Therapy Attendance Among First-Time Mothers Rebounds After Return to Work

Therapy attendance among first-time parents decreases around the perinatal period, suggesting that suggest that more accessible mental health treatments are needed during this time of transition. These study results were published in JAMA Network Open.

Although previous research indicates that pregnancy and postpartum are particularly vulnerable times for parental mental health, relatively little is known about treatment attendance during this period. Therefore, investigators conducted the current study to characterize changes in therapy attendance among first-time parents in the United States military.

The investigators conducted a cohort study of US Army and Navy service members during pregnancy and immediately after the birth of their first child. Parents were matched with non-parent service members as comparators. Outcomes of interest included monthly therapy attendance among parents vs non-parents and weekly therapy attendance among mothers before pregnancy vs after returning to work.

A total of 321,200 parents and matches were included, comprising 15,554,193 person-month observations. Of the participants, 10,193 (3.2%) were mothers, 50,865 (15.8%) were non-mother matches, 43,365 (13.5%) were fathers, and 216,777 (67.5%) were non-father matches.

The investigators found that mothers attended 0.0712 (95% CI, -0.0846 to -0.0579) fewer sessions at 1 month postpartum, relative to the 10 months prior to birth. This equated to a 76.7% decrease in therapy attendance, after accounting for time trends. Fathers attended 0.0154 (95% CI, -0.0194 to -0.0114) fewer sessions in the month of birth, compared with the previous 10 months, for a decrease of 47.5%. Further, first-time parents who had a history of mental health treatment prior to pregnancy experienced even larger reductions in treatment attendance during the perinatal period.

For mothers, weekly therapy attendance increased by 0.555 (95% CI, 0.257-0.852) percentage points when they returned to work after 6 weeks of leave and 0.953 (95% CI, 0.610-1.297) percentage points after 12 weeks of leave. By 4 months postpartum, therapy attendance returned to normative levels for both mothers and fathers.

Among first-time parents, therapy attendance decreased around childbirth, especially among those parents with a history of mental health needs and mothers experiencing longer maternity leaves.  “These findings suggest the transition to parenthood created barriers to mental health treatment and that return to work may have facilitated improved mental health treatment rates for mothers,” the investigators stated, concluding, “These findings suggest that more accessible treatment, including home visits or telehealth appointments, is needed.”

Study limitations include the lack of generalizability to civilians and individuals outside the US, and the inability to disentangle whether decreases in therapy sessions reflected an inability to access needed treatment or less need for treatment.

This article originally appeared on Psychiatry Advisor