Perinatal Mental Health Care Research Articles

A Specialised Antenatal Music Therapy (SAMT) programme for pregnant women with mental health conditions: A mixed-methods proof-of-concept study in Ireland

ABSTRACT Introduction Perinatal mental health has a long-term impact on maternal and infant well-being. Non-pharmacological treatment options are needed for pregnant women and emerging evidence has shown the potential of music therapy to improve perinatal mental health and antenatal attachment. However, research is lacking on individual music therapy for pregnant women with mental health conditions and formal music therapy services are currently absent within perinatal mental health care in Ireland. This mixed-methods, proof-of-concept study aimed to assess the feasibility and preliminary evidence on the effectiveness of a specialised antenatal music therapy (SAMT) programme for pregnant women attending the Specialist Perinatal Mental Health Service (SPMHS). Method Pregnant women between 25 and 33 weeks gestation with various mental health conditions were recruited through the SPMHS to receive six in-person or online sessions of SAMT. Feasibility outcomes included retention, adherence, and fidelity.\\ Assessment of participants’ wellbeing, anxiety, and antenatal attachment were conducted before and after SAMT and each session. Semi-structured interviews were conducted and analysed using thematic analysis. Results Twelve pregnant women were included and nine completed SAMT and assessments, demonstrating a 75% retention rate. High levels of adherence and fidelity were reported. Significant improvements were observed in participants’ wellbeing, anxiety levels, and antenatal attachment. Qualitative findings highlighted the therapeutic benefits, the accessibility and challenges of the online setting, distinctive therapeutic experiences, and participants’ recommendations. Discussion The findings suggest implementing SAMT within the Irish SPMHS is feasible and beneficial. The study offers insights into the therapeutic mechanisms of SAMT and supports the progression to a larger trial.

Enablers of and Barriers to Perinatal Mental Healthcare Access and Healthcare Provision for Refugee and Asylum-Seeking Women in the WHO European Region: A Scoping Review.

Perinatal mental health is a growing public health concern. Refugee and asylum-seeking women are particularly susceptible to experiencing perinatal mental illness and may encounter a range of challenges in accessing healthcare. This scoping review sought to identify the enablers of and barriers to healthcare access and healthcare provision for refugee and asylum-seeking women experiencing perinatal mental illness in the WHO European Region. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews was applied. Nine databases and six grey literature sources were initially searched in April 2022, and an updated search was completed in July 2023. The search identified 16,130 records, and after the removal of duplicates and the screening process, 18 sources of evidence were included in this review. A data extraction table was used to extract significant information from each individual source of evidence, which was then mapped to the seven dimensions of the candidacy framework. Empirical (n = 14; 77.8%) and non-empirical (n = 4; 22.2%) sources of evidence were included. The literature originated from seven countries within the WHO European Region, including the United Kingdom (n = 9; 50%), Germany (n = 3; 16.7%), Denmark (n = 2; 11.2%), Norway (n = 1; 5.6%), Greece (n = 1; 5.6%), Sweden (n = 1; 5.6%), and Switzerland (n = 1; 5.6%). The results indicate that, although enablers and barriers were apparent throughout the seven dimensions of candidacy, barriers and impeding factors were more frequently reported. There was also a notable overall lack of reported enablers at the system level. Unaddressed language barriers and lack of attention to the diversity in culturally informed perceptions of perinatal mental illness were the main barriers at the individual level (micro-level) to identifying candidacy, navigating healthcare systems, and asserting the need for care. The lack of culturally appropriate alignment of healthcare services was the key organizational (meso-level) barrier identified. The wider structural and political contexts (macro-level factors), such as lack of funding for consultation time, focus on Western diagnostic and management criteria, and lack of services that adequately respond to the needs of refugee and asylum-seeking women, negatively influenced the operating conditions and wider production of candidacy. It can be concluded that there are multilevel and interconnected complexities influencing access to and provision of perinatal mental healthcare for refugee and asylum-seeking women.

The use of e-mental health tools in the perinatal context

SUMMARY E-mental health tools are a promising solution to reducing the high prevalence of perinatal mood and anxiety disorders and addressing barriers faced by women seeking professional help. This article summarises the main e-health tools used in perinatal mental healthcare, including examples of evidence-based tools for assessment, prevention and treatment of such disorders. We also highlight the main characteristics of the development process of e-mental health tools, which are based on cognitive–behavioural therapy, as well as the ethical concerns to be considered with their use and integration in healthcare systems.

