Maternal Mental health
Mood behavioral changes can occur at any point during pregnancy or after birth and Molina recognizes the importance of a healthy mind for pregnant and post-partum members. According to the American College of Obstetrics and Gynecologists (ACOG), perinatal mood and anxiety disorders are some of the “most common complications that occur in pregnancy or in the first 12 months after delivery” and “perinatal mental health conditions often remain underdiagnosed, untreated, or under-treated.” In fact, mental health conditions affect 1 in 5 women and childbearing people-- the most common complication of pregnancy and childbirth (Maternal Mental Health Leadership Alliance).
The pregnancy and post-partum periods may trigger new or exacerbate/complicate previous onsets of behavioral health conditions, including but not limited to:
Depression
Anxiety
Psychosis
Substance Use Disorders
Additional considerations when working with the perinatal population include:
Risk and Suicide
According to the Maternal Mental Health Leadership Alliance (MMHLA), suicide and overdose combined are the leading cause of death for women in the first year following pregnancy, with the peak incidence between 6-9 months postpartum. Assessing for risk and previous mental health or suicidal ideation or attempt history is valuable during these periods.
Diversity and Social Determinants of Health
Black women are twice as likely to experience maternal mental health conditions compared to white women, but half as likely to receive treatment (MMHLA). Race, as well as social determinants of health such as housing, education, and access to basic resources can be factors in the mental health and wellbeing of the perinatal population, as they affect quality-of-life outcomes.
Dads (fathers, spouses, partners)
Partners can also be impacted by the pregnancy and postpartum periods. According to the MMHLA, one in 10 fathers will experience postpartum depression or anxiety. Books, support groups, and other community resources exist for fathers or partners who may be struggling with mental health issues related to parenthood.
The Fourth Trimester
The Fourth Trimester refers to the first 3 months of a baby’s life, where both mom and baby experience a range of changes and transition; however, mothers often take a backseat with the newborn being the primary focus. Education and support can help shift this way of thinking to emphasize the continued importance of supporting the wellbeing of mom, as well as baby.
Screening and Assessment:
ACOG recommends ALL perinatal women should be screened for mental health conditions, as well as a comprehensive postpartum assessment that occurs within 12 weeks after birth. Some of the screening and assessment tools include:
Edinburgh Post-Natal Depression Screener
Interventions
Emphasize Self-Care- Emphasizing the importance of self-care can remind mothers to take care of themselves to promote healthy coping skills and wellness. Sleep, nutrition, exercise, and finding support people within their community can truly make a difference in mental health outcomes and well-being.
Identifying Social Supports- The postpartum period may feel overwhelming and lonely for many mothers. Helping mothers identify support people to assist with anything from household tasks to watching their baby or other children can help find the right amount of respite. If your patient is unable to identify supports amongst family and friends, check with community hospitals for support groups.
Refer to Mental Health Professionals- If symptoms or struggles persist, refer your patient to a Molina in-network mental health professional. Therapy and/or psychiatry may be necessary. Molina Healthcare encourages collaboration across disciplines to achieve person-centered treatment.
Provide Crisis and Suicide Prevention Hotline- It is important to be proactive to prevent a crisis from occurring. Provide your patient with information about the National Suicide Prevention Hotline. Call or text 1-800-273-TALK (8255).
Refer to Molina Case Management- Molina strives to improve birth outcomes and reduce the incidence of maternal and neonatal complications by providing pregnant Molina members, who have been identified with high-risk conditions, including behavioral health concerns, with individualized Case Management or Health Management services and care coordination. Members may be referred to and assessed for our High Risk Obstetric (HROB) program, which screens for high-risk conditions that may impact pregnancy and post-partum, and in collaboration with the member and practitioner(s)to provide any or all of the following services: comprehensive initial and ongoing assessment, individualized care planning, coordination of healthcare services, and education. These supports are designed to assist the member in achieving a healthy pregnancy, reducing complications, and delivering a healthy, full-term infant. During pregnancy and postpartum, Molina Care Managers will work with the member and their OB provider to facilitate urgent appointments if significant behavioral health symptoms or elevated assessment tool scores are found. The Molina Care Manager will facilitate rapid and appropriate treatment and care coordination and match Molina in-network providers with providers listed with Postpartum Support International. Reach out to the local Molina Case Management Team for more information or to refer.
Resources
For the complete American College of Obstetrics and Gynecologists Perinatal Mental Health Tool Kit, visit: https://www.acog.org/programs/perinatal-mental-health
Maternal Mental Health Leadership Alliance Fact Sheets: https://www.mmhla.org/factsheets/
National Maternal Mental Health Hotline: The National Maternal Mental Health Hotline provides FREE 24/7 confidential support before, during, and after pregnancy. 1-833-9-HELP4MOMS or 1-833-943-5746
PsychHub Education and Learning Available to You
Through our partnership with PsychHub, an online platform for digital mental health education, Molina network providers are able to access PsychHub’s library of educational courses and material at no charge. To create an account at no cost, please visit the Molina PsychHub landing page at https://resources.psychhub.com/molina . Create an account to find these and other relevant courses:
PsychHub Education and Learning Available to You
Through our partnership with PsychHub, an online platform for digital mental health education, Molina network providers are able to access PsychHub’s library of educational courses and material at no charge. To create an account at no cost, please visit the Molina PsychHub landing page at https://resources.psychhub.com/molina . Create an account to find these and other relevant courses:
