To support healthy maternal and birth outcomes for expectant families, recruit partners for your Health and Mental Health Services Advisory Committee who are knowledgeable about prenatal and postpartum mental health concerns and community resources for referrals.

Depression

Perinatal depression is one of the most common complications of pregnancy and the postpartum period. It can happen at any time during pregnancy or in the 12 months after childbirth. The good news is that screening and referrals for care can prevent or treat depression.

Expectant fathers and fathers of newborn infants may also suffer from depression; the highest rates of depression are at three to six months postpartum. Depression is more likely to affect men of low income. Men with partners who suffer from perinatal depression have higher rates of paternal depression.

Parental depression can also harm an infant’s ability to bond with their caregivers. If the depression continues, infants and young children may have issues with their social and emotional development.

Programs should also develop a policy to continue to offer support to pregnant women and expectant families after a pregnancy loss or the death of an infant.

Tips and Strategies for Addressing Depression During and After Pregnancy

• Use an evidence-based screening tool to check for depression.
• Screen women during pregnancy and again three to six months after they give birth, or more often if mental health concerns are present.
• Train staff on how to talk about depression screening results with families​.
• Work with your mental health consultant or local mental health agencies to develop a referral process for families who need more mental health support and services.

Learn More

• Depression in Mothers: More Than the Blues
• 5 Action Steps to Address Maternal Depression in Head Start Programs
• Family Well-being: A Focus on Parental Depression
• Coping with Grief and Loss

Substance Use

Using alcohol, tobacco, and drugs, including using prescription medicine improperly, during pregnancy harms the growing baby. The chemicals in these substances cross the placenta and enter the baby’s body. 

Alcohol, tobacco, and drug use during pregnancy can cause:

• Stillbirth
• Low birth weight
• Birth defects
• Behavioral problems
• Developmental delays

It is not safe to drink any amount of alcohol during pregnancy. Alcohol use can cause fetal alcohol spectrum disorder in babies. Babies with this disorder can have abnormal facial features, severe learning disabilities, behavioral problems, and other serious issues.

Smoking and exposure to secondhand smoke during pregnancy are linked to poor birth outcomes, including low birth weight and preterm birth, problems with the placenta, increased risk of stillbirth, higher rates of C-section, and increased risk of miscarriage. Babies exposed to smoke may also have poor lung function, persistent wheezing, and asthma.

It is dangerous to use illegal drugs during pregnancy. Babies whose mothers use drugs like cocaine, heroin, and methamphetamine during pregnancy are more likely to be born addicted to those drugs. These babies often suffer from neonatal abstinence syndrome (NAS) as they withdraw from the drugs. Infants with NAS have more risk for vision problems, delayed motor development, sleep disturbances, and behavioral and cognitive problems.

Also, pregnant women who inject drugs are at higher risk of bloodborne illnesses like HIV, hepatitis B, and hepatitis C that can transfer to the baby during pregnancy and childbirth. Drug use during pregnancy can cause lifelong harm to children.

It is not safe for breastfeeding mothers to smoke, use drugs, or drink alcohol because these substances pass through the breast milk to the baby. Talk with families about how to make healthy lifestyle choices for themselves and their baby.

Tips and Strategies for Address Substance Use During and After Pregnancy

• Create policies that describe what your program will do to support pregnant women who use substances or have an addiction.
• Offer training to staff on substance use and addiction.
• Take steps to reduce and prevent the stigma that individuals and families challenged by substance use or addiction often feel.
• Partner with and make referrals to local agencies that treat pregnant women with a history of substance use and addiction.

Learn More

• How Substance Use Can Affect Pregnancy
• Talking About Substance Use and Pregnancy During Home Visits
• How Lifestyle Affects Breast Milk: Smoking, Drugs, and Alcohol