Experts call for systemic reforms as maternal mental health gains public attention

A surge of public attention to maternal mental health follows the trial of a labor-and-delivery nurse accused of killing her three children during postpartum psychosis and the recent death of actress Hayden Panettiere, who had spoken publicly about her own postpartum depression. Advocates say the cases expose long-standing shortcomings in how the health system supports new mothers.

"In no other situation do we have one hospital patient, the mother, caring for another hospital patient, the baby," said Adrienne Griffen, CEO of the Maternal Mental Health Leadership Alliance, recalling her own struggle to obtain treatment for postpartum depression in 2001. She noted that care coordinators are rarely assigned to postpartum patients, leaving many mothers to fall through the cracks.

The American College of Obstetricians and Gynecologists has issued screening guidelines for perinatal mood and anxiety disorders, but implementation remains uneven. "Even though we have guidelines for how to screen for both conditions – gestational diabetes as well as perinatal mood and anxiety disorders – we don’t have the same level of implementation," said Dr. Andrea Diaz Stransky, an assistant professor of psychiatry at Duke University. She added that long therapy waitlists often delay needed care.

Experts stress that untreated anxiety and depression increase risks such as preeclampsia and preterm birth, and that partners and other family members should receive psychoeducation to form a supportive "village." "We need to know who else would be part of that village and have a system to provide psychoeducation to all of them, not just the mom," Diaz Stransky said.

Policy barriers also hinder care. Joy Burkhard, CEO of the Policy Center for Maternal Mental Health, explained that obstetric providers are paid a flat rate covering pregnancy through six weeks postpartum, a model that excludes mental-health services. She cited a federal bill under consideration that would lower out-of-pocket costs for perinatal care.

Stigma remains a major obstacle. Licensed clinical psychologist Dr. Noelle Santorelli warned that many women conceal their struggles to avoid judgment or fear of child removal. "Women get really afraid to be separated from their children, right? If they report what they’re really experiencing, their children might be taken away," she said, urging those in crisis to speak openly with trusted individuals.

Protesters gathered outside the courthouse where the nurse’s trial is being heard, wearing pink to raise awareness of maternal mental health, reflecting a broader movement demanding systemic change.