As maternal anxiety continues to rise in Utah, advocates say help is available

After Evi Hayhurst-Figgat’s first pregnancy with her now-5-year-old son, she experienced postpartum anxiety and psychosis.

“I didn’t know my resources at all, and my recovery took much, much longer than it really needed to,” Hayhurst-Figgat said Wednesday in a virtual news conference hosted by YWCA Utah and other organizations. “I couldn’t see that I needed help.”

She and her husband waited until 2019 to have their daughter, when they knew they were ready. The first months went smoothly, but after their daughter was hospitalized at the beginning of the coronavirus pandemic, Hayhurst-Figgat realized, “I needed help, rapidly,” as “things started to spiral.”

This time, she was prepared. Within a week of noticing her mental health symptoms, Hayhurst-Figgat “was sitting in a psychologist’s office, fully armed and ready to take things head on.”

“Instead of suffering quietly for months, I was able to feel empowered,” she said, thanks to the Utah Department of Health’s maternal mental health program and referral network.

The Salt Lake Tribune reported in 2019 that maternal anxiety was reaching “crazy high rates” in the Beehive State, as the percentage of women experiencing anxiety in the months before they got pregnant doubled in recent years.

That number has continued to rise, according to a new report from the Utah Department of Health. In 2012, 12.8% of mothers reported that they had anxiety before pregnancy. In 2019, it was 27.8%, the report shows.

The percentage of women experiencing symptoms of postpartum depression has also increased, from 11.2% in 2012 to 15% in 2019, according to the report.

Part of the reason for these increases could be greater awareness, with more moms recognizing what they’re experiencing and asking for help, said Nicole Stone, an epidemiologist with the Maternal and Infant Health Program.

As part of those efforts, Gov. Spencer Cox declared February as Utah Maternal Mental Health Awareness Month.

For Brook Dorff, a maternal mental health specialist with the state health department, the “most staggering” figure in the new report is that nearly 43% of Utahns who have recently given birth have been affected by depression or anxiety.

Dorff said she thought about the mothers in the state she works to help and realized, “Basically half of you are going through this.”

It’s important that mothers know, though, that “there is hope,” she said. “You don’t have to feel like this,” Dorff said, “and you don’t have to suffer alone.”

Reducing stigma

When Utah first lady Abby Cox had her first two children, she said, she didn’t struggle with mental health issues. It was after giving birth to her third child that it “hit me really hard,” Abby Cox said Wednesday.

“Frankly, I didn’t know what it was. I didn’t have the language for it,” she said.

Cox had heard a little bit about postpartum depression, but “it wasn’t until years later” that she was able to understand her experience better, she said. Hearing the stories of other moms helped, Cox said, including Emily Cook Dyches, who died nearly five years ago in Utah after experiencing postpartum anxiety.

After giving birth to twins in 2008, Lisa Condie Barlow, a Bountiful mother of five, experienced postpartum depression and obsessive-compulsive disorder. She hid her mental health issues from everyone except her doctor, who provided her with medication, and her husband, she said. She felt too embarrassed to also ask for recommendations to find a therapist, she added.

“I suffered in silence. I suffered alone,” she said.

Ten years later, Condie Barlow was a gestational carrier for her brother and sister-in-law. While giving birth to her niece, she had a near fatal hemorrhage, and then post-traumatic stress disorder “replaying my terror in the operating room,” she said.

In that decade since having her twins, though, there was less stigma, and “this time, I wasn’t embarrassed” to get help, she said.

What the report shows

Maternal mental health challenges tend to go unidentified and underdiagnosed, meaning it’s likely underestimated, according to the report. But Utah’s Pregnancy Risk Assessment Monitoring System, or PRAMS, offers some insight.

PRAMS surveys moms after they’ve given birth, asking about theirphysical and mental health, among other issues. This new report is based on PRAMS data collected from 2017 to 2019, and provides an update to a report published in 2017.

Of the people who had anxiety or depression before or during pregnancy, 25.8% also had symptoms of postpartum depression, compared to 8.3% of people without a history of mental health conditions, the report shows.

There were also higher rates of maternal mental health conditions in mothers under the age of 20, those who were unmarried, living with incomes at or below 100% of the federal poverty level, enrolled in Medicaid, who received nutritional services during pregnancy, had an unintended pregnancy or showed ambivalence about their pregnancy.

“People with multiple life stressors, chronic diseases and past physical abuse reported higher rates of depression and anxiety during pregnancy,” according to the report.

Health care providers play an important role in recognizing signs and risk factors of maternal health conditions during visits, but “we found only 44% of PRAMS participants reported being asked about depression before pregnancy,” the report states.

And while “nearly all (99%) of the people reported attending at least one prenatal care visit,” the report said 69% “said their health care provider asked about depression during pregnancy.”

How to get help

COVID-19 has added extra stress for parents, as schools closed last spring and mothers and fathers have juggled child care responsibilities with virtual learning and work, Dorff said. There are also women who are pregnant for the first time and aren’t able to have baby showers or other experiences they imagined, due to social distancing guidelines, she said.

There is help available for families, Dorff said, including free support groups. She runs the Maternal Mental Health Utah Facebook and Instagram pages to help families throughout the state, where mothers can feel “comfortable sharing their experiences,” she said.

Dorff has also worked with Carolina Barra, the mental support group facilitator for Comunidad Maternas en Utah, an organization that helps expectant Hispanic moms and provides resources in Spanish.

“We just want to make sure that the people that need help get the help they need,” Dorff said.

It may not be possible to stop mothers from experiencing maternal health issues, Hayhurst-Figgat said, “but we can greatly reduce the harmful effects that they can have on families and the population here in Utah through consistent education and support tools.”

Becky Jacobs is a Report for America corps member and writes about the status of women in Utah for The Salt Lake Tribune. Your donation to match our RFA grant helps keep her writing stories like this one; please consider making a tax-deductible gift of any amount today by clicking here.