What We’re Reading
By Joy Burkhard, MBA
Founder and Executive Director, 2020 Mom
This month, articles about cognitive behavioral and digital therapy and its effect on insomnia during pregnancy, and Pharmacogenetics for personalized mental health care are among those that I highlight below. Leave a comment below if any of these articles strike a chord with you.
Maternal Depression Linked with Long-Term Economic Instability
Depression after childbirth can affect mothers' economic welfare and financial stability up to 15 years later, according to a study published in the American Journal of Preventive Medicine.
“My research focuses on the intersection of economics and maternal health.”
Hospital and Doctor Groups Sue Biden Officials Over Surprise Billing Rules
On Thursday, the American Medical Association (AMA) and American Hospital Association sued the Biden administration over regulations to prevent patients from getting stuck with “surprise” medical bills, escalating a fight over the rules.
FDA Greenlights First Monotherapy for Bipolar Depression
Caplyta also gained new indications for adjunctive treatment.
City of Minneapolis Officially Launches Behavioral Crisis Responder Team to Address Mental Health Emergencies
WCCO/CBS Minnesota, December 13, 2021 — An alternative police response team will now provide crisis intervention, counseling, and connection to support services to people in crisis.
Grading Digital Depression Tools
The list of digital interventions to treat depression continues to grow, but little is certain about which tools are right for different patients. One step toward understanding comes from a new meta-analysis of 83 randomized controlled trials of digital depression tools published over the last three decades, published in Psychological Bulletin.
Digital Therapy for Prenatal Insomnia May Prevent Postpartum Depression | UC San Francisco
A UCSF study finds that a digital version of cognitive-behavioral therapy (dCBT) for prenatal insomnia may prevent postpartum depression.
Pharmacogenetics: Is it the Path to Smarter, More Personalized Mental Health Care?
Pharmacogenetics provides additional data on a patient's response to medications.
Layers of Subcontracted Services Confuse and Frustrate Medi-Cal Patients
Many of the 14 million patients in Medi-Cal are in managed care health plans that outsource their care to subcontractors or sub-subcontractors. It can be hard for patients with difficult health care needs to know where to turn. (Bernard J. Wolfson, 12/21)
In Minneapolis, Home to George Floyd, Heavy Policing is Tied to Higher Rates of Preterm Births
In Minneapolis, heavy policing is tied to higher rates of preterm births.
STAT’s Usha Lee McFarling reports that a research team from Minneapolis, a city traumatized by the police killings of George Floyd and other unarmed Black men, reports that the impact of even routine policing may adversely affect the health of pregnant women and their babies. In their study out yesterday in JAMA Network Open, the scientists examined rates of preterm birth, a problem Black people are nearly twice as likely to experience as white people, and found that Black and white people living in neighborhoods with a high number of police contacts were twice as likely to experience a preterm birth. Because more people of color live in these neighborhoods, the stress felt by encountering even routine day-to-day policing and vigilance is higher for Black mothers, the researchers said.
Association Between Perceived Stress and Prenatal Depressive Symptoms: Moderating Effect of Social Support
A new study found that social support decreases the risk of experiencing prenatal depression and improves overall mental health. The report found that interventions related to social support, such as peer support and social media campaigns, should be encouraged.
Gatekeepers Need to Tame ‘Wild West’ of Mental Health and Other Digital Health Therapeutics
There's growing interest in using digital services to help people work through mental health issues, from individuals to employers. It's a solid approach, given how difficult and costly it can be to find and work with an in-person therapist. Yet digital therapeutics currently represent a kind of "Wild West." Gatekeepers need to be more methodical in how they assess these products.
Media Advisory: Nih Researchers Link Depression During Pregnancy to Placental Gene Modifications
Findings suggest the need for long-term studies of children born to mothers who experienced depression in pregnancy.
Miscarriage Can Harm a Woman’s Mental Health Long-term, New Study Finds
The results showed that participants who lose a child are more than twice as likely to suffer from depression and one-and-a-half more times to battle anxiety.
What Might Work to Avoid Low Birth Weight
It’s a preliminary study in one hospital in Spain, but its results could help get at the problem of babies born too small. For the trial described in yesterday’s JAMA, more than 1,100 patients at high risk for delivering newborns small for gestational age were randomly divided into three groups: one got education about the Mediterranean diet (and free olive oil and walnuts), one got instruction in mindfulness-based stress reduction, and one got the usual prenatal care. The two groups doing the diet or mindfulness interventions gave birth to significantly fewer newborns below the 10th percentile.
Perinatal Experiences of Asian American Women
The American Journal of Maternal/Child Nursing
This study aimed to explore the wellbeing and pregnancy, childbirth, and postpartum experiences of Asian American women who gave birth during the COVID-19 pandemic. Thirty-eight Asian American women representing several racial ethnic subgroups (Asian Indian, Chinese, Filipino, Hmong, Laotian, Vietnamese) participated in the study.
