Global crises, such as the COVID-19 pandemic, increase the risk of perinatal depression and anxiety. A recent systematic review of 81 cross-sectional studies reported that the prevalence of perinatal depression and anxiety amid the pandemic ranged from 20% to 64% of perinatal individuals. Increased prevalence is understood to reflect several stressors unique to global crises, including self-isolation, living with an affected person, and limited access to routine or emergency health and social care. Medicaid-insured perinatal individuals are also at greater risk than those privately insured for depression and anxiety disorders and confront additional barriers to quality perinatal mental health care. System-level solutions, such as perinatal psychiatry access programs, hold promise in facilitating a population-based response to address the impact of the COVID-19 pandemic. Developed in 2014, access programs provide consultation to tens of thousands of perinatal care professionals, covering approximately 1.9 million of the 3.6 million births across the country. Supported by federal, state, and other funding sources, the 15 access programs implemented nationally at the time of this study build the capacity of perinatal care professionals to address perinatal mood and anxiety disorders through 3 core components: (1) professional-to-professional consultation, (2) resource and referral, and (3) training. This study sought to identify the barriers to accessing perinatal mental health care among low-income individuals amid the pandemic and the promising system-level solutions available to advance health equity among perinatal individuals who are systematically marginalized.
