Improving Perinatal Maternal Mental Health Starts With Addressing Structural Inequities

Psychological distress during the perinatal period has increased during the COVID-19 pandemic.A systematic review of 81 studies (N = 132 917 pregnant or postpartum women; research published prior to January 31, 2021) reported prevalence of depression and anxiety ranging from 20% to 64% during the ongoing pandemic. 1Although there is still a need to examine more representative samples, a large cross-sectional study 1 of mostly US women corroborated these findings, reporting clinical levels of depression in 36% of perinatal women compared with an estimated prepandemic prevalence of 11% to 17%.Changes in prenatal care and childbirth experiences, including lack of support during delivery and recovery, may also contribute to heightened feelings of distress.Women who gave birth during the pandemic reported an increased acute stress response to childbirth (odds ratio, 1.38; 95% CI, 1.01-1.89),correlating with increased posttraumatic stress disorder symptoms and maternal bonding or breastfeeding problems.In this Viewpoint, we focus on the potential consequences of perinatal maternal mental health on child development and highlight structural inequities that need to be addressed to mitigate maternal psychological distress and improve both maternal and child health and well-being.