The mental health of mothers in the United States is in crisis. Approximately, 20 percent of mothers are impacted by mental health conditions during pregnancy and postpartum, affecting 800,000 families annually, and making it the most common complication of pregnancy. These conditions not only harm the mothers but can also have a profound effect and lasting impact on the health and development of their infants. Preventing and treating maternal mental health conditions should be top of mind for cities as it is both crucial for the well-being of the mother, as well as the healthy trajectory of their children.
Mental Health During the Perinatal Period
The perinatal period is defined as the time during pregnancy and up to one year postpartum. During this time, women are particularly vulnerable to the emergence or exacerbation of mental health conditions. Depression is the most common of these conditions, but others include anxiety disorders, obsessive-compulsive disorder, post-traumatic stress disorder and psychosis. While anyone can experience perinatal mental health problems, certain populations — such as women of color, those impacted by poverty and military service members and spouses — often face stress and health disadvantages that increase their likelihood. According to the CDC, maternal mental health conditions have become one of the major underlying causes of pregnancy-related deaths in the United States. Despite its prevalence, several barriers, such as lack of access to healthcare, feelings of shame, stigma and guilt, and logistical challenges — including not being able to take off work or find child care — make it difficult for women to access the care and support they need.
Risks to the Child
Research has found that poor maternal mental health impacts the baby even before they are born. A study published in the journal JAMA Pediatrics found that anxiety and depression during pregnancy could expose the fetus to increased concentrations of the stress hormone cortisol, leading to changes in brain function and reducing the flow of blood, oxygen and nutrients. Infants born to mothers with untreated mental health conditions are also at higher risk for preterm birth, low birth weight and longer stays in the neonatal intensive care unit. The consequences of untreated conditions are not restricted to infancy, but can extend into toddlerhood, preschool age and even school age. These include risks of insecure attachment, behavioral and cognitive delays and emotional problems.
Municipal leaders have an important role to play in addressing the maternal mental health crisis. Increasingly, cities are demonstrating that local leadership can drive meaningful change.
Examples of City-Led Action
New York City, N.Y.
New York City has strengthened its maternal and perinatal mental health system by pairing long-term infrastructure with targeted investments and cross-agency coordination. In February 2026, Mayor Zohran Mamdani announced a $20 million, three-year investment in the city’s Strong Foundations Initiative to expand mental health programs for families during pregnancy and the early years. This investment expands eligibility for the NYC Nurse-Family Partnership to include parents with more than child and allows enrollment later in pregnancy, increases home visits from registered nurses who provide mental health support, referrals and education and strengthens the maternal mental health workforce. Importantly, the funding also invests in the workforce by funding clinician certification, fellowships and training, with a focus on reaching families with young children facing structural barriers to care.
“The cost-of-living crisis hits New York City families well before the birth of their kids, which is why our administration is stepping up assistance through Strong Foundations. All parents deserve access to high-quality prenatal and perinatal care, and today’s announcement will ensure that all New Yorkers, and particularly those who face structural barriers to care, are provided with the resources they need at the very beginning of their child’s life,” said Mayor Zohran Mamdani.
Baltimore, Md.
Baltimore has adopted a multisector, community-driven approach to provide comprehensive support for mothers and infants. This includes their B’more for Healthy Babies Initiative (BHB), a long-standing initiative which is run by the Baltimore City Health Department in partnership with more than 150 public, private and community organizations (PDF). Rather than relying on a single program, Baltimore has built a coordinated system that aligns home visiting, mental health care, care coordination and neighborhood-level partnerships to meet families’ needs.
A core component of BHB is the Maternal & Infant (M&I) Care Program, which provides free, voluntary home visits to pregnant women and infants by nurses, social workers and community outreach workers. These visits integrate health education, mental health screening, referrals and care coordination, helping families access prenatal, postpartum and supportive services while reducing stigma around maternal mental health. Baltimore also compliments direct services with accessible public education through the BHB online hub which offers accessible resources on topics such as pregnancy support, postpartum mental health and self-care. To deepen impact, the city has also expanded its neighborhood-based service sites in historically underserved communities, enabling providers to build trust, coordinate services locally and tailor mental health and family supports to specific neighborhood needs.
Columbia, S.C.
Columbia offers an example of how a mid-sized city can support maternal and perinatal mental health through partnership and coordination. In 2026, the City of Columbia supported Columbia Black Maternal Health Week (April 11-17) in partnership with the BLK Maternal Health Collective, local health providers and community organizations. This week-long initiative included city-hosted and city-supported events, such as a Moms, Babies and Families Marketplace, wellness activities, educational panels and advocacy workshops focused on pregnancy, postpartum mental health, birth planning and self-care. These events connected families directly to local maternal mental health, prenatal and postpartum resources, while centering community leadership and trusted spaces.
Practical Takeaways from Municipal Action
Drawing from lessons across all three examples, cities can take the following practical steps:
- Build on what already exists: Strengthen and connect existing city assets such as home visiting programs, community wellness centers, health departments and early childhood systems, rather than creating new, standalong programs.
- Leverage the city’s convening power to align partners: Bring together health departments, early childhood agencies, community‑based and Black‑led organizations, hospitals and philanthropy around shared goals.
- Meet families where they are: Deliver services through trusted settings including home visiting programs, neighborhood hubs and community-led events.
- Combine services with education and connection: Pair direct services such as screenings, referrals, care coordination with accessible public education, peer support and resources that reduce stigma and increase awareness.
- Start small when needed: If multi-year investments are not feasible, fund partnerships, support community-led programming and strengthen referal pathways.
Addressing America’s Loneliness Epidemic
Our cities are on the front lines in helping their residents face mental health crises. Thankfully, there are clear actions municipal leaders can take to help their residents.
About the Author
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