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What are Perinatal Mood and Anxiety Disorders (PMADs)?

PMADS, OR PERINATAL MOOD AND ANXIETY DISORDERS, ARE ILLNESSES AFFECTING AT LEAST 1 IN 5 WOMEN/BIRTHING PEOPLE DURING PREGNANCY AND POSTPARTUM. PMADS CAUSE EMOTIONAL AND PHYSICAL PROBLEMS THAT MAKE IT HARD FOR WOMEN TO FUNCTION ADEQUATELY (I.E., CARE FOR THEMSELVES/BABIES/FAMILY).

Having a baby is one of the most exciting yet daunting times of a person’s life. Unfortunately, it is also when many women are at an increased risk for mood and anxiety disorders, such as depression and anxiety.

Why are PMADs important?

  1. 1 in 5 women experience a PMAD, and PMAD rates have risen as high as 70% during the pandemic.
  2. Up to 80% of cases go undiagnosed or untreated due to stigma, lack of awareness, and scarcity of specialized treatment options.
  3. Up to 40% of low-income women experience a PMAD in the perinatal period.
  4. 50% of PMADs develop during pregnancy.
  5. PMADs are the #1 complication associated with childbirth.
  6. PMADs are the #2 reason for maternal mortality in the U.S.
  7. Untreated PMADs can lead to poor mother/baby attachment and developmental delays in children.

Here are some facts to know about PMADs: 

Symptoms and signs:

  • Anxiety
  • Insomnia
  • Fatigue and lack of interest in things previously enjoyed
  • Lack of appetite and weight loss
  • Feeling guilty, worthless, or helpless
  • Lack of concentration or memory
  • Thoughts of death or suicide, or thoughts of harming the baby
WE KNOW TREATMENT WORKS, BUT 80% OF MOTHERS DO NOT RECEIVE CARE.

Many mothers still do not receive treatment due to a lack of understanding, poor referral systems, scarcity of specialized programs, and stigma around mental illness.

Risk factors for developing a PMAD:

  • History of mental illness (personal or familial)
  • Stressful life events and circumstances (finances, relationships, physical/sexual abuse, substance use, recent or unresolved loss, etc.)
  • Previous PMAD (50-75% chance of repeat)
  • Unplanned or unwanted pregnancy
  • Traumatic childbirth or NICU experience
  • A pandemic – isolation, lack of social support, managing high stress and anxiety levels.

What providers can do to support their patients:

  • Start talking to women about their mental health history before conception— provide information about risk factors.
  • Integrate PMAD education from the beginning, throughout pregnancy, and postpartum. Provide psycho-education when partners are present.
  • Integrate routine screening practices throughout pregnancy and postpartum. Deliver screens in the privacy of the examination room. When given to the patient to complete, ask that answers are as honest as possible so that proper care can be recommended.
  • Look your patient straight in the eyes and ask her how she is doing.
  • Use yourself if appropriate/ or offer PMAD story examples.
  • Offer resources/treatment referrals like The Motherhood Center.

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