Public Policy Expert Shares Her Top 10 Must-Reads in Maternal Mental Health
This list of must-reads was curated by MMHLA’s Executive Director, Adrienne Griffen. Adrienne holds a Masters in Public Policy from Harvard’s Kennedy School of Government and has over two decades of experience working in the maternal mental health field. Her lived experience with postpartum depression fuels her work as a peer supporter, educator, and advocate.
When I experienced postpartum depression 23 years ago, there was very little information about maternal mental health available publicly. In the days before online shopping, it took several trips to the library and local bookstores to find a book – This Isn’t What I Expected: Overcoming Postpartum Depression – to help me understand what I was experiencing and how I could recover.
Today, new studies, research, stories, and books are seemingly published every day, and they are continuing to elevate the urgency around this issue. These 10 pieces of work included here are my “must-reads” from 2024. Of course many pieces of work were valuable to the field, but these are the articles and studies I refer to often; in fact, they are bookmarked on my computer and printed out in a stack on the side of my desk so I can access them easily.
This collection offers a great place to start for individuals working in the field of maternal mental health, including policymakers, providers, and people with lived experience, especially in their role as advocates.
JOURNAL
1 | Health Affairs Journal on Perinatal Mental Health & Well-Being
April 2024 | Health Affairs | Learn More
Health Affairs is the leading, peer-reviewed journal of health policy thought and research. Health Affairs articles are cited by thought leaders, policy analysts, and administration officials both in the United States and around the globe. Members of Congress from both sides of the aisle reference Health Affairs in drafting legislation.
In April, Health Affairs published a volume of studies entitled Perinatal Mental Health & Well-Being. In this volume, experts in this field offer seven policy proposals “designed to advance perinatal mental health for all people, especially those living with trauma, inequity, and barriers to care.” This is the second Health Affairs volume focused on perinatal mental health; it follows a previous collection of studies from October 2021 (LINK).
I found the studies published in this volume to be groundbreaking and insightful, especially the study titled Rates of Perinatal Mood and Anxiety Disorders (PMADs) in the U.S. Increased 93 percent in 12 Years (2008-2020), which found that prevalence rates for perinatal mood and anxiety disorders (PMADs) almost DOUBLED from 2008 to 2020.
Whether you work in direct patient care or in policy, these studies will give you valuable perspectives and solutions to some of the most pressing problems we face in maternal mental health.
REPORT
2 | Maternal Mental Health State Report Cards
May 2024 | Policy Center for Maternal Mental Health | Learn More
The Policy Center for Maternal Mental Health recently released their 2024 Maternal Mental Health State Report Cards, identifying key data sets and tracking results by state.
The key data sets — conceived by the Policy Center — include information about providers and programs, screening practices and reimbursement, and insurance coverage and treatment payment.
The good news? The overall national grade improved slightly from a D to a D+ as state grades inched upwards. In addition, 34 state grades improved: 4 states earned Bs (an increase from 1 state in 2023); 5 states earned failing grades (down from 15 states in 2023).
REPORT
3 | The National Task Force on Maternal Mental Health Issues Report to Congress and Strategy to Improve the Health and Well-Being of Childbearing People
May 2024 | U.S. Department of Health and Human Services | Learn More
The National Task Force on Maternal Mental Health — comprised of over 100 members representing the federal government, non-profit organizations, private companies, and individuals with lived experience — began meeting in September 2023 and published two important works in May 2024.
The first is a Report to Congress, which details the Task Force’s findings on maternal mental health conditions and substance use disorders in the United States, related federal programs, and best practices for addressing these issues.
The second work is The National Strategy for Improving Maternal Mental Health Care, which outlines recommendations that focus on ways to improve the prevention, screening, diagnosis, timely referral and intervention, and access to care and other supports for maternal mental health conditions and substance use disorders.
I have had the privilege of participating in The National Task Force on Maternal Mental Health, and I am so impressed with the dedication of all the Task Force members who are working hard to operationalize the recommendations so that the Report to Congress and National Strategy have the impact our nation’s mothers and childbearing people need and deserve.
REPORT
4 | Pregnancy-Related Deaths: Data From Maternal Mortality Review Committees in 38 U.S. States, 2020
May 28, 2024 | Centers for Disease Control and Prevention | Learn More
The Centers for Disease Control and Prevention (CDC) provided updated information about maternal mortality rates based on data from Maternal Mortality Review Committees (MMRCs), which are multidisciplinary teams that convene at the state or local level to comprehensively review deaths during or within one year from the end of pregnancy (pregnancy-related deaths). Learn more about MMRCs HERE.
Data on 525 pregnancy-related deaths from 38 states during 2020 were reviewed. The report concludes that mental health conditions were the overall leading cause of maternal mortality, accounting for 115 deaths or 22.5% of pregnancy-related deaths. Mental health conditions include deaths of suicide, overdose/poisoning related to substance use disorder, and other deaths determined by the MMRCs to be related to a mental health condition, including substance use disorder.
Other leading causes of death include cardiovascular conditions, infection, and hemorrhage. Of note, different racial and ethnic groups have different leading causes of death.
ARTICLE
5 | What Do We Really Know About the Maternal Mortality Crisis? How a measurement change fueled a crisis narrative.
