For many women, the OB-GYN is the healthcare provider they see most frequently throughout their lives. From adolescence to pregnancy, postpartum, and the menopausal transition, these visits often occur during vulnerable times when women may face bouts of depression or anxiety. This reality has driven growing attention to the critical importance of perinatal mental health integration — the seamless combination of behavioral health services with women’s reproductive and general healthcare.
While OB-GYNs are experts in women’s physical health, they often encounter mental health challenges that extend beyond their specialized training. As such, perinatal mental health integration has become essential to adequately support women during pregnancy and after childbirth. Unfortunately, many clinicians report needing more training and resources to feel confident addressing behavioral health concerns that fall outside their core expertise.
The Consequences of Inadequate Care
The consequences of inadequate behavioral health care during and after pregnancy can be devastating. The Centers for Disease Control and Prevention (CDC) reports that mental health conditions—including substance use disorders (SUDs)—contribute to 23% of deaths during pregnancy or within a year postpartum. This alarming statistic underscores why perinatal mental health integration must be prioritized at every level of care.
Experts such as Nancy Byatt, a perinatal psychiatrist, emphasize several barriers to effective care. Stigma often prevents patients from openly discussing mental health struggles with their OB-GYNs, while provider shortages and limited training leave many women without the specialized support they need. “The obstetrician isn’t necessarily an expert in mental health,” Byatt notes, and many general psychiatrists may lack the skills or confidence to treat pregnant or postpartum individuals requiring medication.
The situation is even more dire for marginalized populations, who face disproportionately high rates of maternity-related deaths and systemic barriers like racism and limited access to care. Without robust perinatal mental health integration, these disparities are likely to worsen.
Rising National Momentum for Integration
Fortunately, national momentum is building to address these challenges. Organizations like Relias, a leader in healthcare workforce education, highlight the growing recognition that maternal health outcomes depend not only on clinical care but also on social and mental health factors. According to Elise Valdes, research director at Relias, “Just focusing on clinical care at delivery isn’t enough to improve outcomes. We need comprehensive perinatal mental health integration that addresses all aspects of women’s well-being.”
This need extends beyond policy and awareness into actionable changes, including developing new tools and assessing community resources to better support families. Hospitals, health systems, and payers must act urgently to improve care coordination and access.
Training Gaps and Provider Willingness
Despite the demand for more training, many clinicians are eager to expand their knowledge. A recent study in the Journal of Maternal-Fetal and Neonatal Medicine found that while nearly all respondents had screening protocols for peripartum depression (PPD), 96.5% believed additional training was necessary. This consensus shows widespread acknowledgment that perinatal mental health integration requires not just screening but follow-up, referrals, and ongoing support.
Unfortunately, gaps remain: about 25% of providers have no formal process to follow up on positive screenings, and some do not engage social workers in patient care. This leaves many women with PPD undiagnosed or untreated, highlighting the urgent need for improved systems that truly integrate behavioral health with women’s health.
Innovative Efforts to Improve Integration
Efforts to promote perinatal mental health integration include developing resources that help OB-GYNs manage mood and anxiety disorders as systematically as other chronic conditions. For example, Byatt’s team has worked with the American College of OB-GYN to create tools that support anxiety care workflows, emphasizing regular screening, treatment, and follow-up until remission.
Innovative models such as peer support programs, doula training in trauma-informed care, and virtual multidisciplinary teams also contribute to bridging behavioral and women’s health. Iron Health, launched in 2023, offers a digital platform partnering with OB-GYNs to provide integrated primary care, behavioral health, chronic disease management, and nutrition support — delivering data back into the OB-GYN’s electronic medical records to create a more continuous care experience.
Similarly, Elevance Health’s Empower program integrates behavioral, physical, and social health for women at risk of or experiencing pregnancy, showing how comprehensive approaches embody the principles of perinatal mental health integration.
Policy Challenges and the Path Forward
Despite these advances, significant challenges remain, including reimbursement policies that discourage preventive care, lack of mental health parity, and limited access to reproductive planning. As Byatt explains, “We need policies that promote prevention and health rather than forcing providers into reactive modes.”
The path forward requires continued commitment from all stakeholders — clinicians, health systems, policymakers, and payers — to advance perinatal mental health integration so that women receive holistic, coordinated care that addresses both their physical and behavioral health needs.
Conclusion
As the healthcare landscape evolves, embracing perinatal mental health integration is vital for improving maternal outcomes and supporting women throughout the transformative stages of their lives. By bridging the gap between mental health and women’s health care, we can reduce preventable deaths, alleviate suffering, and build healthier futures for women and families.
