Mental health service use in pregnancy and early postpartum: A longitudinal study

Background Longitudinal patterns and predictors of perinatal mental health service use (MHSU) remain unclear. Thus, the present study examined patterns and predictors of MHSU in pregnancy and postpartum in a general population of pregnant individuals.Methods Data from the Experiences of Pregnancy cohort study were used. Participants were recruited in their first trimester of pregnancy and followed each trimester and once postpartum (M = 9.37, SD = 2.62 weeks postpartum), with MHSU measured each time. Sociodemographic characteristics, psychosocial factors, and labor/delivery experience were also collected.Results 45.5% of participants used mental health services during pregnancy. Individual counseling/therapy and prescription medication were the most common services used. In univariate models, having less minors in the household, being white, identifying as LGBTQ+, as well as higher depression and anxiety symptoms were associated with higher odds of MHSU in pregnancy – all but depression remained significant in multivariate models. 31.0% of participants who used services in pregnancy had stopped MHSU postpartum. In both univariate and multivariate analyses, desisting from MHSU was predicted by being younger, identifying as cisgender heterosexual, and a more positive labor and delivery experience. 14.6% of participants who did not use services in pregnancy initiated MHSU postpartum, which was predicted by higher depression and anxiety symptoms.Discussion Sociodemographic, psychosocial, and identity factors predict perinatal MHSU beyond the effect of mental health symptoms, suggesting a need for accessible mental health services as well as for mental health screening during pregnancy and postpartum.