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World J Psychiatry. Apr 19, 2023; 13(4): 149-160
Published online Apr 19, 2023. doi: 10.5498/wjp.v13.i4.149
Reducing psychiatric illness in the perinatal period: A review and commentary
Jessica Rohr, Farhaan S Vahidy, Nicole Bartek, Katelynn A Bourassa, Namrata R Nanavaty, Danielle D Antosh, Konrad P Harms, Jennifer L Stanley, Alok Madan
Jessica Rohr, Nicole Bartek, Katelynn A Bourassa, Namrata R Nanavaty, Alok Madan, Department of Psychiatry and Behavioral Health, Houston Methodist, Houston, TX 77030, United States
Farhaan S Vahidy, Department of Neurosurgery, Houston Methodist, Houston, TX 77030, United States
Danielle D Antosh, Konrad P Harms, Jennifer L Stanley, Department of Obstetrics and Gynecology, Houston Methodist, Houston, TX 77030, United States
Author contributions: Rohr J and Madan A were responsible for conceptualization, writing-review and editing, project administration, supervision, and funding acquisition; Vahidy FS, Bartek N, Bourassa KA, Nanavaty NR, Antosh DD, Harms K, and Stanley JL were responsible for writing-review and editing; all authors have read and approve the final manuscript.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jessica Rohr, PhD, Director of Women’s Mental Health, Department of Psychiatry and Behavioral Health, Houston Methodist, 6550 Fannin Street, SM2509, Houston, TX 77030, United States. jrohr@houstonmethodist.org
Received: December 16, 2022
Peer-review started: December 16, 2022
First decision: January 12, 2023
Revised: February 8, 2023
Accepted: March 31, 2023
Article in press: March 31, 2023
Published online: April 19, 2023
Processing time: 122 Days and 14.8 Hours
Abstract

This brief overview highlights the global crisis of perinatal psychiatric illness (PPI). PPI is a major contributor to many adverse pregnancy, childbirth, and childhood development outcomes. It contributes to billions of dollars in spending worldwide each year and has a significant impact on the individual, their family, and their community. It is also highly preventable. Current recommendations for intervention and management of PPI are limited and vary considerably from country to country. Furthermore, there are several significant challenges asso-ciated with implementation of these recommendations. These challenges are magnified in number and consequence among women of color and/or minority populations, who experience persistent and negative health disparities during pregnancy and the postpartum period. This paper aims to provide a broad overview of the current state of recommendations and implementation challenges for PPI and layout a framework for overcoming these challenges. An equity-informed model of care that provides universal intervention for pregnant women may be one solution to address the preventable consequences of PPI on child and maternal health. Uniquely, this model emphasizes the importance of managing and eliminating known barriers to traditional health care models. Culturally and contextually specific challenges must be overcome to fully realize the impact of improved management of PPI.

Keywords: Perinatal psychiatric illness; Postpartum depression; Equity-oriented care; Minority populations; Maternal mortality; Pregnancy

Core Tip: Perinatal psychiatric illness is a major contributor to maternal mortality and morbidity rates, especially among women of color. This paper explores the ways in which current standard of practice is failing to address these disparities and offers an alternative framework for consideration.