Inequities in perinatal mental health: findings from IMAgiNE Research Network across 13 countries
M Lazzerini, M Carlino, M Camanni, I Mariani, LG Cora, M VerdecchiaAbstract
Background
Perinatal mental health (PMH) is a global public health concern, affecting women during pregnancy and up to 12 months postpartum. Depression and anxiety are the most common disorders and are associated with adverse maternal outcomes. This study estimated gaps in care among women reporting experiencing PMH symptoms, being screened, and receiving support.
Methods
Data were collected through an anonymous online questionnaire within the IMAgiNE Research Network (May 2024-September 2025). Eligible participants were women aged ≥18 years who gave birth in a health facility between March 2020 and September 2025 and provided consent. Analysis included key PMH indicators (symptoms, screening, support), excluding women with missing PMH data, those from countries with <350 participants, and those without consent.
Results
Of 116,691 responders, 48,484 women from 13 countries were included. Most had a vaginal birth (65.6%), 27.2% caesarean and 7.2% instrumental birth. Educational attainment was high (36.3% university, 28.9% high school). Overall, 44.9% reported MH symptoms; among them, 33.7% received support, and <14% were screened at all recommended visits. Substantial cross-country variation was observed, with different patterns across countries: Across the 13 countries, no pronounced gaps were observed across the three indicators. Sweden reported higher support (57.6%) and screening (47.0%), alongside a high prevalence of symptoms (53.6%), suggesting a more responsive pattern. In contrast, Croatia showed very low screening (4.3%) and limited support (13.5%), despite a notable prevalence of symptoms (34.7%).
Conclusions
Substantial gaps in PMH care persist. Despite high symptom prevalence, two-thirds of symptomatic women did not receive support, and only 11.2% were screened and supported. Needs did not align with care provision, highlighting major inequities. Strengthening perinatal care through universal screening and access to support is urgently needed.