Maternal Mental Health: Personal Reflections and Professional Insights

By: Shelly Bohmert, MA LADC LPCC; Director of Mental Health

Maternal mental health is often discussed within the mental health community but remains less recognized by the general public. What is it about associating “mental health” with pregnancy, childbirth and postpartum that makes it feel unrelated?

Maternal mental health conditions, as reported by the Maternal Mental Health Leadership Alliance, are the most common complications of pregnancy and childbirth, affecting 1 in 5 mothers. These conditions can include depression, anxiety, obsessive-compulsive disorder, PTSD, bipolar illness, psychosis, and substance use disorders. Untreated maternal mental health conditions can lead to long-term negative impacts on mothers, babies, and families. [Policy Center for Maternal Mental Health, 2025].

What does this mean? In the United States, this means that approximately 1 in 5 mothers will experience a maternal mental health condition, impacting around 800,000 families each year This equates to approximately 800,000 families per year that will be impacted. Postpartum depression diagnosis rates have increased from 9.4% in 2010 to 19.0% in 2021. Granted some of that rise can be equated to the COVID-19 pandemic which isolated all of us and provided barriers and additional hurdles in pregnancy and postpartum. [Policy Center for Maternal Mental Health, 2025; Policy Center for Maternal Mental Health, n.d.].

What else? Did you know that suicide and overdose are the leading causes of death for women in the year following pregnancy. It is believed that approximately 75% of women who are impacted by a maternal mental health condition remain untreated. Additionally, the approximate cost of not treating MMH is $14 billion each year in the United States alone. [Policy Center for Maternal Mental Health, 2025].

So what is it? Society often describes the postpartum period as ‘the baby blues,’ suggesting it’s ‘no big deal’ and that women will ‘grow out of it’ as they adjust to motherhood. What you may not realize is that maternal mental health is more than “baby blues” and can include that, and then some. They can include depression, anxiety, obsessive-compulsive disorder, post-traumatic stress disorder, bipolar illness, psychosis and substance use disorders. [Policy Center for Maternal Mental Health, n.d.]

Myth: Only those with preexisting mental health conditions are at risk. This is false. Data provided by The Policy Center for Maternal Mental Health indicated that 40% of women studied developed symptoms following childbirth and 33% developed symptoms during their pregnancy. Only 27% entered their pregnancy with symptoms of anxiety and/or depression. So, while having a preexisting mental health condition can be a predictor for experiencing maternal mental health, it is not the only one.

Is the development of a maternal mental health condition the mothers fault? Absolutely not. Research has shown that these conditions are impacted by a combination of bio-psycho-social factors. Simply put, everyone’s biological makeup can be different and impacted by the hormonal changes in pregnancy and postpartum; the changes and adjustment impact everyone differently; socially it can be all over the board – isolating, stressful, changes in job, home, etc.

So what happens if we leave MMH conditions untreated? Women who experience untreated conditions during pregnancy are more likely to experience poor prenatal care and are more likely to experience some type of abuse [physical, emotional or sexual]. Women who experience untreated conditions postpartum are more likely to experience hurdles and struggles in connecting with their baby, less responsive to baby cues and question their overall competency as a mother. Additionally, we know that some of the most important developmental and attachment years are in our early childhood. So not only should we be mindful of how this could impact the mother, but there is an impact to the child additionally. Impaired parent-child interactions can lead to adverse childhood experiences, potential developmental delays/concerns and ruptures within the family system.

Why do some women not talk about how they feel? Anyone who has been to a OB appointment knows about the “screening” tools they use, whether it’s the GAD-7 for anxiety or the PHQ-9 for depression, they are providing a brief screener. But does anyone look at that form or ask any follow up questions? It is easy to write down that everything is fine, but often it is our nonverbals that will give away how we truly feel. Stigma is a significant barrier for women accessing care. Not only experiencing stigma within the healthcare system but within our support system and family. Many of us experiencing motherhood currently or entering motherhood have grown up with older family members with the mentality of “don’t be so emotional” or similar. I would guess that many of us with that experience may not feel overly comfortable going to those same family members or support system and asking for help or stating something is wrong. Mothers are ingrained to have this fear of being considered a “bad mom”. This has only been made worse in the age of social media with Facebook, Instagram, etc. Honestly, some of the least helpful and “mean” people that I have personally experienced in my parenting journey, have been other mothers in “support” groups on Facebook. Yes, read that again. I have found the least supportive people and/or the harshest critics to be other mothers.

Additional barriers include:

• Social bias within our healthcare system
• Logistical challenges [lack of transportation and/or childcare]
• Fear of social services being involved
• Racial, cultural and/or religious beliefs

Mothers who are individuals of color and/or individuals of low income are the least likely to access care and some of the most likely to experience maternal mental health.