Should Mother Baby Units be renamed Parent Baby Units? A critical reflection on gendered language in perinatal psychiatry.

Mother Baby Units provide mental health care to parents experiencing severe perinatal mental illness. The majority of admitted parents identify as mothers and are the birthing parent and primary caregiver for their infants. However, there is increasing recognition of transgender and gender diverse people who birth and parent infants, as well as awareness of the mental health needs of fathers, people in same-sex relationships, and other non-birthing parents. As such there are moves to use ungendered language for health services including renaming these units as Parent Baby Units. This paper explores this debate, critically reflecting on emergent tensions. Movements towards, and resistance against, changing language in perinatal mental health care are attempts to ensure the visibility of groups within mainstream services. Whether to adopt new terminology is a complex question. But ensuring MBUs meet the needs of people who require them should remain paramount.

Culturally Sensitive Perinatal Mental Health Care: Experiences of Women From Minority Ethnic Groups.

Current research has identified how ethnic minority women experience poorer health outcomes during the perinatal period. In the United Kingdom, specialist perinatal mental health services provide mental health treatment for women throughout the perinatal period. Service users have previously highlighted that perinatal services are hard to access and lack cultural sensitivity, whereas healthcare professionals have described limited opportunities and resources for developing cultural competency. We explored the experiences of ethnic minority women with National Health Service (NHS) specialist perinatal teams and identified what culturally sensitive perinatal mental health care means to this group. Individual semi-structured interviews were conducted, and an interpretative phenomenological analysis framework was used to analyse the interview transcripts. Participants were recruited from NHS specialist perinatal teams and online via social media. Six women were interviewed. Four group experiential themes central to the experiences of participants emerged: (1) strengthening community networks and peer support; (2) valuing cultural curiosity; (3) making sense of how culture, ethnicity, race and racism impact mental health; and (4) tailoring interventions to ethnic minority women and their families. The findings capture how ethnic minority women experience specialist perinatal teams and offer insights into practising culturally sensitive care. Perinatal mental health professionals can support ethnic minority women by strengthening their access to community resources and peer support; being curious about their culture; helping them to make sense of how culture, ethnicity, race and mental health interact; and applying cultural and practical adaptations to interventions. A Lived Experience Advisory Group (LEAG) of women from ethnic minority groups contributed to the design and conduct of this study. The LEAG had lived experience of perinatal mental health conditions and accessing specialist perinatal teams. The LEAG chose to co-produce specific aspects of the research they felt fit with their skills and available time throughout five group sessions. These aspects included developing the interview topic guide, a structure for debriefing participants and advising on the social media recruitment strategy.

A global perspective: Access to mental health care for perinatal populations

Perinatal mental health care differs around the world. We provide a global perspective on the current status of service provision, barriers and facilitators to access, and strategies to improve access in high-income and low- and middle-income countries across five continents (Asia, Africa, Europe, North America and South America). Many of the countries considered do not have universal healthcare coverage. This poses a challenge to perinatal mental health care access. However, there are other social and structural barriers to access, including stigma and other sources of marginalization and discrimination. Yet there are opportunities discussed herein to learn more about what perinatal mental health services work for what populations* and in what circumstances, by adopting a global lens to examine innovative solutions utilized across geographical settings.

Seeking help for perinatal depression and anxiety: a systematic review of systematic reviews from an interdependent perspective.

Seeking help for perinatal mood and anxiety disorders is crucial for women's mental health and babies' development, yet many women do not seek help for their condition and remain undiagnosed and untreated. This systematic review of systematic reviews aimed at summarizing and synthesizing findings from all systematic reviews on seeking help for PMAD in the context of interdependence theory, highlighting the interdependent relationship between women and healthcare providers and how it may impact women's seeking-help process. Four electronic databases were searched, and 18 studies published up to 2023 met inclusion criteria for review. The capability, opportunity and motivation model of behavior was used as a framework for organizing and presenting the results. Results demonstrate that seeking help for PMAD is a function of the interdependent relationship between perinatal women's and healthcare providers' psychological and physical capabilities, social and physical opportunities, and their reflective and automatic motivation. Unmet needs in perinatal mental healthcare is an important public health problem. This systematic review of systematic reviews highlights key factors for policymakers, researchers, and practitioners to consider to optimize healthcare systems and interventions in a way that enhances perinatal women's treatment whenever necessary.

Non-specialist delivered psycho-social interventions for women with perinatal depression living in rural communities: A systematic review.

