Closing Gaps in Care: Enhancing Mental Health Through PMAD Screenings

While Mental Health Awareness Month may have come to a close, it’s important to underscore how supporting mental health in the workplace is not just a monthly practice, but a critical, year-round task. This is especially true for new parents – the journey into parenthood often offers a new perspective in regards to a person’s mental health. New responsibilities, routines, stressors, emotions, and work-related accommodations, along with the physical healing and bonding process with a baby, will significantly impact a parent’s mental health needs. Statistically, women are more likely to develop depression and anxiety symptoms during the first year after childbirth than at any other time in their lives.1 As health plans and employers, it’s our collective responsibility to provide the necessary support. 

Up to 80% of women who give birth report feeling postpartum “baby blues,” making perinatal (the time just prior to and following childbirth) mood and anxiety disorders (PMADs) one of the most common complications of pregnancy. PMADs have a quite significant adverse impact on the mental, physical, and emotional health of not only the women who experience them, but also their children and families. They are associated with adverse pregnancy outcomes, miscarriage, pre-eclampsia, preterm birth, and low birth weight. Dealing with PMADs can compromise parenting, impair behavior regulation, and lead to insecure attachment with the infant.2

Despite the sobering facts, there is a lack of screening or treatment for PMAD symptoms. Of particular concern is that up to 50% of mothers experiencing symptoms will not seek mental health treatment.3 Even though the risk of being diagnosed with PMADs is higher among racial and ethnic minorities, these groups are even less likely to be screened or receive the mental health support they need.4 Studies also show that Medicaid beneficiaries are less likely to be screened, creating further potential consequences for populations more likely to need support.5 These statistics demonstrate the urgent need for digital health solutions that can address perinatal and parental mental health, starting with closing the gaps in mental health screenings.

The importance of mental health screenings

The six-week postpartum visit, based on standards set by the American College of Obstetricians and Gynecologists (ACOG), is critical. This comprehensive checkup assesses a patient’s physical and emotional well-being, allowing early identification of health issues while transitioning from pregnancy care to long-term care for chronic illnesses or PMADs. It marks the shift from focusing on pregnancy care to prioritizing a parent’s overall health.6

During the six weeks after giving birth, the significant life changes of becoming a new parent can dominate parents’ daily routine. Many struggle to prioritize their own health while managing various responsibilities, such as returning to work, dealing with costly childcare, and adjusting to changes in their family dynamics. Only about 60 percent of women attend their postpartum visits, and rates are even lower for beneficiaries of Medicaid or CHIP.7 One study found that even when new parents attend the standard six-week postpartum appointments, only half of the providers asked their patients about PMAD symptoms at the visit.8

Increasing attendance rates is only part of the challenge – timing can also be a critical factor. In the U.S., the national diagnosis rate for PMADs is 11.5 percent, but Ovia’s research suggests that the true rate of PMADs is as high as 30 percent.9 In a study of over 160,000 Ovia members, we found a notable increase in PMAD mental health screener scores three to twelve months postpartum, which extends beyond the typical six-week screening window.10 It’s clear that cases of postpartum depression, anxiety, OCD, and psychosis are often being missed. People are likely to fall through the cracks when their symptoms appear later. The American Academy of Pediatrics recently amended their infant well-child visits to add in additional PMAD screening, but adherence to this guideline is inconsistent due to restricted patient interaction time and the focus of the appointment being on the child rather than the parent. 

These missed and insufficient screenings provide us the opportunity to close gaps in mental health support by offering more frequent PMAD testing beyond the clinical setting. Additionally, through increasing the attendance rate at six-week postpartum visits, we can connect more people to the care they need to prevent or treat adverse health outcomes after birth. 

How Ovia closes gaps in mental health care

Ovia helps remove cost barriers to reproductive education and helps parents understand the care they need in order to take control of their health journeys. We do this by giving all members evidence-based clinical content tailored to their specific needs and risks and providing them with simple, convenient tools to track their health before, during, and after pregnancy. We understand that creating a strong bridge of communication, information, guidance, and support can significantly improve the way parents prioritize their mental health.

In the case of PMADs, Ovia’s digital health solutions can act as a safety net for those whose providers or circumstances don’t offer frequent mental health screenings. While using the Ovia Pregnancy and Ovia Parenting apps, members are given the universally validated Edinburgh Postnatal Depression Scale (EPDS), the same validated tool providers use in clinical settings.

Ovia members take the screener via their smartphones, allowing them to screen more often, regardless of whether their doctors provide the screening or if they miss a healthcare visit. Prompts urge members to take the EPDS during the first and third trimesters of pregnancy and at least twice within the first six months after birth. Studies suggest that members may under-report depression symptoms in a setting where they feel uncomfortable or discriminated against — such as a doctor’s office.11 By screening at home, members may report their symptoms more accurately. 

When members take the EPDS through Ovia’s solution, we offer them vital recommendations quickly. They receive an interpretation of their score right away, and when the score is high — indicative of a potential PMAD — we deliver a recommendation to contact their provider for care. Due to our approach, members participating in this program were 67% more likely to complete the screener.12 

The Ovia app not only facilitates PMAD screenings but also serves as an educational tool. Through push notifications, we remind and encourage members to attend a six-week postpartum healthcare visit – reassuring them that their postpartum health is a priority. In the third trimester, the Ovia Pregnancy app automatically provides information about what to expect at the appointment and what questions to ask the provider. This information is shared again as soon as a member installs the Ovia Parenting app. Creating a clear line of communication and messaging supports members as they prioritize and organize their needs while managing their family and life dynamics. Educating the member on the importance of attending the appointment, reminding the member of the upcoming appointment, and normalizing postpartum care ultimately increases the likelihood of attendance.

The results are promising: postpartum visit rates were 86% among Black Ovia members enrolled in Medicaid or CHIP and 89% for American Indian and Alaskan Native Ovia members enrolled in Medicaid or CHIP. Compared to the national average of 60%, that’s a 43% increase.13 These numbers are a testament to the potential impact of our digital health solutions. While we’ve made strides in increasing mental health screenings and access to care, we recognize the ongoing need to strive for health equity. To effect lasting change, we must confront systemic racism and connect more individuals with community resources and health programs. If your organization is committed to addressing PMADs and enhancing mental health among employees and members, a partnership with Ovia is a strategic move. 

1. National Library of Medicine:,et%20al.%2C%202015).

2. National Library of Medicine:,et%20al.%2C%202015).

3. National Library of Medicine:,et%20al.%2C%202015).

4. National Alliance on Mental Illness:

5. Archives of Women’s Mental Health:

6. The American College of Obstetricians and Gynecologists (ACOG):

7. American College of Obstetricians and Gynecologists (ACOG):

8. Centers for Disease Control and Prevention (CDC):

9. Bradley et al., 2020. Risk of perinatal depression among women screened within a mobile application. The International Marce Society for Perinatal Mental Health Conference.

10. Bradley et al., 2020. Risk of perinatal depression among women screened within a mobile application. The International Marce Society for Perinatal Mental Health Conference.

11. Journal of Personality Assessment:

12. Ovia Health:

13. Ovia Health: