Gaps in mental health training, rural access to care compound Arizona’s maternal mortality crisis
Arizona Center for Investigative Reporting by and
Within hours of giving birth to her first child, Araceli Aquino-Valdez was engulfed by an intense sadness. She sobbed for days after arriving home, grieving the loss of her life before motherhood and feeling dismissed by her care providers.
Medical professionals had warned the Yuma mother-to-be early in her pregnancy that prior mental health challenges put her at an increased risk of postpartum depression, she said. They’d offered no further information or resources at the time, though, so she didn’t think much of the warning.
When she visited her OB-GYN for the standard six-week postpartum checkup, she shared her ongoing feelings of hopelessness with a different doctor. Again, she said, there was no discussion of possible solutions, referrals to mental health specialists or even a plan to follow up.
Aquino-Valdez turned to online forums, like Reddit, to look for answers her doctors weren’t offering. She got the impression that mothers who lived elsewhere were getting a different standard of care—one she couldn’t access.
“It seemed like postpartum depression was taken seriously in those places,” she told AZCIR. “I thought it would be taken more seriously here.”
Perinatal mental health conditions are among the leading causes of death during or within one year of pregnancy in Arizona, with substance use often emerging as a contributing factor, according to the state’s Maternal Mortality Review Committee. Between 2018 and 2019, the most recent year for which data is available, almost 40% of pregnancy-associated deaths in the state involved a mental health condition—and nearly all of those deaths were deemed preventable.
“Women are not being assessed properly as they should be. We’re not identifying mental health (as a problem) until it becomes an emergency,” said Cara English, CEO of the Arizona-based Cummings Graduate Institute of Behavioral Health Studies. “This is where women die.”