States across the country improved policies and support for maternal mental health — but only slightly.
The country’s overall grade increased from a D+ to a C- this year, according to a new report. Only Alabama and Mississippi are still receiving failing grades.
States were graded by the Policy Center for Maternal Mental Health, a national think tank, and George Washington University based on 20 different measures, including levels of uninsured, food insecurity, and whether there are enough therapists trained to identify conditions like postpartum depression.
Maternal mental health conditions impact roughly 1 in 5 pregnant and postpartum people in the U.S. every year. That includes post-traumatic stress disorders and at least one or more anxiety disorders. And studies have suggested suicide may account for roughly 20% of postpartum deaths.
Caitlin Murphy, a research scientist who worked on the report, said it’s estimated that around half of mothers with postpartum depression go undiagnosed and only a quarter of women with a maternal mental health problem ever receive care.
“The need is massive, and the policies to address the need are not occurring at the rates we know that they need to,” she said.
Murphy said states have only made incremental gains since 2023, when the report card began.
Indiana and Ohio saw their grades increase from a D to a C. Kansas moved from a D- to a D, Missouri moved from a D- to a D+, and Kentucky from a D- to a C-. And Iowa’s grade rose from an F in 2023 to a C this year.
Nebraska jumped a letter grade from an F to a D, Illinois stayed flat at C, and Oklahoma saw a decline, dropping from a D+ to a D.
Those changes were based on moderate policy improvements and missed opportunities in each state.
For example, Kentucky created a Maternal Mental Health Task Force, and Missouri community-based organizations began offering maternal mental health care services. Oklahoma lost points for a lapsed Maternal Mental Health Task Force.
Murphy said Indiana’s letter grade improved for a variety of measures.
“[Indiana] requires Medicaid plans to report out on rates of maternal mental health screening, and we also know from the data that's being reported out that screening is occurring within Indiana at higher rates than other states,” Murphy said. “Indiana is also currently meeting what we call the prescriber ratio for maternal mental health.”
But the state isn’t meeting a number of benchmarks. Those include not having enough therapists trained specifically to identify perinatal mood and anxiety disorders, not creating inpatient and outpatient maternal mental health support programs, or developing a maternal mental health task force.
Leah Morton, a licensed clinical psychologist in Indiana, said the state needs to improve access to care. According to the state’s Maternal Mortality Review Committee, 71% of pregnancy-associated deaths in the state were preventable.
“Women in our state are dying at a much higher rate than most other states in our country for what we would consider treatable mental health-related conditions,” she said.
And experts like Morton and Murphy say the moderate gains in maternal mental health could be impacted by proposed cuts to Medicaid at the federal level. The program covers roughly 40% of all U.S. births. Those proposed changes are likely to have sweeping impacts across healthcare, including for maternal mental health.
“If we do see cuts to Medicaid, we're anticipating that much, much fewer moms will be able to get the mental health care that they need,” Murphy, who worked on the study, said. “And we will see states’ scores start to backslide in terms of the state report cards.”
Morton said the effect of cuts would be wide-ranging and impact more than just Medicaid recipients. She pointed to cuts to other programs like the Supplemental Nutrition Assistance Program (SNAP), which help ensure that new mothers with lower incomes continue to have access to food in the months after giving birth.
“I use the term devastating, and I'm not even sure devastating is a severe enough a term,” she said.
Contact WFYI and Side Effects Public Media’s Health Reporter Benjamin Thorp at bthorp@wfyi.org.
Side Effects Public Media is a health reporting collaboration based at WFYI in Indianapolis. We partner with NPR stations across the Midwest and surrounding areas — including KBIA and KCUR in Missouri, Iowa Public Radio, Ideastream in Ohio and WFPL in Kentucky.
