Latendresse’s studies use mindfulness-based cognitive behavioral therapy (MBCT), a treatment that blends cognitive therapy with meditation and mindfulness for those wary of taking medication. MBCT can help interrupt the spiraling feelings of shame, guilt, and self-criticism that affect many mothers with perinatal mood disorders—often believing they aren’t good parents or shouldn’t feel as sad as they do.

Sarah McCormick was no stranger to this shame. Diagnosed with multiple sclerosis in her early 20s, McCormick had been put on medication with depression as a side effect. But the birth of her first child in 2013 brought on something new: severe postpartum depression, more disabling than what she’d experienced before.

“I’d have lots of fatigue, no energy. I’d find that I just feel really numb,” she says. “Everything feels like a chore. And everything feels heavy. You can’t find the good things and the joy in life.” When the same thing happened after the birth of her next three children, she sought counseling at some times, medication at others. Mostly, she was resigned to a new, darker outlook and put a lot of blame on herself, saying, ‘Well, unless I’m willing to eat 100% right and exercise, and make sure I’m getting sleep… [depression] is just going to be my lot in life.’

After her daughter Amelia’s birth in 2020, McCormick joined Latendresse’s program and was stunned to feel immediate results. “When I combined medicine with this program, it finally was like, Oh! This is the ticket.”

The telehealth group not only interrupted McCormick’s circular negative thinking but helped her find others with shared experiences. “It normalizes it; you don’t feel as marginalized,” she says. “You can feel like you are part of a community.”

Because these groups were available to women across Utah, they also offered some anonymity, which helps with that powerful social stigma about mental health.

“We live in a small town. If you don’t know someone directly, you know somebody that knows them, and that’s a worry, if women don’t want to talk with people that know them or their family.”

^{-SARA BRABY, RN}

Thanks to these regular screenings, mental health is becoming a readily more common topic in patient visits. "We're super proud of the progress we've made," says Braby. "We have a lot of moms that say, 'This is what's going on with me; where can I get help?' Now, it's become a part of the visit—like, 'Let's take your blood pressure, let's do your temperature, your depression screening was this number, let's talk about it.'"

Accessibility, affordability, community, just enough anonymity. The groups worked: Women in Latendresse’s first study group had much lower depression scores, even six months later. When participation dropped during the COVID-19 pandemic, Latendresse’s team pivoted again and developed a suite of on-demand mental health resources, connected to U of U Health’s web-based YoMingo^® patient education platform. Women could browse resources at their convenience. Interestingly, most users log on at 9 pm (once kids are in bed) or 3 am (when moms can’t sleep).

Programs like these enshrine a vital truth: While postpartum recovery looks different for every mother, each deserves a community they can rely on, exactly where and when they need it.

For those feeling lost in or overwhelmed by motherhood, telehealth is an important lifeline to stay afloat. But that’s a drop in the bucket. What’s needed next is extended support through the postpartum period.

Currently, 40% of U.S. births and 22% of Utah births are covered by Medicaid through a federal mandate that covers prenatal and perinatal care for mothers, but only until 60 days post-delivery. After this point, mothers must qualify and re-apply for coverage through other Medicaid programs, where eligibility is determined by the individual state, leaving many mothers to fall through the gaps.

Applying for Medicaid is not easy. Eligibility varies by program, and coverage is not guaranteed. But it can be well worth the effort. Consider this: The federal poverty level for an individual is $14,580. The average U.S. birth costs between $10,000–16,000.

These issues existed long before COVID-19, too. A recent Health Affairs article found that among prenatal Medicaid enrollees who lost coverage in the early postpartum period, two thirds remained "consistently uninsured" at nine and 10 months postpartum. So, alongside new adjustments to parenthood—the stress, sleep deprivation, and physical recovery—mothers are often tasked with conducting research, submitting applications, finding new providers, and enrolling in a new plan, all in the hopes of continued coverage. Motherhood certainly doesn’t end at delivery, and it doesn’t end 60 days after.

In April 2022, Medicaid offered some relief. Through a new amendment, each state could choose to extend their postpartum coverage to a year post-delivery. By December, 27 states had approved extensions; eight other states were in the process of implementing their own. Utah joined them with S.B. 133, a bill passed in March 2023 that modified Medicaid coverage to cover a full year postpartum with some restrictions.

S.B. 133, sponsored by Utah State Senator Wayne A. Harper, MS, offers many Utah families much-needed support. “If mothers and newborns don’t have quality of care in that first year, it can affect them for a long time, even throughout their life,” Harper says. “We’ve got to realize that people have a variety of experiences with childbirth. If you work for a good company, have good insurance, family and social support, that’s great. But sometimes you don’t. We need to make sure everybody with a newborn has the safety net they deserve.”

Though not a complete solution, bills like these are a vital step toward better care for mothers. “This is something that Utahns actually are paying attention to,” says Utah State Representative Rosemary Lesser, MD, also an OB/GYN. “Our health care systems are also paying attention to this; the University of Utah has really led out.” Lesser was the sponsor of H.B. 220, another Utah bill that—though it did not pass—raised vital awareness about the urgent need for extended postpartum coverage. “When I would be caring for women under Medicaid, we would be scrambling to accomplish our health care goals by 60 days,” she says. “That’s what informed my presentation of this legislation.”

Progress is on the horizon at a national level, too. Earlier this month, the Food and Drug Administration (FDA) approved the first oral drug for postpartum depression. A once-daily pill taken for 14 days, Zurzuvae can be conveniently taken at home and acts much quicker than other antidepressants (which can take weeks or months to take effect). Though not a cure-all, especially considering the many factors that can cause postpartum depression, this medication can support mothers during those crucial first days following childbirth.

The message all this work sends is simple: Mothers matter. With broadened access to care, new interventions, and insurance coverage through every stage of pregnancy, the goal is healthier, happier parents and babies across the state. Telehealth groups, universal screening, integrated care, and a stronger safety net are some of the best tools we’ve got to get there.

Additional Resources

If you or someone you know may be struggling with perinatal/maternal mental health issues, you can find a provider through the Huntsman Mental Health Institute. For a list of local agencies and support groups available, visit Postpartum Support International Utah.

Sources for all data within this story can be found online.