Delayed care during pregnancy and postpartum linked to poor maternal mental health: evidence in the United States

ABSTRACT

Background

Mental health disorders are important prenatal and postpartum health complications. In the rapidly changing healthcare landscape, concerns have been raised about maternal mental well-being in the United States. This study aimed to investigate the relationship between delayed perinatal care and women’s mental health during pregnancy and postpartum.

Methods

We conducted a cross-sectional survey from March through April, 2022, of women currently pregnant (n = 590) or one-year postpartum (n = 525). A generalised linear model examined the association of delayed care during pregnancy and postpartum with mental health outcomes, specifically Major Depressive Disorder (MDD) and Generalised Anxiety Disorder (GAD).

Results

Individuals who experienced delayed care tended to exhibit higher rates of mental health symptoms compared to those without delays, especially during postpartum (69.4% vs. 30.7% for MDD; 46.6% vs. 24.8% for GAD). The results from multivariable regression analysis were consistent, showing a greater prevalence of MDD (aPR [adjusted Prevalence Ratio] 2.25, 95%CI 1.82–2.79; p < .001) and GAD (aPR 2.00, 95%CI 1.53–2.61; p < .001), respectively, when delays in postpartum care occurred. Reasons for delayed care, such as financial and time issues, lack of transportation, nervousness about seeing a doctor, and rural residency, were associated with increased mental health symptoms.

Conclusion

The current analysis highlights the significant adverse health impact of delayed care among pregnant and postpartum women. Continued, targeted efforts to reduce practical barriers to accessing prenatal and postpartum care are required to ensure maternal mental health.

KEYWORDS:

• Delay in care
• pregnancy
• postpartum
• mental health
• disparities

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

De-identified datasets generated and analysed in the present study may be provided to researchers upon request to the study’s principal investigator, Dr. Jeffrey Howard (email: [email protected]).

Additional information

Funding

This study was funded in part by the Lutcher Brown Fellowship through the University of Texas at San Antonio (Dr. J. Howard).