Mediators of Maternal Mental Illness
Mothers have experienced a near doubling of depression and anxiety symptoms pre- to during the COVID-19 pandemic. The current study examined whether women with higher levels of depression and anxiety symptoms pre-pandemic, reported higher levels of depression and anxiety symptoms during the pandemic, and whether these increases were mediated by perceived stress, strained relationships, coping attitudes, participation in activities, alcohol use, and financial impact.
New List Recognizes Best Hospitals For Maternity Care
U.S. News & World Report has recognized 237 hospitals in its inaugural list of best hospitals for maternity care for 2021-2022. The hospitals were evaluated based on their performance in five quality metrics: newborn complications, cesarean delivery rates in low-risk women, scheduled early deliveries, exclusive breast milk feeding rate and option for vaginal births after cesarean.
Read More → U.S. News & World Report (12/7), Becker's Hospital Review (12/7)
Cognitive Behavioral Therapy for Insomnia During Pregnancy
If sleep disturbance is the harbinger of perinatal depression, it might make sense to place more emphasis on this symptom. At the very best, prescribing an intervention to improve sleep may reduce risk for perinatal depression. At the worst, we would give new mothers some tools to manage a very distressing and common problem.
White House, Advocates Call for Changes to Improve Maternal Care on 'Day of Action'
— "Systemic inequities" are driving adverse outcomes, says Vice President Harris
The White House and CMS proposed new strategies to help prevent maternal deaths and complications related to childbirth, including new funding, such as the $3 billion proposed in the Build Back Better Act to address maternal health; new guidance aimed at extending healthcare coverage for mothers after childbirth; and a "birthing-friendly" hospital designation.
Experts Weigh in on Addressing Mental Health in Seniors, Mothers
Before the COVID-19 pandemic, social isolation affected 1 in 4 older adults. It's almost two years into the pandemic, and now it affects two out of three adults in general and two out of five low-income older adults, according to data from the AARP Foundation. Depression in homebound.
In First 'Best Hospitals for Maternity' List, Not All States Have High Performers
— While eight states had 10 or more top-rated facilities, nine states had none
For patients and families considering where to seek maternity care, there are 237 facilities that earned top marks on the inaugural "Best Hospitals for Maternity" list from the U.S. News & World Report.
Universal Postpartum Mental Health Screening for Parents of Newborns with Prenatally Diagnosed Birth Defects
To describe the implementation of a nurse-led project to screen parents for depression and traumatic stress in the postpartum period after visiting their newborns in the NICU.
On the Elicitation of Bipolar Symptoms in Primary Care
M3 Information is committed to improving the accurate diagnosis of Bipolar Disorder (BD) and Bipolar Spectrum Disorders and minimizing their misdiagnosis. The current trend in non- and mistreatment entails tremendous though avoidable morbidity and mortality, wasteful healthcare costs, and lost productivity.
Mental Health Stigma Improving; First Remote Depression Study; LSD Trial on Hold
— News and commentary from the psychiatry world
According to a survey of over 4,000 individuals, there was a significant drop in the public stigma towards depression since the mid-'90s.
One Quarter of Pregnant and Postpartum Struggle to Afford Health Care
Women with private insurance and those living on lower incomes were more likely to experience unaffordable health care.
Outcomes for Virtual Prenatal, Postpartum Care Similar to In-Person Visits
A Massachusetts clinic saw similar outcomes among pregnant patients' in-person and telehealth visits and high telehealth utilization rates for prenatal and postpartum care services.
This Doula's Postpartum Tips for Black Moms Went Viral—and are Helping Us Demystify the Fourth Trimester
The fourth trimester isn't something new parents are often taught about upfront, but they should be. Too often, new moms are left to figure out how to heal—and how to take care of a new baby—alone.
New mother and medical student Korrine Sky was confronted with this gap in information and the overwhelming feeling of being unprepared after giving birth in March. Though her pregnancy went smoothly, she felt under-informed.
She Hired a Postpartum Doula—Now She's Defending Why New Moms Need Them
Second-time mother, Brittany Bright, posted a TikTok video detailing her preparation for the nighttime doula who supports her family twice a week from 8 p.m to 6 a.m. She said the help has been crucial as she managed the first 12 weeks as a mother of two. She hadn't anticipated that the decision to prioritize her mental health might be regarded as controversial…
Skipping Nighttime Checks No Remedy for Bad Sleep in Hospitals
— It may still make sense to let sleeping patients lie, some argue
Fewer disturbances from nighttime checks did not translate into better sleep in the hospital for patients, according to a randomized trial. For the study's primary endpoint, randomization to the sleep promotion intervention was not associated with a reduction in delirium compared with usual care in the general medicine service, and the intervention failed to improve sleep satisfaction as well, reported.
State Medicaid Programs CAN Reimburse Audio-Only Telehealth Visits
On December 6, 2021, the Centers for Medicare & Medicaid Services (CMS) announced that state Medicaid programs can reimburse for audio-only telehealth during public health emergencies. States have broad flexibility to cover and pay for Medicaid services delivered via telehealth, including determining which telehealth modalities may be used to deliver Medicaid-covered services. The policy is included in an update of the "CMS State Medicaid & CHIP Telehealth Toolkit: Policy Considerations for States Expanding Use of Telehealth."