August 6, 2024 | The Atlantic | Learn More
As we know from the CDC report above, the United States is in the midst of a maternal mortality crisis. Our nation’s maternal deaths doubled in just 20 years (from 1999 to 2019), even as maternal mortality rates in other industrialized nations were declining.
Scores of articles have been published about the worsening maternal mortality rate in the United States, especially for Black women and other women of color.
This article looks at the rising maternal mortality rate from a new perspective: it suggests that the increase is due in part because of measurement changes, including the implementation of a “pregnancy check box” on death certificates.
As the United States continues to experience unacceptable rates of maternal mortality, it is important that researchers and public health professionals understand clearly the factors that are contributing to these rates.
STUDY
6 | Brain Changes Observed During Pregnancy
October 1, 2024 | National Institutes of Health | Learn More
Researchers have observed brain changes before, during, and after pregnancy by collecting 26 magnetic resonance imaging (MRI) scans in a first-time mother. The scans covered the period from three weeks before conception through two years after giving birth.
Here is what researchers observed: The MRIs showed that the woman’s brain underwent changes on an almost weekly basis during pregnancy.
This supports the idea that pregnancy is a period of high neuroplasticity – the capacity of networks of neurons in the brain to adapt and reorganize. The results reveal pronounced shifts in regions throughout the brain and provide the first detailed map of the human brain during pregnancy.
And we thought “mommy-brain” was all in our heads! Turns out — it is!
ARTICLE
7 | She Had Thoughts of Harming Her Baby. To Treat Her, Doctors Kept Them Together.
October 9, 2024 | The New York Times | Learn More
Mother-baby units (MBUs) are specialized psychiatric units created to treat women experiencing severe mental illness during and following pregnancy, allowing mother and baby to stay together during treatment.
This article provides an inside look at MBUs and how they prioritize treatment for women (and their babies) who experience serious mental illness such as psychosis and bipolar disorder.
The United Kingdom launched the first MBU in 1948 and now has 22 such units in England, Scotland, and Wales.
How many MBUs exist in the United States? ZERO.
Perhaps if our country had MBUs we might have fewer tragedies like the Lindsay Clancy case (see below).
We continue to be perplexed as to why our nation’s medical and legal systems continue to prevent MBUs from being established in the United States.
ARTICLE
8 | A Husband in the Aftermath of His Wife’s Unfathomable Act
October 14, 2024 | The New Yorker | Learn More
In January 2023, Lindsay Clancy — a well-educated, middle-class, married, White woman, who lived in the Boston suburbs, and worked as a labor and delivery nurse — took the lives of her three young children and then attempted suicide. She is now paralyzed from the waist down and is awaiting trial for murder.
This article does an excellent job describing the nuances and complexities of severe postpartum mental illness, including postpartum psychosis. The article focuses on Lindsay’s husband, Patrick, who says, “I wasn’t married to a monster…I was married to someone who got sick.”
In many other countries, including those in Europe, women who commit crimes in the first year postpartum receive psychiatric care rather than prison sentences. Again, the United Kingdom is out in front on this issue, having passed a law in 1938 that recognizes the mental health of the mother as a unique factor in cases of infanticide.
Here are two other recently-published journal articles on postpartum psychosis:
Postpartum Psychosis, Two Sides of the Story features a firsthand account of postpartum psychosis by Meghan Cliffel along with the clinical perspective shared by reproductive psychiatrist Dr. Susan Hatters Friedman.
The Criminalization of Women With Postpartum Psychosis: A “Call for Action” for Judicial Change is written by Susan Benjamin Feingold (psychologist) and Barry Lewis (attorney), the team that helped pass ground-breaking legislation in Illinois to consider maternal mental health as a factor in cases of infanticide.
PAPER
9 | Illinois Experts Develop a Maternal Health Toolkit for Emergency Department Education
November 2024 | Women’s Health Issues | Learn More
The Illinois Maternal Mortality Review Committee (MMRC) found that the majority of people who died while pregnant or within one year postpartum visited the emergency department. In response to these findings, the Illinois MMRC recommended improving emergency department provider education, care guidelines, and best practices. (Learn more about MMRCs HERE).
The result was The Maternal Health Emergency Department Toolkit, produced by an interdisciplinary task force who identified existing resources and developed new content to address the gaps in maternal care.
This study details the Toolkit components and reports the findings from the Toolkit development process to help other organizations who want to produce similar toolkits.
REPORT
10 | Nowhere to Go: Maternity Care Deserts Across the U.S.
November 2024 | March of Dimes | Learn More
Where you live matters when it comes to the options available for maternity care. The March of Dimes updated their Maternity Care Deserts Report in 2024 showing that over 35 percent of counties are considered maternity care deserts, meaning that there is not a single birthing facility or obstetric clinic.
Furthermore, data shows that women living in these maternity care deserts have poorer health before pregnancy, receive less prenatal care, and experience higher rates of preterm birth.
According to the March of Dimes, these findings show that U.S. systems, policies, and environments are failing moms and babies.
Other articles you may enjoy
The Top Maternal Mental Health Articles of 2023
2025 Maternal Mental Health Conferences
Overview of the National Institutes of Health Roundtable on Maternal Mental Health Research
