Maternal Mental Health is in full crisis mode. The two leading causes of death after a baby’s birth may shock you.

Suicide and drug overdose are two leading causes of death during postpartum.

Postpartum is the timeframe right after the baby is born that lasts several weeks until the mother’s body has returned to its pre-pregnancy state. However, some experts say that the postpartum period can last up to 12 months (or even longer) after the baby is born and often include multiple medical, physical, and emotional issues associated with this period. Needless to say, it can be a very stressful time. Then throw in massive sleep deprivation and adjustments to caring for a little one, and you can see how difficult it can be. Maternal clients of mine often talk about how isolating and helpless those postpartum months are following the birth of the baby.

I’ll talk more about how stigma is a leading factor in all of this in just a moment.

You can read more about maternal suicide and postpartum in the U.S. here. For our families and society, this is a staggering wake-up call! ☎ The report reviewed risk factors of maternal suicide, which included a prior suicide attempt, a prior mental illness, lack of social support, family conflict, and others. No matter how you view this issue, it’s a really bad sign that many of our moms are not OK.

And that’s just the half of it.

Dr. Vivek Murthy, the former U.S. Surgeon General, produced an advisory report (2024) entitled, Parents Under Pressure. You can read the full report here. He concluded that parental stress is a national health crisis. He found that 41% of parents feel so stressed they are unable to function while 48% of parents feel completely overwhelmed compared to 26% of other adults.

So this crisis includes fathers, too. I will write more about dads in a future edition.

Back to moms.

Another report published in JAMA’s Internal Medicine journal shows that the “excellent” mental health of mothers (cross-sectional sample of 198,417 mothers) significantly declined while “poor/fair” mental health of mothers increased between 2016 and 2023. Further, rates of postpartum mood and anxiety disorders are rising for mothers and are often undiagnosed. According to the University of Kentucky, nearly 80% of these postpartum cases involve mothers who didn’t receive timely mental health care. Mental health stigma is correlated with not getting help.

Our society loves to tell mothers how important they are, and I agree.

Mothers are the single most important group of people on the planet.

They are important to our families, to our children, and to our mental and spiritual health as a society. ❤ There’s so much more I could say about that.

And yes, they remain the most important people to athletes when looking into the camera. 🏈⚾🏀🎥

I like this take on why mothers are important: Top 10 Reasons Why Moms Are Important | Psychology Today. And that view only scratches the surface!

It’s not lost on me that hearing about the importance of mothers may be difficult for some women. Maybe they didn’t grow up with a mother presence in their lives. Or maybe they had a mother, but it was a strained relationship. Maybe their mom walked away and never returned home. I become reminded of these realities whenever Mother’s Day comes around. This topic can also be a difficult reminder when some want to be a mother more than anything else in the world but can’t.

Cultural Stigma, Secrets, & Sickness

Social pressure and cultural expectations about motherhood abound which fuels stigma. And that pressure lasts well beyond postpartum. This is usually how part of the conversation goes:

“Be strong like a rock,” they say. “Be grateful…Motherhood means always being joyful.” That’s why mothers stay silent feeling guilt and shame about their need for help. Stigma enhances the secrecy and shame of it all. I’ve heard many of my maternal clients reference this kind of conversation more times than I can count in 22 years of working in mental health.

You’re only as sick as your secrets, a saying that is often attributed to Alcoholics Anonymous. And I think that’s true here, too. By staying secret and silent in suffering due to social/societal/familial stigma, which prevents a mother from speaking up, it only perpetuates the cycle.

Stigma Doesn’t Impact Everyone Equally

For Black, Latina, Indigenous, and other underserved groups, the stigma is even heavier. A 2023 report shows that Black mothers are significantly more likely to be hospitalized for perinatal mental illness — and yet they often report feeling unseen or stereotyped by providers. Seeking mental health help is still viewed as weakness or failure for many cultures. Maven Clinic’s research further highlights how this stigma compounds the crisis: women face both external judgment and internal guilt, creating a chokehold of silence.

What is Maven Clinic? I Recommend!

If you have never heard of Maven, I highly recommend them as a resource. They are the largest online women’s healthcare & infertility clinic and provide resources and mental health support for mothers and families. They are a very big deal in the infertility treatment & healthcare space. You can learn more about Maven and their resources here.

Our Societal To-Do List

I know, I know. I said I would only give you one thing to do as a takeaway, but here’s four. I’ll do four just this once…maybe. 🤞

- Places of faith should be a vital community resource once again. Maternal mental health should not only be an individual problem. It’s a social responsibility. Churches, temples, mosques, and other places of faith used to be the hub or community center where people received help in time of need. Some still are that very thing, but it’s probably more an exception than the rule. If you belong to a place of faith, talk to leadership about starting a support group for mothers for starters. Respond to this email if you want other ideas! I read and reply to each email.

- Fund mental health care as an American right, not a privilege. Stop treating mental health treatment as an optional luxury only. I haven’t always believed that healthcare (and mental healthcare) should be a standard right of every American, but the older I get, the more I’m a believer in this idea. By having that as a right for every citizen, it crushes the stigma surrounding mental health and will improve access to care at the same time. Reach out to your legislative representatives and ask that they co-sponsor a new bill for maternal mental health. Again, if you need guidance about how to do that, email me and I will assist.

- Check your language when talking to moms. Reminds me when a friend used to say, “Check yourself before you wreck yourself!” Or may I add, wreck someone else. Whatever you do, don’t go saying I’m the free speech police, 👮‍♂️ because I’m not telling you what to say and what not to say. However, “Be strong” sounds encouraging to some, but for others it can become a muzzle. Be mindful of how your communication lands.

- Ask, “How are you really doing?” By asking it this way, it gives permission to the person to provide real answers outside of the expected social reply “I’m fine” and creates an environment for more authentic dialogue. Compassionate authenticity shines light on the darkness of shame and silence and provides a way out of it. Encouraging authenticity is a surefire way to reduce the stigma of the hidden.

Thanks to all of you who have joined me in this newsletter journey. We are growing nearly every day! If you’ve made it this far and haven’t done it yet, be sure to hit that subscribe button above!

Until next week, come back…be here.

Keith