Perinatal Mental Health Concerns Are Underreported

HARTFORD — Mental health advocates warned this spring that perinatal mood disorders remain a hidden public-health crisis in Connecticut, with the vast majority of depression and anxiety during pregnancy and the postpartum period going unreported or unrecognized, according to new research and state data[2][7]. While perinatal mood and anxiety disorders are now the number one complication of pregnancy and childbirth, clinicians say symptoms are still frequently dismissed as “normal” fatigue, stress or baby blues, delaying lifesaving treatment for parents and their infants[4][10]. The concern has taken on new urgency as state agencies and health systems work to close gaps in screening and crisis services for pregnant and postpartum people across Connecticut[1][5].

Psychology Today reported that more than 80 percent of maternal mental health concerns in the United States go unreported or unrecognized, a pattern that experts say holds true in Connecticut, where routine data on perinatal depression is not yet systematically collected[2][7]. “We hear from families every week who say, ‘I thought I was just tired or a bad mom,’ when in fact they were experiencing a treatable depressive episode,” said Dr. Elizabeth Garrigan, a reproductive psychiatrist and clinical leader with ACCESS Mental Health for Moms, a statewide consultation program for perinatal providers[9]. Advocates emphasize that simple, concrete questions about sleep, appetite, brain fog, feelings of inadequacy and any thoughts of self-harm can help clinicians and loved ones distinguish typical pregnancy stress from a more serious mood disorder, and guide families toward crisis supports like 988 and the Crisis Text Line when needed[2].

Perinatal mood and anxiety disorders, often referred to as PMADs, encompass depression, anxiety, obsessive-compulsive symptoms, post-traumatic stress and, more rarely, psychosis that emerge during pregnancy and throughout the first year after delivery, according to Hartford’s Institute of Living[4]. The center and other Connecticut resources note that these conditions can range from mild but persistent distress to severe, impairing symptoms and are now recognized as the leading complication associated with pregnancy and childbirth in the United States[4]. State health officials estimate that 10 to 15 percent of Connecticut women experience perinatal depression, though they acknowledge that the true prevalence may be higher because the state does not routinely collect comprehensive data on maternal mental health[7]. National figures cited by Psychology Today suggest that, when anxiety and other related diagnoses are included, maternal mental health conditions may affect one in five to one in three perinatal individuals, underscoring the scale of unmet need[2][8].

Experts say underreporting stems from a combination of clinical blind spots, structural barriers and stigma. Psychology Today’s analysis explained that fatigue, trouble concentrating, moodiness and sleep disturbances are common in pregnancy and postpartum, yet they are also classic symptoms of depression that warrant closer evaluation, particularly when they intensify or interfere with basic functioning, such as eating adequately or keeping medical appointments[2]. “Some degree of tiredness is expected when you’re pregnant or caring for a newborn, but when a parent says, ‘I can’t get out of bed’ or ‘I don’t feel connected to my baby,’ that’s a red flag, not a character flaw,” said Dr. Laura Saunders, a child and adolescent psychologist at Hartford Hospital’s Institute of Living who works closely with perinatal teams[4]. Research published in the medical literature has further found that up to 70 percent of women hide or downplay their symptoms due to fears of judgment or losing custody, leading to undetected and untreated conditions that erode maternal and child well-being[3].

Connecticut has taken recent legislative steps to address these gaps, though implementation remains uneven across regions and health systems. The Policy Center for Maternal Mental Health notes that House Bill 5500, adopted in 2022, required the state’s Maternal Mortality Review Committee to develop educational materials on perinatal mood and anxiety disorders and evidence-based screening tools for obstetric and other health care providers[5]. The law also directed birthing hospitals to distribute these materials to every postpartum patient, and called on the governor to declare May as Maternal Mental Health Month and May 5 as Maternal Mental Health Day to raise awareness statewide[5]. In 2025, UConn Health highlighted that May was formally recognized in Connecticut as Perinatal Mental Health Month following passage of a broader maternal health act, signaling growing political attention to the issue[1]. “Policy changes matter, but families feel the difference only when every OB/GYN, pediatrician and primary-care provider knows how to ask about mood and where to refer,” said Dr. Lisa Wainwright, medical director of UConn Health’s perinatal mental health services[1].

