HEALTHmattersMD

One in three pregnant people experience anxiety or depression symptoms during or after pregnancy¹. Trusted providers are essential in identifying and addressing mental health conditions, which are the most common medical complications during pregnancy and the postpartum period. To ensure members have access to the highest quality of care, we want our providers who care for pregnant individuals to be aware of guidelines for screening and diagnosis of mental health conditions in the peripartum period.

Why this screening is important

More than 80% of mental health conditions during pregnancy go unreported.² One reason for this is the lack of structured systems in place for screening², leading to delayed diagnosis and missed opportunities for support throughout a pregnant person’s journey. Untreated perinatal mental health conditions are linked to:

• Preterm birth and low birth weight
• Increased cesarean section
• Increased rates of self-harm or suicide for mother
• Behavioral and developmental disorders in children
• Increased risk of sudden infant death syndrome (SIDS)
• Lower likelihood of being breastfed³

The screening requirement 

As of January 1, 2025, providers are required by California state law to conduct at least one maternal mental health screening during a member’s pregnancy and at least one additional screening during the first six weeks of the postpartum period. Additional postpartum screenings may be conducted by the provider if determined to be medically necessary and clinically appropriate. (Medical necessity for a pregnant and postpartum individual is based on risk factors.) Perinatal Mental Health screening done during pregnancy and postpartum are covered services for HPSM members.

Screening tools 

Evidence-based screening tools in the perinatal period include the Edinburgh Postnatal Depression Scale (EPDS), Patient Health Questionnaire (PHQ-9), Mood Disorder Questionnaire (MDQ), General Anxiety Disorder (GAD-7) scale and Primary Care PTSD Screen (PC-PTSD-5). More information on screening is available at ACOG.⁴

Additional resources and member support

1. Members can directly access mental health services by calling the BHRS ACCESS Call Center at 1-800-686-0101 (TYY: 7-1-1)
2. After discussing recommendations with patients, providers can complete and submit HPSM's Behavioral Health Referral Form by fax
3. For more information, check out HPSM’s Maternal Mental Health Resources and Behavioral Health Resources

References

_{1. Maternal Mental Health. Ca.gov. Published 2019.} 

_{2. The Importance of Integrating Maternal Mental Health with Pregnancy Care | Brown University Health. Brown University Health. Published 2022.} 

_{3. Luca DL, Garlow N, Margiotta C, Zivin K. Societal Costs of Untreated Perinatal Mood and Anxiety Disorders in the United States. Mathematica Progress Together. Published April 2019.} 

_{4. ACOG. Patient Screening. www.acog.org. Published 2025.}