Feelings of fear, shame, embarrassment, and guilt over being perceived as a “bad mom” were common among respondents experiencing MMHDs. This cycle of negative emotions led to worsening symptoms, delays in seeking care, and slower recovery even aftercare was accessed. Many respondents engaged in “self-stigmatization” by playing down their struggles during the perinatal and postpartum period, and as a result, did not share the extent of their difficulties even when connected to a health care provider.

“My six-week appointment with my OBGYN came. I lied when she asked me how I was feeling and how my moods were. I told her I was fine. I had felt so much guilt and shame around my feelings. I thought having those feelings would mean I was a bad mother and wife. Remember that negative stigma surrounding mental health I mentioned earlier? That’s a big reason I didn’t want to admit to these feelings.”

Many respondents noted the lack of healthcare providers that were trained on maternal mental health. For example, some respondents with MMHDs who were seeing their primary care provider, obstetrician, or gynecologist were not receiving care related to mental health. On the other hand, respondents that were referred to psychiatrists did not receive care relevant to the perinatal period. Respondents shared how many providers failed to recognize signs of MMHDs or dismissed their mental health concerns outright. As a result, many felt isolated during the care-seeking process and discouraged from further attempting to access services. According to respondents, few providers were trained in screening for and treating MMHDs, and subsequently transferred patients out of their care, making patients feel unseen, embarrassed, and further stigmatized for living with a disorder perceived as “untreatable.”

“Through tears I said to the receptionist ‘I think I have postpartum depression.’ She forwarded my call to the nurse where she asked if I was suicidal, too embarrassed to actually admit I was, I said no … She told me I ‘just had the baby blues’ and that was that… I cried so hard because I knew I needed help but I wasn’t getting it.”

A significant barrier to care access and recovery for respondents was the lack of paid time off work they received during the perinatal period. Many were concerned about being laid off, or having no source of income while taking maternity leave, and were forced to return to work shortly after giving birth to maintain their employment. Most workplaces required respondents to resume work within a few weeks postpartum, and for those struggling with MMHDs, this led to worsening symptoms, delayed care-seeking behavior, and poor recovery. Not having income or medical coverage during the perinatal period adds significant financial and psychological stress during a time when moms must focus on their own health and that of their children.

“Mommas are returning to work with a bleeding wound the size of a dinner plate because they can’t afford to stay home. Mommas are “missed” because their Medicaid ran out at eight weeks postpartum. And, Mommas are taking their own lives because they are not seen or heard.”