Maternal Mental Health – A National Crisis
The United States is in a maternal health crisis that continues to worsen. After the onset of COVID, 2021 recorded one of the highest maternal mortality rates in recent years (since 1965), exceeding that of other developed countries. According to the Centers for Disease Control and Prevention (CDC), leading causes of pregnancy-related deaths are suicide and overdose, which are preventable.
There is currently a significant gap in awareness, education, and funding towards addressing this stark reality. However, entrepreneurs, researchers, policymakers, and investors have begun to take action. In August 2023, the U.S. Food and Drug Administration approved the first oral medication to treat postpartum depression in adults. In June 2023, Pomelo Care raised $25M in Series A funding to deliver value-based maternal care. Below, we take a closer look at the severity and prevalence of maternal mental health conditions in the United States and highlight several more promising digital start-ups that have made it their mission to tackle this national crisis.
Photo by Jonathan Borba on Unsplash
Overview: Understanding the problem of US maternal mental health
Perinatal mental health (PMH) is a term used to describe any mental health condition that occurs within a 2-year time frame from conception, through pregnancy and childbirth, and up until the child’s first birthday. This includes symptoms like depression, anxiety, post-traumatic stress, substance use, and psychosis, along with pre-existing mental health conditions and mental health condition relapses during pregnancy.
All women are at risk of developing a PMH condition. In the United States, 4 in 5 parents experience mild mood changes, and 1 in 5 experience serious mental health issues each year. The most prevalent condition is depression. Suicide and overdose are the leading causes of death in the first year postpartum, and sadly, 100% of these deaths can be preventable.
However, an astounding 75% of women experiencing PMH concerns do not receive sufficient care. Left untreated, these illnesses can have long-term negative impact not only on the mothers but also on the newborn and other family members. When quantified financially, this amounts to an estimated cost of $32,000 per mother-infant pair.
Maternal mortality and PMH prevalence are further exacerbated by widening health disparities. “Maternal care deserts” disproportionately impact rural communities, and the number of specialists trained in perinatal mental health continues to be scarce. The graphic below shows how 48 of 50 states have fewer than 5 certified providers per 1,000 births.
Source: Policy Center for Maternal Mental Health; graphic by CNN
The impact of PMH conditions is especially significant for individuals of color or individuals living in low income neighborhoods who are less able to access quality, preventive care. Mothers of color experience postpartum mood disorders at a rate double that of white mothers, largely due to receiving less social support, and almost half of these new mothers do not receive proper screening or treatment. Their limited access to mental health care can be due to a number of factors, including geographic inaccessibility, financial cost, and lack of cultural sensitivity in the current mental health workforce. Despite being more likely to experience PMH symptoms, women of color are also less likely to seek help.
Although these statistics are concerning, maternal mental health disorders are indeed treatable. The World Health Organization (WHO) states that early, effective interventions can be delivered even by well-trained non-specialist health providers. Individuals with mild to moderate PMH conditions can try self-managed tactics such as journaling, acupuncture, and mindfulness. Others often have positive results from a combination of medical intervention and therapy. Still, the WHO continues to stress the urgent need for “evidence-based, cost-effective, human rights-oriented” care for early diagnosis and management of maternal mental health disorders.
Market Size: Opportunity and impact of addressing maternal mental health
Maternal mental health conditions place a significant and often fatal emotional and physical burden on mothers and families. There are also massive national healthcare cost implications. A cost model created by researchers at Mathematica found that untreated mood and anxiety disorders during the perinatal period cost about $14.2 billion when following the mother and child pair for 5 years. The market opportunity for maternal mental health remains large. An estimated 20 million women in the US attempting to conceive, are pregnant, or are in the postpartum period can be at risk for developing a mental health disorder. With roughly 25% of these women receiving some form of treatment (and hopefully, this number continues to grow) at an average mental health expenditure per person of $1,751, the annual revenue opportunity is $8.8 billion within the maternal mental health market.
Market Map: Digital players in the maternal mental health market
Source: Coyote Ventures (Venture Fellow Emily Chen)
As the burden of maternal mental health problems is significant and historically overlooked, there are many recently launched digital health companies gaining market share with their various approaches. From collating educational resources, providing telehealth options, integrating AI to create customized treatment plans, and using a multidisciplinary approach— these companies use different strategies to provide necessary solutions that women can rely upon for preventative health, diagnosis, and treatment of perinatal mental health conditions. Moreover, through providing these resources through a digital platform, these companies can offer greater accessibility.
Conclusion
Overall, maternal mental health continues to be a serious healthcare issue contributing to the high maternal mortality rate in the US, with 9% of maternal mortality attributable to suicide. These conditions are treatable, although there exists barriers to access of care which disproportionately impact certain populations, like communities of color and low-resource communities. Fortunately, we continue to see a strong emergence of new digital health startups innovating in the maternal mental health space, utilizing different approaches and technologies, and improving quality of care, affordability, and access.
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Market map company descriptions
Candlelit Care strives to improve perinatal mental healthcare for pregnant and postpartum Black women. They provide mental health screening, personalized care plans, virtual group counseling sessions, and 1:1 coaching. Using AI, Candlelit pairs parents with coaching and digital therapy to improve birth outcomes.
Canopie creates a personalized program tailored to its clients needs and then uses evidence based therapeutic techniques, stories from other patients, and practical tips to help new mothers through common challenges. Canopie uses both technology and human support to screen, monitor, and escalate patients.