Clinical leaders and advocates are urging a more standardized approach to screening during pregnancy and after birth, paired with clear pathways to care. The March of Dimes and other national organizations recommend universal depression screening before, during and after pregnancy to identify women at risk and ensure appropriate referral and treatment, a practice that Connecticut providers are increasingly adopting, according to recent guidance[6][7]. ACCESS Mental Health and Substance Use for Moms, funded to support obstetric, pediatric and primary-care clinicians treating pregnant and postpartum patients up to one year after delivery, offers phone consultation with reproductive psychiatrists on complex cases Monday through Friday, reinforcing the state’s push toward integrated, team-based care[9]. “What we tell providers is that one or two targeted questions — ‘How is your sleep?’ ‘Are you enjoying things at all?’ ‘Have you had any thoughts of harming yourself?’ — can open the door to a lifesaving conversation,” Garrigan said[2][9]. When those answers suggest imminent risk, clinicians and families are advised to connect individuals directly to 988, the national Suicide & Crisis Lifeline, or the Crisis Text Line, and to emergency services for suspected postpartum psychosis, which experts describe as a true medical emergency[2][4].

Families and clinicians are also being coached on how to recognize more subtle expressions of distress that might otherwise be missed. Psychology Today advises loved ones to pay attention when a pregnant or postpartum person repeatedly describes themselves as “a bad mom,” reports constant feelings of inadequacy, or appears unusually withdrawn, irritable or overwhelmed, especially if they struggle to eat, sleep or care for themselves and the baby[2]. The article suggests asking follow-up questions such as “How is this affecting you?” and, if the person mentions being “stressed” or “snappy,” gently probing for depressive symptoms, including pervasive sadness, loss of interest, feelings of hopelessness or any self-harm urges[2]. Connecticut’s Department of Public Health reinforces that risk rises when there are additional stressors, such as a difficult pregnancy or birth, medical problems in the mother or baby, lack of sleep or feeling alone, emphasizing the importance of social support and early intervention[7]. “Partners, grandparents, friends — they are often the first to notice changes, so giving them clear language and permission to speak up is a critical part of prevention,” Wainwright said[1][7].

Local mental health organizations stress that effective, evidence-based treatments are available and can significantly improve outcomes for both parent and child when accessed promptly. Hartford’s Institute of Living notes that PMADs can be successfully treated with a combination of self-care, social support, psychotherapy and, when appropriate, medication, tailored to the individual’s symptoms and medical needs[4]. Peer-led programs, state clearinghouse resources and national groups such as Postpartum Support International offer additional education and support for Connecticut families navigating these conditions[7][10]. Still, advocates caution that workforce shortages, transportation barriers and cultural stigma continue to limit access in many communities, particularly for Black, Latino and low-income parents who face disproportionate maternal health risks, as national data show[3][8].

As Connecticut’s health systems and policymakers deepen their focus on maternal mental health, experts say the next phase of work will hinge on embedding mental-health questions into every perinatal visit and ensuring that crisis and specialty services are available when answers raise concern. UConn Health and statewide partners are expanding perinatal mental health programs and collaboration across obstetrics, pediatrics and psychiatry, while legislative efforts aim to strengthen data collection on maternal mood disorders and evaluate the impact of existing mandates[1][5]. “Our goal is straightforward,” Garrigan said. “No parent in Connecticut should suffer in silence when a simple question, an empathetic conversation and a timely referral could change the trajectory for them and their baby”[2][9]. Advocates say that as awareness grows and families become more comfortable naming perinatal depression and anxiety, those once underreported concerns may finally move into the light, where support and recovery are possible[1][3].