Evidence from low- and middle-income countries suggests that non-specialist-delivered interventions effectively improve access to perinatal mental health care. However, there have been no systematic attempts to synthesize the evidence on effectiveness, relevance, and application of this strategy to resource-limited settings such as rural areas. The aim of this review is to synthesize the evidence about the effectiveness of non-specialist delivered interventions in improving depression and related outcomes in women with perinatal depression living in rural communities. Seven electronic databases were searched using the following search concepts: perinatal depression (e.g., puerperal depression, antenatal depression), rural areas (e.g., remote, nonmetropolitan, underserved), and non-specialist workers (e.g., lay worker, volunteer aide, informal caretaker. The risk of bias was assessed using RoB-2 and ROBINS-I tools. A narrative synthesis was performed as the high degree of study heterogeneity precluded a meta-analysis. Nine unique studies were eligible for inclusion. Psychoeducation and problem-solving techniques were the most used intervention elements. Two interventions significantly reduced the prevalence of perinatal depression compared to usual care, and three interventions reported effectiveness in reducing depression symptom severity. There was little to no consistent evidence for other outcomes, including but not limited to maternal health care utilization, breastfeeding behaviors, and child health. This review provides limited evidence to suggest that non-specialist delivered interventions effectively improved outcomes among women with perinatal depression living in rural communities. The paucity of high-quality studies included in this review demonstrates that this rural demographic is frequently neglected in the context of maternal mental health research.

National strategy introduced to address maternal MH, SUD crisis

Observing the need to identify a set of evidence‐based, evidence‐informed and promising practices to address maternal mental health care, a first‐ever national strategy released last week by a federal task force is calling for a seamless integration of perinatal mental health and substance use care across medical, community and social systems that increases equity and access.

Developing consensus to enhance perinatal mental health through a model of integrated care: Delphi study.

Perinatal mental illness is an important public health issue, with one in five birthing persons experiencing clinically significant symptoms of anxiety and/or depression during pregnancy or the postpartum period. The purpose of this study was to develop a consensus-based model of integrated perinatal mental health care to enhance service delivery and improve parent and family outcomes. We conducted a three-round Delphi study using online surveys to reach consensus (≥75% agreement) on key domains and indicators of integrated perinatal mental health care. We invited modifications to indicators and domains during each round and shared a summary of results with participants following rounds one and two. Descriptive statistics were generated for quantitative data and a thematic analysis of qualitative data was undertaken. Study participants included professional experts in perinatal mental health (e.g., clinicians, researchers) (n = 36) and people with lived experience of perinatal mental illness within the past 5 years from across Canada (e.g., patients, family members) (n = 11). Consensus was reached and all nine domains of the proposed model for integrated perinatal mental health care were retained. Qualitative results informed the modification of indicators and development of an additional domain and indicators capturing the need for antiracist, culturally safe care. The development of an integrated model of perinatal mental health benefitted from diverse expertise to guide the focus of included domains and indicators. Engaging in a consensus-building process helps to create the conditions for change within health services.

Digitally enabled perinatal mental health programmes: a Scottish perspective

This article provides an overview of the use of digitally enabled programmes to support perinatal mental healthcare in the NHS in Scotland, focusing on the Perinatal Wellbeing Programme from SilverCloud®. This follow up to a previous article published in the British Journal of Midwifery considers the experiences of using this programme in a Scottish context, examining feedback from users of the intervention.

A systematic review of midwives' training needs in perinatal mental health and related interventions.

Midwives may be key stakeholders to improve perinatal mental healthcare (PMHC). Three systematic reviews considered midwives' educational needs in perinatal mental health (PMH) or related interventions with a focus on depression or anxiety. This systematic review aims to review: 1) midwives' educational/training needs in PMH; 2) the training programs in PMH and their effectiveness in improving PMHC. We searched six electronic databases using a search strategy designed by a biomedical information specialist. Inclusion criteria were: (1) focus on midwives; (2) reporting on training needs in PMH, perinatal mental health problems or related conditions or training programs; (3) using quantitative, qualitative or mixed-methods design. We used the Mixed Methods Appraisal Tool for study quality. Of 4969 articles screened, 66 papers met eligibility criteria (47 on knowledge, skills or attitudes and 19 on training programs). Study quality was low to moderate in most studies. We found that midwives' understanding of their role in PMHC (e.g. finding meaning in opening discussions about PMH; perception that screening, referral and support is part of their routine clinical duties) is determinant. Training programs had positive effects on proximal outcomes (e.g. knowledge) and contrasted effects on distal outcomes (e.g. number of referrals). This review generated novel insights to inform initial and continuous education curriculums on PMH (e.g. focus on midwives' understanding on their role in PMHC or content on person-centered care). The protocol is registered on PROSPERO (CRD42021285926).

