Verified by 
Key points
- Perinatal mental health received national attention in 2024.
- Research continues to demonstrate the significant mental health impacts of parenting.
- The past year saw continued promising trends in the treatment of postpartum depression.
This year there were several victories in terms of perinatal mental health receiving attention at the national level. As such, I look forward to seeing the future impacts on research, prevention, and treatment.
Research, Policy, and Funding
Following initiatives launched in 2023, an executive order was signed in March of 2024 to expand research and funding for women’s health and healthcare across the lifespan, which will include the pivotal pregnancy-postpartum continuum. As a result, the National Institutes of Health (NIH) will support women’s health research and policy to improve the prevention, diagnosis, and treatment of diseases and conditions, such as postpartum depression (PPD), which affects up to one in eight women.
National attention continued to shine a spotlight on this area when the Office of the Surgeon General dedicated a Surgeon General’s Advisory to Parental Mental Health and Well-Being. The public statement called attention to the stressors that impact the mental health and well-being of parents and caregivers, the critical link between parental mental health and children's long-term well-being, and the urgent need to better support parents, caregivers, and families. I covered this advisory earlier in the year in a dedicated blog post, which can be found here.
A specific policy to pay attention to as it unfolds is the MOMS Who Serve Act. This bill to support military mothers was passed on December 18, 2024. The MOMS Act will provide mental health support for service members before and after giving birth by integrating evidence-based maternal and pediatric programs into the military healthcare system. This is an important step in the prevention and treatment of this population, which has demonstrated maternal mental health conditions at two to three times the rate of their civilian counterparts.
An important continued shift in pregnancy-related healthcare coverage comes from the Centers for Medicare & Medicaid Services (CMS), who released a letter this year to supplement a 2021 letter—"Improving Maternal Health and Extending Postpartum Coverage in Medicaid and the Children's Health Insurance Program." There are new options for states to provide 12 months of postpartum coverage. This is significant because Medicaid covers around 4 in 10 births, and low-income mothers are at a greater risk for PPD, with reported rates as high as 40 percent to 60 percent. At present, 47 states, including DC, have implemented the 12-month extension!
Lastly, I will share a study that caught my attention and the attention of many people in the maternal mental health space. USC Dornsife Center for the Changing Family partnered with The Fair Play Policy Institute to conduct one of the few empirical studies on cognitive labor, also known as the mental load. The mental load is the invisible mental work involved in managing a household and family (e.g., planning, organizing, anticipating, delegating, following up, etc.). Unlike physical execution tasks, due to the invisibility of the mental load, it is difficult to recognize and measure.
In the new study, they found that mothers consistently shoulder more household responsibilities than their male partners and that the burden of cognitive labor was even more gendered than physical labor. In other words, cognitively demanding, child-related tasks (e.g., kids’ healthcare, tidying, packing kids’ backpacks) were shouldered disproportionately by mothers. Of further significance, the researchers found that mothers who reported a greater share of cognitive labor had increased depressive symptoms, stress, burnout, and lower relationship quality.
Screening and Treatment
Last year, the first oral medication specifically meant for treating postpartum depression (PPD), Zurzuvae, was approved by the FDA and became available to the public. While it showed promising results in providing quick and effective treatment for PPD, there were major barriers to access due to a lack of insurance coverage.
Six of the largest insurers have published coverage policies, and most state Medicaid programs are largely covering Zurzuvae without restrictions. As a result of the effectiveness of Zurzuvae and increased access, the first medication (Zulresso or brexanolone) that was developed in 2019 for the treatment of PPD will be discontinued due to its more difficult method of delivery (i.e., administered as a continuous intravenous infusion > 60 hours at a certified facility).
