It’s Time To Make Reproductive and Postpartum Care Accessible For All
Postpartum mental health and reproductive justice are public health issues that need to be addressed with accessibility in mind given alarming rates of perinatal mood and anxiety disorders and maternal mortality. So, during a time when the world is revealing the possibilities that technology and internet have to offer, it’s time to revolutionize birthing practices and finally make them about health, care, and equity.
Researchers with the UNC School of Medicine’s Center for Women’s Mood Disorders explain that depression is one of the most common pregnancy and postpartum complications. So, for new parents who live in a culture that glorifies thin bodies and stigmatizes mental illness, the chances of developing a perinatal mood or anxiety disorder are particularly high. According to a 2018 Black Women’s Health Imperative report, for instance, 20% of birthing people will develop a perinatal mood or anxiety disorder.
Moreover, 10% of birthing people experience postpartum anxiety (PPA), 1–6% of birthing people will experience postpartum post-traumatic stress disorder (PPPTSD), and 3–5% will experience some of the symptoms of postpartum obsessive-compulsive disorder (PPOCD) as reported by the American Pregnancy Association. And it’s not just something that birthing parents are at risk of developing.
In the United States, about 5–10% of non-gestational parents, namely fathers, will experience PPD, according to U.S. Centers for Disease Control and Prevention, and researchers urge doctors and therapists to screen all new parents after delivery to ensure that parents at risk are given the support they need. And a 2017 study published in Obstetrics and Gynecology Clinics of North America revealed that for LGBTQIA+ parents, the risk of developing PPD may be higher than other new parents due to minority stress and social factors. Often, these perinatal mood and anxiety disorders go misdiagnosed and overlooked.
Consider the 2016 Forbes article What If Physical Illness Were Treated Like Mental Illness? by Robert J. Szczerba that explained that “one of the most widely believed and most damaging myths is that mental illness is not a physical disease.” He then went on to describe the countless ways that this myth negatively impacts society, particularly when it comes to people who are living with mental illness in a society that often views mental health as something distinct from physical health.
When it comes to pregnant and birthing people of all gender identities, paternalistic thinking often impacts how they are treated with respect to interpersonal interactions, policy, and legislation. When it comes to pregnant and birthing people who are women, sexism and misogyny add even more layers to this situation. It’s time for a change. As Dara Purvis, J.D., professor of law at Penn State Law, urged in her 2017 article in the Tennessee Law Review, “the rules of maternity must be rewritten, from borders limiting the choices of individual mothers to principles respecting their autonomy.”
Additionally, though, legislation and policy related to pregnancy and parenthood must be rewritten as well. Postpartum checkups, that studies claim are vital for early diagnosis, need to be accessible to all which means that remote and in-home options must be available. Further, any checkups and appointments that can be done in-home should be an option for people who need it. In cities where medical professionals cannot make visits to patients in their homes, funding for accessible transportation services must be provided to families in need.
Also, as I stated elsewhere,
“Issues like undiagnosed pre-existing conditions, systemic and structural barriers to regular care, or lack of access to culturally respectful care, disproportionately impact Black pregnant people and mothers, and result in dramatically different experiences of being pregnant. The Harvard T.H. Chan School of Public Health reported that more than half of people who die while pregnant, or from preventable postpartum complications, are Black women. According to the CDC, pregnancy-related deaths impact Black women four times more than white women. And another study, published in 2007, revealed that “of five medical complications that are common causes of maternal death and injury, Black women were two to three times more likely to die than white women who had the same condition,” NPR reported.
An important aspect of quality care is preventative measures. In order to prevent complications, though, people must be seen, treated, and feel comfortable and safe to share what they are experiencing with transparency. For some, systemic racism and discrimination negatively impact their experiences before, during, and after birth. Aside from ensuring that diverse communities have access to the funding and mentorship needed to pursue and thrive in medical careers, adjustments to the existing system must be made to account for flaws in the historically racist and classist biomedical industry. Health and care must be prioritized instead of profit.
Pregnant and birthing people need access care and treatments that meet them where they are. Pregnant and birthing people deserve to feel safe and have their autonomy respected during every stage of these transformative experiences. Policy and legislation must reflect the varied needs of all pregnant and birthing people in a way that prevents vulnerable people from falling through the cracks. The lives, minds, and bodies of parents and their children depend on it.