Most states receive D’s, F’s in maternal mental health report card

May 15, 2024

Jaqueline Sharp, 35, remembers her anxiety “went through the roof” shortly after she gave birth to her son in 2019.  

Her mental health got worse as she tried to balance recovering from a cesarean section, mastering breastfeeding and baby sleep schedules all on very, very little sleep.  

By the time her son turned a month old, Sharp recalls feeling numb, overwhelmed and like she was a failure as a mother.  

“I remember thinking to myself that my husband and my son would be better off if I just wasn’t here,” Sharp said.

She tried to confide in friends about how she felt, but the conversations were difficult. “I felt so much shame to come out and say I’m thinking of killing myself.” 

Sharp is one of the millions of women whose mental health declined after delivery. About 1 in 5 pregnant or postpartum women in the United States will experience a mental health disorder like depression, anxiety or suicidal ideation, according to the American Psychiatric Association. But very few of these women will receive treatment.  

Nearly every state in the country is doing a poor job meeting the mental health needs of new and expecting mothers, according to a new report from the Policy Center for Maternal Mental Health.  

In the report, 24 states scattered across the country received D grades and five states received a failing grade for their efforts to help recent or expecting mothers with their mental health.  

States were graded across three categories: providers and programs, screening and screening reimbursement and insurance coverage and treatment.  

Only three states earned higher than a C+ on the report card — California, Pennsylvania and Washington.  

California earned the highest grade out of all 50 states, receiving a B+, in part due to the state having one inpatient maternal mental health treatment program and its expansion of Medicaid coverage a year postpartum, according to the report.  

Of the 18 measures used to calculate each state’s score, California successfully adhered to 14.  

But the Golden State still has some work to do. California still doesn’t meet the ratio of nonprescriber maternal mental health providers to the perinatal population or a perinatal quality collaborative that prioritizes maternal mental health.  

Obstetric providers in the state are also not required to submit claims to private insurers for prenatal maternal mental health screenings, something that would allow researchers to collect better data on mental health conditions among pregnant people, according to the organization.

Providers in general in the state are not submitting claims to private insurers for prenatal maternal mental health treatment, according to the report.  

Overall, the country earned a grade of D+, a slight improvement from what the nation earned in the think tank’s 2023 maternal mental health report cards.  

Last year, the U.S. earned a D grade, and 40 states plus Washington, D.C., received D’s or F’s.  

The only state to earn a grade higher than a C in last year’s report was California, which received a B-.  

“We’re seeing incremental improvements in state efforts to address maternal mental health and improvements in the state-level data that is available,” said Caitlin Murphy, a research scientist at the George Washington University’s Milken Institute School of Public Health, who helped create the report cards.  

 “Yet, grades are still dismally low. … States should be commended for their hard work to address maternal mental health disparities, and we still have a long way to go,” she said.