Mental health screenings should be standard in maternal health care

Keeping a woman’s heart healthy during pregnancy shouldn’t stop at blood pressure cuffs and glucose tests. A 2025 scientific statement from the American Heart Association says mental health screenings should also be considered part of routine maternal care.

Growing evidence shows that untreated mental health conditions such as depression and anxiety during and after pregnancy can raise the risk of serious complications for mothers. Treating these conditions and their risk factors during the perinatal period, which is up to a year after pregnancy, may improve the short- and long-term health of both mother and child.

“Pregnancy is an important time of life from a health perspective,” said Dr. Garima Sharma, who led the panel that wrote the statement. She noted that many health care professionals may not perform routine psychological screenings because they don’t understand the link between emotional well-being and heart health.

Sharma, director of preventive cardiology and women’s cardiovascular health at Inova Schar Heart and Vascular in Fairfax, Virginia, said it’s “critical” to redefine maternal cardiovascular health to include psychological health.

She urges that psychological health screenings should be just as important as screening for high blood pressure, Type 2 diabetes and other modifiable heart disease risk factors. 
Research shows poor mental health can directly and indirectly strain the heart. Depression and anxiety may contribute to poor sleep, unhealthy eating and less physical activity. Maternal psychological health can affect the child’s neurodevelopment and well-being, too, the statement says.

Perinatal mental health conditions are among the leading underlying causes of maternal deaths in the United States, with an estimated 52% of reproductive-age women reporting a history of a psychological health disorder and 40% of women from underrepresented groups experiencing anxiety or depression during the perinatal period. Maternal mortality in the U.S. is two to three times higher than in other high-income countries and has worsened since the COVID-19 pandemic. The maternal mortality rate for non-Hispanic black women is 2.6 times higher than non-Hispanic white women.

Risk factors for psychological conditions include sleep disorders, domestic violence, limited partner support, unemployment, racism and discrimination. Complications in prior pregnancies, such as miscarriage or high blood pressure, also increase the risk of perinatal anxiety and depression.

The statement recommends screening for mental health concerns early in pregnancy and repeating it at least once. Because symptoms can change, health care professionals are encouraged to ask about emotional well-being at every prenatal and postpartum visit.

Experts also call for culturally responsive, family-centered care and multidisciplinary teams. A health care professional can determine how to safely treat mental health conditions during pregnancy. Medication may be needed or nondrug approaches, such as counseling, cognitive behavioral therapy, exercise and stress management.