On August 4, 2023, the Food and Drug Administration (FDA) approved the first pill for postpartum depression (PPD), marking a significant milestone in treating a condition that affects one in five California women. Zurzuvae is the first oral medication approved by the FDA to treat PPD. Data from clinical trials show that the pill works quickly and can improve feelings of depression in as little as three days. Compared to general antidepressants, which can take weeks or longer to improve PPD symptoms, the newly approved drug may encourage more women suffering from PPD to seek treatment.
Postpartum depression can affect all women. However, Black and Latina women, low-income women, or those who have experienced difficulties in their childhood or during pregnancy are at a heightened risk of suffering from PPD. Depression during pregnancy can lead to continued depressive symptoms after childbirth and is associated with significant risks for new mothers. PPD also poses substantial risks for infants and toddlers.
A mother’s emotional well-being during the pre and postnatal periods are critical to the development of their child. Children undergo significant brain development and growth within the first two years of life. Positive brain development, as well as positive social, emotional, and cognitive development, are dependent on the bonds a baby makes with their caregivers or parents, especially with their mother. PPD can make it difficult for new mothers to provide their infants and toddlers with the necessary care and bonding required for healthy development.
Studies show that PPD can have significant impacts on infants’ mental and behavioral development as well as their cognitive development. Another study found associations between PPD and delayed cognitive and language development in infants, disorganized or insecure attachment, and higher rates of behavioral problems. Moreover, researchers at UCSF have found that symptoms of PPD, such as maternal stress, are associated with higher rates of depression and anxiety in children.
Although the longer-term benefits of Zurzuvae are still unknown, the FDA approval of the drug adds to the list of treatments and services to bolster maternal mental health and, subsequently, infant health and development. During the pre and postnatal period, other interventions are available in California to support maternal mental health, such as dyadic care and home visiting. Dyadic care and home visiting work to support maternal mental health and the parent-child dyad by providing a two-generational approach that addresses family mental health concerns and supports healthy child development.
At the beginning of 2023, California added a dyadic care benefit to its Medi-Cal program as part of its larger CalAIM Medi-Cal transformation. The benefit covers dyadic care, integrated physical and behavioral health screenings and services for the whole family – and is a landmark change for California. Such a significant policy change should be matched with a robust effort to ensure all eligible families can make use of it. California can further protect and improve early relational health by strengthening home visiting services. Home visiting offers a holistic, family-centered approach to supporting new parents and caregivers during and after pregnancy that has been proven effective for improving maternal mental health and child health and development.
Maternal mental health conditions are normal and treatable. With timely interventions and supports like those discussed here, maternal mental health conditions can be effectively addressed to provide the necessary support to new parents and their infants and toddlers.
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