Digitally enabled perinatal mental health programmes' role in contemporary maternity care

This article explores the use of digitally enabled programmes to support perinatal mental healthcare in the NHS. Focusing on the Perinatal Wellbeing Programme from SilverCloud® by Amwell®, participant experiences drawn from published case studies are considered. With mental health conditions recognised as a continued and significant cause of maternal death in the UK, the need for innovative, flexible and effective interventions and support has never been more important. Exploring the place of digitally enabled programmes in contemporary midwifery practice, and the need for further evidence of their efficacy, this article continues the discourse of a previously published article on digital mental health platforms.

Enhancing Postpartum Mental Health: Evaluation of the Effect of Remote Peer Support Intervention

IntroductionThe postpartum period poses a risk of both onset and relapse of mental health disorders in mothers, which can impact maternal-child relationships and development of children. Timely intervention is crucial, especially considering that majority of at-risk women do not seek professional help.ObjectivesThis study aims to evaluate the effectiveness of Mom Supports Mom, a remote peer support intervention, in improving the mental health of postpartum women.MethodsA randomized controlled trial with 488 Czech postpartum women with depressive symptoms (Edinburgh Postnatal Depression Scale, EPDS score ≥ 10 shortly after giving birth) assessed the impact of Mom Supports Mom on depressive and anxiety symptoms (EPDS and Perinatal Anxiety Screening Scale, PASS) and health-related quality of life (Assessment of Quality of Life, AQoL-8D) at 6 weeks postpartum. The Mini-International Neuropsychiatric Interview 5 (MINI) was used to assess psychiatric diagnoses.ResultsThe intervention significantly reduced depressive (Cohen’s d = 0.30; p = 0.003) and anxiety symptoms (Cohen’s d = 0.29; p = 0.003) and improved health-related quality of life (Cohen’s d = 0.27; p = 0.008) at 6 weeks postpartum. No significant difference was observed in psychiatric diagnoses between the intervention and the control group.ConclusionsMom Supports Mom intervention reduces postpartum depressive and anxiety symptoms and enhances health-related quality of life. These findings support the integration of peer support into perinatal mental health care, addressing barriers that women face in seeking help.Disclosure of InterestNone Declared

THE BURGEONING BURDEN OF PERINATAL MENTAL HEALTH IN LOWER MIDDLE-INCOME COUNTRIES

THE BURGEONING BURDEN OF PERINATAL MENTAL HEALTH IN LOWER MIDDLE-INCOME COUNTRIES

The association between postpartum depressive symptoms and contraception

BackgroundPostpartum depression affects 10-20% of birthing people and is associated with changes in healthcare utilization. Little is known about the association between postpartum depressive symptoms and choice to use contraception, however both un- or under-treated depression and short interpregnancy intervals pose significant perinatal health risks. ObjectiveTo evaluate whether postpartum depressive symptoms are associated with changes in decisions to use any method of contraception. Study DesignThis retrospective cohort study included birthing people who delivered between 2017-2022 and were referred to a collaborative care program for mental health care. Through this program, birthing people with mental health conditions have access to specialized perinatal mental health care and prospective symptoms monitoring via a patient registry. Postpartum depressive symptoms are assessed via the Patient Health Questionnaire-9 (PHQ-9) and scores were stratified by severity according to clinical cutoffs. Contraceptive method choice was determined by documentation in the electronic health record and dichotomized as “none” if the participant declined all forms of contraception both at delivery and at the postpartum visit. Bivariable and multivariable analyses were performed. ResultsOf the 1871 participants that met inclusion criteria, 160 (8.5%) had postpartum PHQ-9 scores > 14, representing moderately severe or worse depressive symptoms and 43 (2.3%) had severe (PHQ-9 > 19) depressive symptoms. Compared to birthing people with PHQ-9 ≤ 14, those with higher PHQ-9 scores were more likely to have medical comorbidities, have a higher body mass index, to self-identify as Black, Native Hawaiian or Pacific Islander, or Hispanic/Latina, have a preterm delivery, and less likely to be married or nulliparous. There were no differences in any other sociodemographic or clinical characteristics. The choice to use any contraceptive method decreased with increasing depressive symptoms in bivariable and multivariable analyses, reaching statistical significance in birthing people with severe depressive symptoms (aOR 2.92, 95% CI 1.46-5.84). ConclusionSevere perinatal depressive symptoms are associated with a declination of any form of postpartum contraception. This finding becomes increasingly relevant as abortion access continues to be threatened across the US, compounding the potential impact of opting not to use contraception.