What does treatment look like? It can include the following components

• Self-Care:
  • Encouraging mothers to get basic needs met like sleep, nutrition, interaction with others.
  • Helping mothers get basic movement in [a light walk], time outside and just time with oneself.
• Support from Others:
  • Support new mothers by providing emotional support, support by just sitting with them, offer to take things off their list like laundry, groceries, cooking, etc.
  • Yes we all want to support by taking the baby, but often that is not what the mother needs at that time.
• Therapy:
  • Therapy is focusing on both symptom relief and coping skills.
  • It can be helpful to seek out a therapist/provider who has perinatal mental health training to ensure they have additional training and qualifications.
• Medication:
  • Medications exist that are safe to take when pregnant, nursing, etc.
  • Best to consult with both an OB and a psychiatric provider.
• Specialized Treatment:
  • In MN we are lucky to have specialized programs to support mothers when the above is not providing relief. [Source: NAMI MN].
    • PrairieCare offers specialized Psychiatric Care and an Intensive Outpatient Program (IOP) to support and empower pregnant and postpartum women with children ages 0-5.
      • Psychiatric Care is provided by board certified perinatal psychiatrists.
    • Hennepin HealthCare Mother and Baby Program (Redleaf Center)
    • Nystrom & Associates Mother Baby Program
    • Mental Health Systems: Perinatal Dialectical Behavior Therapy Program
• General Resources
  • HRSA National Maternal Mental Health Hotline
    • Call or text 1-833-TLC-MAMA (1-833-852-6262)
    • Culturally sensitive support offered in English, Spanish and with interpreter services for 60 languages.
  • Pregnancy & Postpartum Support Minnesota (PSI-MN)
    • Call or text 1-800-944-4773 (Text en Espanol: 971-203-7773)
    • Can help provide access to online support meetings [Free!]

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Personal Reflection:

Maternal mental health is a topic of particular interest to me, not only because of its importance but also because I have personally experienced. My children are now four years old, but I still experience lingering symptoms that I continue to cope with and learn to manage. In my opinion, no one goes into pregnancy fully prepared, and I certainly was not prepared in 2020. The world was struggling with the daily changes of do we isolate, can we go outside, just all the things. Learning that we were expecting was both an exciting but intimidating experience, especially as I was alone in the doctor’s office with my husband on facetime due to covid precautions. Learning that we were having twins also made it more of a journey. During my pregnancy in late 2020 and early 2021, I had over 16 ultrasounds, and my husband was able to attend only three of them.

He wasn’t able to attend in person to the OB checkups so it was a fairly isolating experience. When it came time to have them and navigating wearing a mask or not wearing a mask, no visitors and all of the precautions and restrictions, it added additional layers for a new mother [with pre-existing anxiety for note]. In the days following their arrival it was evident that something was “off” for me; I knew that I wouldn’t feel myself as there was so much going on and so many changes, but the way that I was beginning to fixate on the twins and would feel a spike in my emotions if I didn’t see them or someone else had them, I knew something was off. Additionally I was finding that I was checking on them constantly, whether during nap/sleeping, how they were buckled, laying, everything. I knew as a mental health clinician that something was off with my mental health and it was more than the typical emotional/hormonal reset.

After several appointments, I was diagnosed with Postpartum Obsessive Compulsive Disorder (Postpartum OCD). I recall that appointment being both a sense of relief but also a gut punch as my thoughts were “how am I going to face people”, “people will judge me now for this” and all sorts of other negative self-talk. However, what I have learned since that time in April 2021 is that if I let people support me, the good ones will show up. I avoid those mom Facebook groups, which is also probably good for my amazon budget, and rely on support and advice from people in my life that I trust, admire and care for. Now in May of 2025, just over 4 years later, I feel clarity more often than not, my symptoms are minimal and fairly maintained but I am mindful of what spikes them and grateful for the ability to work through them. I have learned not to be ashamed of my journey, and looking back, I truly wish I had sought out additional resources during that first year postpartum.

Today, in my practice as both a supervisor and clinician, I emphasize the importance of understanding maternal mental health and the resources available to support it. Reflecting on my journey, I feel grateful for the privilege of having access to the care and support I needed. My hope is that as a society, we can continue to normalize discussions about how women truly feel during pregnancy and postpartum, ultimately reducing these statistics. The first step is to begin having those conversations within your social groups and not being afraid to be that emotional support or guide for someone in your life. As with most challenging mental health conversations, the first step is to look at those in your life and show up for them.

In Closing:

Maternal mental health is a crucial aspect of overall well-being that deserves attention and support. My journey has shown me the importance of seeking help, embracing support, and advocating for better resources. As we continue to raise awareness and normalize conversations around maternal mental health, we can create a more compassionate and supportive environment for all mothers.

Remember, you are not alone. Whether you are a mother experiencing these challenges or someone who knows a mother in need, your support and understanding can make a significant difference. Let’s work together to ensure that every mother has access to the care and resources she needs to thrive.

If you or someone you know is struggling with maternal mental health, don’t hesitate to reach out for help. There are resources available, and seeking support is a sign of strength. Together, we can build a community where maternal mental health is prioritized and supported.

And as always, feel free to reach out to our Mental Health Clinic, where we can provide anything from an initial triage assessment to individual, family, and couples therapy—supporting you and your loved ones through the season and beyond.

Reach out to our Central Access Team at (952) 956-3100 or submit a mental health inquiry on our website. A member of the mental health team will be in touch to guide you through the process and provide the support you need.

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References:

• [1] Policy Center for Maternal Mental Health, “Mental Health Fact Sheet: 2025 Update,” Policy Center for Maternal Mental Health, 2025. [Online]. Available: https://policycentermmh.org/mental-health-fact-sheet-2025-update-mmhweek/. [Accessed: 08-May-2025]
• Format: [1] Policy Center for Maternal Mental Health, “Maternal Mental Health Fact Sheet,” Policy Center for Maternal Mental Health, n.d. [Online]. Available: https://policycentermmh.org/maternal-mental-health-fact-sheet/. [Accessed: 08-May-2025].