Researchers studying Veterans Affairs health care across the country found that maternal pregnancy-related anxiety, depression, and post-traumatic stress disorder can lead to problems for pregnant veterans and their children, including greater difficulties with child-parent bonding and increased parenting stress.

In response, health care providers across the country, including at the Iowa City Veterans Affairs Media Center in Iowa City, are working with their pregnant population to reduce these issues.

According to a study by researchers in Veterans Affairs hospitals across the country, maternal related anxiety, depression, and post-traumatic stress disorder have adverse outcomes for pregnant people and their children. The study found that postpartum depression was significantly associated with more difficulties with bonding and parenting stress.

Janelle Beswick, outreach and marketing coordinator for the Iowa City Veterans Affairs Health Care System said the hospital doesn’t have obstetric services, but works to cover medical care for their pregnant population.

“We do check-ins for care, including postpartum stress if they need it,” Beswick said. “We also cover all officer visits, genetic testing, and anything the mother might need like milk supply bags.”

During each trimester, Laura Johns, the Iowa City Veterans Affairs Health Care System maternity care coordinator, calls to check in on pregnant patients. She also said she screens patients for mental health, intimate partner violence, and tobacco and alcohol abuse.

“I provide a basic screening, making sure to refer women to mental health providers if there are any concerns,” Johns said. “If they test positive at all for depression or other mental health issues, I can refer them to someone within the VA or in the community to provide mental health counseling.”

Many veterans use this service, Johns said. Last fiscal year, 34 people received maternal care from the VA. Of those screened, 15 women had PTSD and 24 had a mental health diagnosis.

Jess Beswick-Honn, assistant chief engineer for the Iowa City Veterans Affairs and a pregnant patient of the hospital, has received care since before her pregnancy. She’s worked with the VA since she got back from a tour in Iraq in 2006 and has undergone fertility treatment with the VA and the University of Iowa.

“Laura works with me to talk about how I’m feeling during the pregnancy,” Beswick-Honn said. “She’s helped me with all sorts of stuff and asks leading questions about my mental health that I never would’ve thought of.”

Johns said her patients can sometimes hesitate to disclose mental health information in phone calls, but she lets them know that resources are always available to them.

“It’s important to help pregnant women establish mental health care before they are pregnant, so they can reach out to providers with any concerns,” Johns said. “Even if women don’t screen positive for having mental health concerns, it’s good to help them get connected with counselors and other providers.”

The VA offers programs to help struggling pregnant and new mothers, Johns said.

One program, called Annie, sends text reminders to reach patients. The program has helped mothers navigate a variety of issues, including safe sleep for babies and postpartum depression.

Something Johns said she’s noticed in her work with pregnant women is that indicators of postpartum depression can start earlier in the pregnancy, rather than after the baby is born.

“Some of the symptoms of depression start before they deliver, which is why it’s important to connect mothers with mental health professionals before their babies are born,” Johns said. “There are a lot of contributing factors for postpartum depression, including anxiety during pregnancy and levels of social support from spouses and other family members.”

Beswick-Honn said she had depression before her pregnancy, so she’s worked with her obstetrician to make sure she keeps taking her medicine.

Another program in the Iowa City center called ROSE (reach out, stay strong essentials) offers four group therapy sessions before and after delivery to mothers by providing education on postpartum depression, Johns said.

“The biggest thing we do is let patients know we’re here if they need help,” Johns said. “Pregnancy and motherhood can be difficult, and this is a smaller population that we work hard to help.”

Beswick-Honn said she’s participated in the program and finds it rewarding to meet with a group of people who understand what it’s like to have depression and anxiety during pregnancy.

“I’m not somebody who necessarily reaches out and asks for what I need, so Laura has been extremely helpful with her check-ins,” Beswick-Honn said. “It’s cool to have someone like Laura fighting for maternity care and making sure pregnant women get their benefits and support throughout pregnancy.”