State of perinatal mental health care in the WHO region of Europe: a scoping review.

Although perinatal mental disorders are the most common health complication among women in the perinatal period, there is a huge gap in the implementation of related research findings in the health care system. We mapped the state of perinatal mental health (PMH) care in the WHO Europe region with aim to identify leading countries, which can serve as models for countries with less developed perinatal mental health care. Guidelines, policies, and documents related to screening and treatment services for PMH were searched as grey literature. Results were analysed to assess the status of PMH care in the WHO European countries and to identify gaps (absence of relevant service or documents). The state of perinatal mental health care was scored on a 0-5 scale. The grey literature search resulted in a total of 361 websites. Seven countries (Belgium, Finland, Ireland, Netherlands, Sweden, UK, Malta) received full points for the presence of relevant PMH services or documents, while five countries received zero points. Most WHO European countries (48/53) have general mental health policies, but only 25 countries have policies specifically on perinatal mental health. Ten countries offer PMH screening, and 11 countries offer PMH service (of any type). Any PMH guidelines were provided in 23/53 countries. Perinatal mental health care is in its infancy in most WHO European countries. Leading countries (Belgium, Finland, Ireland, Netherlands, Sweden, UK, Malta) in PMH care can serve as conceptual models for those less developed and geopolitically close.

Preparing for the ‘Blues’: Building Midwives’ Capacity for the Delivery of Perinatal Mental Health Care and Services in Ghana

Background: There is limited empirical evidence on the use of standardized and validated assessment tools such as PHQ-9 and GAD-7 by midwives in Ghana to screen perinatal women for symptoms of anxiety and depression and provide the needed support accordingly. Preliminary studies have reported a lack of sufficient knowledge, skills, and preparedness among medical staff, including midwives for the task of screening pregnant women for mental health disorders [21]. This study intends to inform midwives of the availability of tools to assist them make appropriate diagnostic impression of depression and anxiety and to provide a clear pathway to support the perinatal women in their care. Overall, the aim of this study is to promote the exchange of ideas and collaboration among stakeholders to ensure that the training and practice of midwifery in Ghana become more robust and meet global standards. Additionally, it is meant to inform, prepare competent, resourceful, knowledgeable, and most importantly adaptable midwives who can contribute to and promote the overall health of the women in their care. Objective: To address the gap in maternal mental health practice by equipping midwives with the requisite knowledge and skills on the use of globally validated and reliable assessment tools for depression and anxiety to support the perinatal women in their care. Methods: The study involved different two sections. In the first section, a structured questionnaire was used to collect data from 319 participants (midwives) to explore their knowledge on perinatal depression and anxiety assessment tools whiles the second component involved equipping midwives with the requisite mental health assessment skills through a two-week seminar that was organised and facilitated by the research team. Feedback on the level of confidence, suitability, and competence as well as the resourcefulness of the use of the tools was collected from participants (midwives) after three (3) months. The study was conducted in selected hospitals across all 16 regions in Ghana. The regions have several government and private hospitals that provide primary and specialised health care services to the public. They include teaching hospitals, regional hospitals, municipal hospitals, district hospitals as well as clinics within the sub-districts. Basic descriptive quantitative analysis was used based on frequency tables, pie chart and graphical illustration to interpret the data. Results: The study revealed that lack of resources and inadequate capacity-building to practically equip midwives are a major setback for the delivery of perinatal mental health services. It also identified perceived discrimination and stigmatisation on the part of the perinatal women as a major barrier in the provision of maternal mental health services. However, the participants demonstrated having adequate knowledge on the impact of perinatal anxiety and depression on birth and maternal outcomes. Nonetheless, there remains a huge deficit in their ability to use the validated and reliable assessment tools in recognizing clinical cues related to anxiety and depression among perinatal women. Surprisingly, over 50% of the midwives were unfamiliar with the commonly used assessment tools for depression and anxiety such as the GAD-7 and PHQ-9. Additionally, nearly 40% of the participants lack the requisite assessment skills for assessing perinatal anxiety and depression. In furtherance, over 97% of the participants demonstrated an appreciable level of confidence in terms of using the PHQ-9 and the GAD-7 following the post-assessment tool seminar. Conclusion: Perinatal mental health should be made a critical component of perinatal care, with midwives being well situated to recognize the manifestations of deteriorating mental health among the perinatal women in their care and provide the needed support and required level of supervision. It is therefore imperative to train midwives on basic mental health assessment skills and encourage them to incorporate mental health care into the delivery of routine perinatal care and services.

