41 percent of parents are often so stressed they can’t function. What do we do about it?

Pregnant women and new mothers are particularly vulnerable. In the United States, 1 in 5 women suffer from a mental health disorder in the months leading up to or following childbirth. According to the American Association of Medical Colleges, perinatal mental health disorders are the leading cause of maternal mortality in the U.S., accounting for 23 percent of such deaths. The rates among black and Native American patients are even higher. And 75 percent of people with PMH problems never receive treatment.

Next week, I’ll be addressing this topic at the Closing the Gaps in Maternal Mental Health Care conference, part of Globe Summit 2024, where I’m moderating a conversation with professionals on the front lines of women’s mental health. In the meantime, I spoke with one of those experts, Jamaica Plain-based perinatal psychotherapist Divya Kumar, about how to actually support mothers, all the time.

“We can’t understand anything about perinatal mental health, how it presents and how it expresses itself in people, without understanding the systems in which it occurs. When we think about making changes, we need to look at it from a public health perspective and understand that change can’t just happen in individuals, but it has to happen in communities and larger systems of government,” she says.

Here are excerpts from our conversation. More next week.

Where are we now? What is the background to all this stress? The Surgeon General just issued a warning, but: Does it do any good?

When I read that part, I thought, Great. I’m glad Dr. Murthy is bringing attention to this issue. And also that there was one short sentence in that article about the role of government in making a difference when parents are dealing with things like gun violence.

Two days later, there was a school shooting in Georgia. No kidding. We’re stressed because the government won’t ban guns. So when you talk about parenting stress: That’s fine, but it doesn’t matter unless you do something about it.

He talked about communities supporting each other, and I think that’s really important. If you want solutions, the government needs to pay for paid parental leave for all parents for at least six months. When we think about what people can do, I think it’s really important that they have an eye on systemic solutions.

Gun violence creates a constant, omnipresent cloud of worry. What else fuels our stress?

That’s a great question. I would say finances, lack of resources, lack of time. People are very pressed for time. Often they can’t make all the choices they want to make because of lack of resources and lack of time. That’s huge.

Then there are existential things like climate, gun violence, racism. I can’t talk about that without talking about racial trauma: I have clients who are Black women who had boys in the summer of 2020 and thought, “What’s going to happen to my son?”

And the trauma of the pandemic is real. I have clients who had babies in 2020 and 2021. They had babies at a time when they had no idea what health and safety would look like. They didn’t have access to community support.

What resources should people have?

Everyone needs to know about PSI, Postpartum Support International. Anyone can call: if you are a partner, if you are a survivor, if you are pregnant, postpartum, an adoptive parent, or if you have experienced loss. There are groups, literally, for everyone. The hotline is 1-800-944-4773. You can call or text and someone will call you back.

And the National Maternal Mental Health Hotline is free, 24/7. The number is 1-833-TLC-MAMA. There’s a live answering machine. Those are the two most important resources that everyone needs to have. And of course, call 988 if someone is in crisis.

My goal is for anyone who touches a pregnant person or a new parent to know about perinatal mental health resources, because perinatal mental health complications are the most common complications of pregnancy and childbirth. It’s everyone’s responsibility, just like many new parents tell each other, “This is where you check your car seat.”

If you’re pregnant and no one is screening you for perinatal mood and anxiety disorders, you can say to your obstetrician or midwife, “Hey, can we talk about perinatal mental health? What resources can you give me?”

My kids are almost 8 and 14. I am outside that window. But how can I be supportive? How can readers with kids who are a little older play their part?

I would put on my advocate hat here and check if you’re at the pediatrician’s office: Does the pediatrician’s office have PSI pamphlets? Do they have a maternal mental health hotline number? I think it’s really okay to ask the pediatrician at a routine child visit.

How can employers be helpful? When I say employers, I don’t just mean large organizations. I mean being the person who is the boss—who may forget or not know what it’s like to be pregnant or a new mom.

I think there’s only so much that individuals can do if the corporate system doesn’t support their choices. But I mean, be nice and be human. I can’t remember how many times I had to call in sick when my kids were babies.

If you as an employer have the ability to grant additional time off: Grant it. Don’t punish employees for not doing a good job because they’re exhausted. The whole system is setting us up for failure. How are you supposed to function when you’re 12, 15 weeks postpartum and falling asleep?

And that goes for moms of older kids, too. This is where you can chime in, not just at the pediatrician’s office, but also go to your HR: “Hey, what’s our paid family leave policy?” I’m always the agitator: “How can you get your workplace to have a better leave policy?” I hate to say it, but anything else is just a band-aid.

And finally, what else can we do — as people living in this world, trying to support others?

Ask someone how they really feel. If you know someone who has had a baby, ask the hard things: “Are you feeling okay? How do you really feel?”

Someone’s going to take all the bottles and diapers and everything, but (that’s great) if someone says, “Hey, do you want to talk honestly? Let me know.”

The interview has been edited and condensed.

Kara Baskin can be reached at [email protected]. Follow her @kcbaskin.