We talk a lot about what it takes to have a healthy pregnancy and a healthy baby. We talk much less about what it takes for a mother to be healthy, especially when it comes to her mental health.
That gap matters. Maternal mental health conditions are common and treatable, yet too many women still struggle without receiving the recognition, support or care they need.
Motherhood does not make someone immune to serious mental health challenges. Yet our culture still treats emotional suffering during pregnancy and after childbirth as something women should quietly endure rather than recognize, discuss and address.
As an OB-GYN, I have spent my career caring for women through some of the most important moments of their lives. I have heard their excitement during pregnancy. I have shared in their hopes for the future.
I have also witnessed something else that receives far less attention: how difficult it can be for women to talk openly about emotional suffering before and during pregnancy, after childbirth and beyond.
We celebrate motherhood openly, but many women still feel pressure to hide the parts of the experience that are difficult, frightening or emotionally overwhelming.
We readily acknowledge that pregnancy affects the heart, blood pressure, metabolism and nearly every other part of the body. However, when it comes to mental health, many still view emotional struggles as a personal weakness rather than a medical condition deserving care and attention. The result is that too many women suffer in silence or delay seeking care.
Maternal mental health conditions are the most common complication of pregnancy and birth, affecting 1 in 5 mothers and 800,000 families annually in the United States. Despite how common these conditions are, three out of four women never receive treatment. Some never receive a diagnosis at all. Others spend months trying to navigate a fragmented system while caring for a newborn, recovering physically, returning to work and adjusting to a completely new chapter of life. The consequences can be profound. Mental health conditions contribute to nearly a quarter of pregnancy-related deaths, underscoring why maternal mental health must be recognized as a core component of maternal care.
What makes this especially troubling is that pregnancy is one of the few times in a woman’s life when she is regularly interacting with the health care system. If we cannot recognize emotional distress during one of the most closely monitored periods of care, we should ask ourselves why.
We screen women for numerous physical conditions during pregnancy because we understand that early recognition matters. We monitor potential complications because we know outcomes improve when concerns are identified before they become crises.
Mental health deserves the same level of attention, but many women still encounter a system that relies on them to recognize symptoms, overcome stigma and ask for help on their own.
That assumption overlooks what we know about maternal mental health. Shame can be a powerful barrier, as can fear. Many women worry they will be judged. Some worry they will be perceived as incapable. Others struggle to find the language to describe what they are feeling in the first place.
In my experience, one of the greatest challenges is that many women believe they are alone. They are not. What they are experiencing is often far more common than they realize. Yet our national conversation about maternal mental health frequently swings between two extremes: we either ignore it altogether, or we only discuss it in the aftermath of tragedy.
There is a vast middle ground that rarely receives attention. It includes women experiencing anxiety that keeps them awake at night. Women who feel disconnected from themselves. Women who are overwhelmed by expectations they believe they must meet without complaint. Women whose struggles may not be visible to anyone around them.
These stories are less likely to make headlines. They are also far more common.
If a woman develops gestational diabetes, no one suggests she simply try harder. If she develops high blood pressure, we do not expect her to manage it alone. We recognize those conditions as part of health care.
Maternal mental health should be no different. The goal is not simply to raise awareness, but to continue destigmatizing these conditions as legitimate medical issues that deserve the same attention as any other pregnancy-related complication. That means asking about mental health, screening for it universally and responding when women tell us they are struggling.
It also means acknowledging that access remains a significant challenge. Despite recent growth in the maternal mental health workforce, only 16% of the childbearing population lives in areas with an adequate supply of maternal mental health providers, leaving thousands of communities without sufficient access to care.
Addressing that gap will require more than increasing awareness or training additional specialists. It will also require expanding access through integrated and virtual care models that can reach women wherever they live. At CVS Health, behavioral health providers receive specialized training in maternal mental health through Postpartum Support International, and virtual behavioral health services are available nationwide through employer-sponsored offerings and in nearly every state through direct-to-consumer care. These approaches will not solve the workforce shortage on their own, but they demonstrate how care can be brought closer to patients while helping narrow the gap between what clinical guidelines recommend and what many women actually experience.
The problem isn’t that we do not understand maternal mental health. We do. The challenge is ensuring that screening leads to care, and that care is available. Until we close that gap, too many women will continue to hear that help exists without being able to access it.
Women should not have to choose between being seen as good mothers and being honest about their struggles. Maternal mental health conditions are real, common and treatable. The sooner we recognize that, the more women and families we can help before a crisis ever occurs.
Joanne Armstrong, MD, is vice president and chief medical officer for women’s health at CVS Health
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