abert, 2015].
We owe it to mothers—and future generations—to acknowledge these factors and provide care that reflects the real experiences of women.
What Can Be Done? A Path Forward
1. Adopt Inclusive and Equitable Policies
We must prioritize sex- and gender-specific research, particularly for underserved populations, and allocate funding accordingly.
2. Invest in FemTech
The private sector is leading the charge. Companies like Thrive Lab are revolutionizing care by offering hormonal support, virtual therapy, and holistic wellness solutions—all covered by most insurance.
3. Train Providers to Reduce Implicit Bias
A powerful framework from Siden et al. (2022) recommends four key steps for improving maternity care:
- Education & self-awareness (e.g., using the Implicit Association Test)
- Patient engagement
- Cognitive reframing
- Communication training
This is how we begin to build trust—and safety—for all birthing people.
Final Thoughts
Addressing the maternal mental health crisis isn’t just about reducing suffering—though that alone should be reason enough. It’s about honoring women’s lives, health, and contributions to society. By correcting systemic failures in medical research, care delivery, and provider training, we can radically transform the perinatal experience and create a healthier future for mothers and children alike.
References
- Albert, P. R. (2015). Why is depression more prevalent in women? Journal of Psychiatry & Neuroscience, 40(4), 219–221.
- Biaggi, A., et al. (2016). Identifying the women at risk of antenatal anxiety and depression: A systematic review. Journal of Affective Disorders, 191, 62–77.
- Boyd, R. C., et al. (2011). Postpartum depression screening in pediatric settings: Program development and lessons learned. Mental Health in Family Medicine, 8(2), 119–126.
- Ellingrud, K., et al. (2024). The economic promise of improved women’s health. McKinsey Health Institute.
- Howard, L. M., & Khalifeh, H. (2020). Perinatal mental health: A review of progress and challenges. World Psychiatry, 19(3), 313–327.
- Hutchens, B. F., & Kearney, J. (2020). Risk factors for postpartum depression: An umbrella review. Journal of Midwifery & Women’s Health, 65(1), 96–108.
- Miller, L. J., & LaRusso, E. M. (2011). Preventing postpartum depression. Psychiatric Clinics of North America, 34(1), 53–65.
- Mohamoud, S., et al. (2023). Mistreatment during maternity care in the United States: Findings from the CDC’s Listening to Mothers Survey. MMWR, 72(29), 778–784.
- Onyewuenyi, A. C., et al. (2023). Neighborhood disadvantage and racial disparities in maternal mental health care. Maternal and Child Health Journal, 27, 75–86.
- Pollack, A. M., et al. (2022). Racial and ethnic disparities in postpartum depression and mental health service use. Medical Care, 60(4), 289–295.
- Stepanikova, I. (2020). Perceived gender discrimination and women’s mental health during pregnancy. Women’s Health Issues, 30(1), 7–14.
- Siden, H., et al. (2022). Reducing Implicit Bias in Maternity Care: A Framework for Action. JAMA Health Forum, 3(11), e224030.
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