The Mother of All…Gaps in Basic Maternal Care
In December 2024, The New York Times shared the disturbing results of a study focused on the accessibility of maternity care in the United States. Between 2010 and 2022, over 500 hospitals closed their maternity units; during the same time period, only 130 maternity units were opened (Kilff, 2024). After some quick math, that leaves the US with 370 less maternity units in 2022 than in 2010—a stark statistic that doesn’t even account for the unknown number of wards that have closed since the Supreme Court’s overturning of Roe v. Wade in 2022.
Why Maternity Units matter
Maternity units provide essential care for birthing people throughout the entire perinatal journey—from conception through delivery and beyond. And this care isn’t just medical, it’s also psychological. Maternity units are on the front lines of perinatal mental health care; they are the primary providers of perinatal mental health screenings, which help clinicians identify and address serious mental health concerns throughout pregnancy, birth, and the postpartum period.
In reflecting on the study’s results, its lead researcher remarked that there is a “severe maternal mortality crisis” (Kliff, 2024) going on, a description that aligns with the alarming fact that the U.S. currently ranks 64th out of 186 countries globally in maternal mortality rates (CIA, 2020). Given these sobering facts, one might expect national efforts to expand perinatal care access. After all, who doesn’t want more safe places for birthing people to receive care and give birth? Instead, as the study shows, the opposite is happening. Why?
The Hidden Maternal Mental Health Crisis
Sadly, I don’t know the answer. But considering the prevalence of perinatal mental health issues in the U.S., the closure of maternity units seems even more shocking (Maternal Mental Health Now & Department of Mental Health + UCLA Prevention Center of Excellence, 2023):
Perinatal depression is the number one complication of childbirth.
Suicide is the leading cause of perinatal-related deaths.
In Los Angeles County, one in four birthing people experience perinatal depression.
Among Black and Latinx communities, perinatal depression rates can reach as high as 60%.
More broadly, every single person on this Earth is affected by perinatal mental health—whether through our own experiences of becoming parents or through the experiences of those who birthed us. Given its universal impact, how could perinatal mental health not be one of our healthcare priorities?
The Consequences of Disappearing Care
Once again, I don’t know the answer. But, I do know that birthing people require care and support that is systemically being taken from them, with maternity wards being just one example of this. To make matters worse, this systemic reduction in care resources goes largely unnoticed by the general public! When maternity units close and resources diminish with no explanation or alternatives provided, birthing people often internalize blame for difficulties that actually stem from systemic failures. This self-blame can exacerbate perinatal mental health disorders, creating a troubling cycle where systemic barriers to perinatal care directly contribute to worse mental health outcomes.
This reality underscores why clinicians serving birthing people must understand how systemic factors influence their clients’ health and mental health. The perinatal period creates unique needs that deserve specialized care from providers with appropriate education and training.
Finding Hope and Support
Fortunately, there is a growing number of organizations and clinicians, internationally and locally, developing specialized expertise in perinatal health and mental health care. Specialized organizations, like Postpartum Support International and Maternal Mental Health Now (in LA), may provide:
Educational programs and resources about perinatal issues
Community-building opportunities for birthing people and their families
Connections to specialized perinatal care providers
Specialized therapists, like my supervisor and myself, can utilize our education and training to help birthing people and their families navigate the life-changing perinatal period, treat existing mental health concerns (both perinatal-related and otherwise), and prevent future mental health issues.
An Invitation to Birthing People
If you are currently pregnant or have recently given birth, I invite you to consider what unique supports you need during this transformative time. Then, I encourage you to seek those supports unapologetically—whether through resources in your own life or at the organizations highlighted here.
Should you find it challenging to identify or access the support required for your unique needs, therapy offers a safe, confidential environment in which to build these capacities and understand your barriers to them. You deserve comprehensive care during this critical life transition!
Resources
Maternal Mental Health Now: https://www.maternalmentalhealthnow.org/
Postpartum Support International: https://www.postpartum.net/
REFERENCES
CIA. (2020). Maternal Mortality Ratio - the World Factbook. Www.cia.gov.
https://www.cia.gov/the-world-factbook/field/maternal-mortality-ratio/country-comparison/
Kliff, S. (2024, December 4). Most Rural Hospitals have Closed their Maternity Wards, Study
Finds. The New York Times. https://www.nytimes.com/2024/12/04/health/maternity-wards-closing.html
Maternal Mental Health Now, & Department of Mental Health + UCLA Prevention Center of
Excellence. (2023, April 6). Perinatal Mental Health 101: What to Know. Wellbeing for LA Learning Center; Department of Mental Health + University of California Los Angeles. https://learn.wellbeing4la.org/detail?id=401103&k=1680819564
