November 2024 marks an important decision for those of us living in the United States. On election day, we get to cast our votes for the leaders who will take us and our families into the future. We will never suggest anyone vote in a certain way. We do want to share three topics we’re watching closely because of their importance to perinatal mental health. If you’re voting with perinatal mental health in mind, here’s a brief guide to policies that will deeply impact perinatal people.
1. Paid Leave
Paid Family Leave is standard around the globe- with 40 out of 41 countries in the Organisation for Economic Co-operation and Development (OECD) offering some sort of mandated paid leave. Can you guess which country is the one? Ours!
U.S. citizens technically have 12 weeks of leave through the Family and Medical Leave Act (FMLA). That time is unpaid (unless you live in one of 13 states) and mostly job protection. Most people don’t have three months of expenses in savings to take leave from their job after birthing a baby. Not to mention partners taking leave is equally important to help prevent additional stress in the perinatal period. In Hong Kong, extending paid maternity leave from 10 to 14 weeks reduced postpartum depression by twenty-two percent. Imagine what we could do increasing from zero to any number of weeks (preferably 12+).
2. Medicaid Expansion
Wisconsin is one of 10 states in our country that hasn’t expanded Medicaid. A bit of background- when someone becomes pregnant, the eligibility requirements for Medicaid change to ensure a pregnant person can access Medicaid and receive critical. In Wisconsin, at 60 days postpartum, those benefits expire. That leaves an insurance gap, where someone may make too much to qualify for “normal” Medicaid, but not enough to afford care with their private or employer insurance plan copays and deductibles.
This matters deeply for perinatal mental health in our state because perinatal mental health conditions are the leading cause of death in the first year postpartum. And, the highest risk time for maternal death by suicide is six to nine months postpartum. In Wisconsin, Medicaid benefits expire before postpartum people reach the highest risk period for dying from a completely treatable and preventable disease.
3. Doula Coverage
Doulas are amazing. We can hardly say enough good things about having a doula during pregnancy, labor and postpartum. Most importantly for our purposes, in each stage doulas are often the front line to recognizing perinatal mental health conditions. From navigating scary test results in pregnancy to getting a new mom out of bed for the first time in 48 hours when she’s struggling, doulas can also protect a perinatal person from experiencing significant symptoms of depression or anxiety while guiding them toward help. They’re in the room for birth and can help mitigate birth trauma and systemic racism, leading to a healthier life for mom and baby. It seems like a no-brainer for insurance to cover something so great!
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