A consensus statement on perinatal mental health during the COVID-19 pandemic and recommendations for post-pandemic recovery and re-build.

The COVID-19 pandemic posed a significant lifecourse rupture, not least to those who had specific physical vulnerabilities to the virus, but also to those who were suffering with mental ill health. Women and birthing people who were pregnant, experienced a perinatal bereavement, or were in the first post-partum year (i.e., perinatal) were exposed to a number of risk factors for mental ill health, including alterations to the way in which their perinatal care was delivered. A consensus statement was derived from a cross-disciplinary collaboration of experts, whereby evidence from collaborative work on perinatal mental health during the COVID-19 pandemic was synthesised, and priorities were established as recommendations for research, healthcare practice, and policy. The synthesis of research focused on the effect of the COVID-19 pandemic on perinatal health outcomes and care practices led to three immediate recommendations: what to retain, what to reinstate, and what to remove from perinatal mental healthcare provision. Longer-term recommendations for action were also made, categorised as follows: Equity and Relational Healthcare; Parity of Esteem in Mental and Physical Healthcare with an Emphasis on Specialist Perinatal Services; and Horizon Scanning for Perinatal Mental Health Research, Policy, & Practice. The evidence base on the effect of the pandemic on perinatal mental health is growing. This consensus statement synthesises said evidence and makes recommendations for a post-pandemic recovery and re-build of perinatal mental health services and care provision.

Unmet needs in mental healthcare for women with clinically significant symptoms of perinatal depression and/or anxiety during the COVID‐19 pandemic

AbstractObjective/BackgroundUnmet needs in perinatal mental healthcare are an important public health issue particularly in the context of a stressful life event such as the COVID‐19 pandemic but data on the extent of this problem are needed.AimThe aim of this study is to determine the (1) proportion of women with clinically significant symptoms of perinatal depression, anxiety or comorbid symptoms of depression and anxiety, receiving mental healthcare overall and by country and (2) factors associated with receiving mental healthcare.MethodWomen in the perinatal period (pregnancy or up to 6 months postpartum) participating in the Riseup‐PPD‐COVID‐19 cross‐sectional study, reported on sociodemographic, social support health‐related factors, and COVID‐19 related factors, and on symptoms of depression (Edinburgh Postnatal Depression Scale [EPDS]) and anxiety (Generalised Anxiety Disorder [GAD‐7]) using self‐report questionnaires. Clinically significant symptoms were defined as EPDS ≥ 13 for depression and GAD‐7 ≥ 10 for anxiety. Mental healthcare was defined as self‐reported current mental health treatment.ResultsOf the 11 809 participants from 12 countries included in the analysis, 4 379 (37.1%) reported clinically significant symptoms of depression (n = 1 228; 10.4%; EPDS ≥ 13 and GAD‐7 ⟨ 10), anxiety (n = 848; 7.2%; GAD‐7 ≥ 10 and EPDS ⟨ 13) or comorbid symptoms of depression and anxiety (n = 2 303; 19.5%; EPDS ≥ 13 and GAD‐7 ≥ 10). Most women with clinically significant symptoms of depression, anxiety, or comorbid symptoms of depression and anxiety were not receiving mental healthcare (89.0%). Variation in the proportion of women with clinically significant symptoms of depression and/or anxiety reporting mental healthcare was high (4.7% in Turkey to 21.6% in Brazil). Women in the postpartum (vs. pregnancy) were less likely (OR 0.72; 95% CI 0.59‐0.88), whereas women with previous mental health problems (vs. no previous mental health problems) (OR 5.56; 95% CI 4.41‐7.01), were more likely to receive mental healthcare.ConclusionThere are high unmet needs in mental healthcare for women with clinically significant symptoms of perinatal depression and/or anxiety across countries during the COVID‐19 pandemic. Studies beyond the COVID‐19 pandemic and covering the whole range of mental health problems in the perinatal period are warranted to understand the gaps in perinatal mental healthcare.