Digital mental health for postpartum women: perils, pitfalls, and promise

Abstract

Postpartum mental health conditions are a public health concern, affecting a large number of reproductive-age women and their families. Postpartum depression alone affects at least 14% of new mothers and their families. However, very little has been written about how advances in digital mental health can benefit women in the postpartum period, or how those advances may poorly serve this vulnerable population. This manuscript takes a high-level view of the advances in different areas of digital mental health, including telehealth, apps, and digital phenotyping. In this comment, we explore ways in which digital interventions for postpartum mental health may help with connection to treatment, accessibility, agency, and ease of access. We also note particular concerns for how digital postpartum mental health may encounter issues of low-quality resources, ethical considerations, and equity considerations. We provide suggestions for how to leverage the promise and avoid the pitfalls of digital mental health for postpartum women.

Risk of Postpartum Depression: The Considerable Role of Maternal Health Status and Lifestyle

“…A study from 2017 found a prevalence rate of over 50% that was significantly associated with maternal age, level of education and employment, monthly income, medical issues, unplanned pregnancy, and previous mental health issues [20]. We propose that the prevalence rate of PPD may be higher than detected in the studies reviewed, as many women may face these issues alone and do not report their struggles to healthcare providers due to societal expectations and concerns around the stigma associated with mental health issues [6,8,9,16,21].…”

“…The World Health Organization (WHO) prioritizes a healthy diet, that is, nutrition, weight management, physical activity, planned pregnancy, and physical, mental, and psychosocial health for women of reproductive age [1][2][3][4][5]. (Women's health issues are complex, and collaborative efforts are required to unravel some of these complexities in order to support women through their reproductive experiences, to enhance health and well-being, and to ensure better maternal outcomes [6][7][8][9]. Postpartum depression (PPD) is a common issue among childbearing women, as up to one in seven women will experience PPD [8,10,11].…”

“…Common symptoms of PPD include lack of interest or enjoyment, loss of appetite or ability to sleep, anxiety, racing or scary thoughts, difficulty concentrating or in decisionmaking, feelings of guilt or worthlessness, self-blame, excessive irritability, anger or agitation, crying, sadness or misery, fear of not being a good enough mother or of being left alone with the baby, or thoughts of harming the baby or self-harm [6,10,11]. If these symptoms persist longer than two weeks after delivery, professional help may be required, and recovery is possible with proper treatment and support [6,[9][10][11]. PPD can affect all women, whether they were involved in low-or high-risk pregnancies, are first-time mothers, or have more than one child [6,10,11].…”

“…According to the WHO, the rates of PPD are increasing exponentially and must be addressed more proactively by healthcare professionals through the use of integrative approaches within women's health [2,3,6,9,32]. The COVID-19 pandemic significantly increased the risk of PPD in women [7,9,33,34].…”

“…According to the WHO, the rates of PPD are increasing exponentially and must be addressed more proactively by healthcare professionals through the use of integrative approaches within women's health [2,3,6,9,32]. The COVID-19 pandemic significantly increased the risk of PPD in women [7,9,33,34]. If undetected and untreated, the consequences of PPD are far-reaching and pose an urgent public health concern that will have serious economic implications [7,33,35].…”