A recent study published in Pregnancy reveals that individuals living in urban areas of the United States with postpartum depression or anxiety are less likely to receive pharmacologic or psychotherapy treatment compared to those residing in rural areas.
Despite a higher prevalence of chronic disease and poverty in rural regions, which also show higher postpartum depression rates, urban patients face lower treatment rates for these conditions.
The retrospective study analyzed data from the IBM MarketScan database, covering insured women aged 13 to 50 who gave birth between 2011 and 2020 and were diagnosed with postpartum depression or anxiety within 12 months after delivery.
Among the 181,185 participants, 88% lived in urban areas. Key findings show only 55.1% of urban residents with postpartum depression or anxiety received any treatment within a year postpartum, compared to 59.4% in rural areas.
When broken down by treatment type, 31.8% of urban patients received medication alone versus 39.6% in rural areas, while psychotherapy-alone rates were similar in both groups (44.8% urban, 46% rural).
The reduced odds of urban patients receiving treatment were mainly driven by lower pharmacologic treatment rates. Time from delivery to first prescription fill was also slightly longer in urban areas, though not significantly.
These findings highlight treatment disparities, underscoring an urgent need for improved postpartum mental health care access and follow-up in urban settings. Investigators emphasize many individuals with postpartum depression go untreated, likely underestimating gaps.
They call for targeted efforts to understand and bridge urban–rural differences to ensure all mothers receive timely and effective mental health support.
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