Depression is one of the most common mental health conditions worldwide, and pregnancy increases the risk of developing it. Yet, many pregnant women may not be getting the care they need, according to new research from McGill University, Stanford University, and the University of Chicago Booth School of Business.
The study analyzed private insurance claims from over 385,000 women from two years before pregnancy to two years after childbirth. Researchers tracked how often women filled prescriptions for antidepressants and attended psychotherapy sessions, revealing key trends in mental health care use.
Before pregnancy, about 4% of women had filled prescriptions for antidepressants. But during pregnancy, this number dropped by nearly half. Psychotherapy visits also declined, showing that most women did not substitute medication with therapy. Interestingly, their spouses did not show a similar change in mental health treatment patterns, suggesting that the decline was tied directly to the pregnancy experience.
After giving birth, antidepressant use increased to levels even higher than before pregnancy. However, the researchers caution that restarting treatment after childbirth may not be enough. Because antidepressants take time to work, this gap can leave new mothers vulnerable during the critical postnatal period when depression risk remains high.
The decline in treatment may stem from fears about medication safety during pregnancy. While some studies have explored potential risks to the fetus, the evidence remains limited. Still, concern persists, potentially leading women to pause treatment during pregnancy, despite continuing it before and after.
Medical guidelines from the American College of Obstetricians and Gynecologists (ACOG) recommend therapy, antidepressants, or both for treating depression during pregnancy. They do not suggest that women already on antidepressants should stop taking them. Instead, the guidelines promote a personalized approach to treatment through shared decision-making between women and their healthcare providers.
The researchers emphasize the importance of open discussions and informed choices about mental health care during pregnancy. Their findings point to a significant treatment gap that could have lasting effects on both mothers and children. Boosting awareness and support for pregnant women with depression is essential to ensuring better outcomes for families.
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