Dana is an app that uses predictive intelligence to create a personalized mental health plan for women during preconception, pregnancy, and early motherhood. Dana provides a digital wellbeing coach which can provide screening, diagnosis support, and patient monitoring for mental health disorders.
E-Lovu is a clinically guided digital ecosphere that seamlessly integrates with existing OBGYN and midwife practices. Clinical guides assess and monitor expectant mothers and babies with Bluetooth-enabled medical devices and co-design care triage with existing primary care practitioners to help patients navigate through a wide range of services including mental health.
Emmawell provides a personalized mental health program inclusive of education, guidance, and support through pregnancy and postpartum. Support is provided through group therapy and individual therapists. Education and guidance is provided through organized resources and on-demand webinars. The program is designed to manage existing anxiety and mood disorders and prevent postpartum depression.
FamilyWell is a provider of health services intended to solve the perinatal mental health crisis and close the health equity gap. The company specializes in providing individualized care plans that include monthly mental health screenings during pregnancy and postpartum, on-demand texting with peer coaches, virtual health coaching and therapy sessions, and guidance for providers on medication management.
Lunajoy provides holistic, personalized women’s mental health care with 1:1 therapy, counseling, and medication management through all phases of life including adolescence, pregnancy, postpartum, infertility, miscarriage, loss, perimenopause, and aging.
Mavida Health supports mental health from preconception through postpartum. Preparing for a fall 2023 launch, Mavida plans to support virtual-based mental health care through its mobile application. Services will include an online community forum, individualized treatment plans, medication management, access to telehealth appointments, and group or individual therapy.
MamaZen is an app that provides hypnotherapy, meditation, and mindfulness targeted at mothers. MamaZen provides 5-15 minute recorded sessions created to help reduce stress, guilt, fatigue, and burnout associated with parenting.
Mammha provides customized care through telehealth care coordination and individual support for pregnant and postpartum women. Providers screen patients through the Mammha platform and patients are immediately triaged to a care coordinator to provide ongoing support.
Mindful Mamas app uses mindfulness, meditation, mood tracking, emotional awareness, and sleep support to promote positive mental well-being outcomes for the entire lifecycle of motherhood — from trying to conceive through empty nesting.
Moms Matter Now provides an online course that includes videos, on-demand content, and exercises focused on mental-health and wellness geared towards expecting mothers. Through a 9-module course, this company provides evidence-based practices which strive to help mothers be proactive about the emotion and physiological changes during pregnancy and postpartum periods.
Nourish App provides mindful meditations, breathing exercises, and psychology insights to support mothers through improving mental health and wellbeing. The Nourish app uses a multidisciplinary approach, using information from psychiatrists and psychologists, wellbeing coaches, therapists, sleep experts, yoga instructors, nutritionists, and mindfulness coaches through audio, video, and quick reads.
Pomelo Care is a virtual, value-based care platform focusing on improving maternal and newborn health outcomes. They provide dedicated care teams that include perinatal mental health specialists and customized care plans that could include treatment for postpartum depression.
Poppy Seed Health is an on-demand telehealth solution that seeks to restructure pregnancy and postpartum care, emphasizing emotional and mental health support that puts accessibility, equity, and radical empathy at the center of the care model. The platform offers 24/7 text support access to certified and licensed doulas, midwives, and nurses for birthing people navigating pregnancy, postpartum, miscarriage, and loss.
Prospera is a nationwide provider of maternal mental health support. They provide care for women at all stages of their perinatal journey from fertility through postpartum. Their mission is to remove all barriers to moms accessing high quality mental health support. Using an approach that combines mental health coaches, digital tools, and therapists who work behind the scenes, Prospera is able to reduce the cost of care, increase the reach of services, and maintain quality. Their offering is derived from evidence-based interventions.
Seven Starling provides specialized therapists, group therapy sessions, and medication evaluation to support women through all stages of motherhood. Seven Starling creates personalized treatment plans to support clients through fertility challenges, pregnancy, pregnancy loss or miscarriage, abortion, postpartum, and early parenthood.
Tandem Community provides maternal and postpartum emotional and wellness support for women of color and culture. Based on an assessment about client heritage and life stages, Tandem creates a recommendation of unique mental wellness support for each client incorporating one of two postpartum wellness programs: a free SMS text check-in or a support group.
Vital Start uses virtual and augmented reality combined with AI analytics to measure and create a personalized care plan for women experiencing perinatal mood and anxiety disorders. Vital Start offers self-guided mindfulness, coach-guided VR enabled personalized coaching, and therapist-guided VR therapy.
Additional Maternal Mental Health Organizations
In addition to the exciting innovation occurring in this space, there are several additional resources available through the government and other public and private organizations.
Postpartum Support International is an international organization that provides a hotline that connects individuals to local resources and provides weekly support sessions.
Maternal Mental Health Leadership Alliance is a nonprofit organization that provides information and toolkits for individuals experiencing maternal mental health conditions and individuals supporting those experiencing maternal mental health conditions
National Maternal Mental Health Hotline is a hotline through the government that provides free support 24/7 in over 60 different languages for during the pregnancy and postpartum period.
March of Dimes Maternal Mental Health Resources is a document created by March of Dimes, an organization that supports research, education, and advocacy focusing on the health of mothers and babies.