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Improving Maternal Mental Health Outcomes: The National Maternal Mental Health Hotline’s First Anniversary

Bintou Diarra, A.B Candidate | Medical Anthropology, Brown University | May 31, 2023

May 12th, 2023, marked a year since the launch of the United States’ first Maternal Mental Health Hotline. Available 24 hours a day, seven days a week, the National Maternal Mental Health Outline provides free, confidential, emotional support, resources and referrals before, during, and after pregnancy. It is accessible by phone or text in English and Spanish. On the other line are counselors, which include licensed health care providers like nurses, physicians, certified doulas, certified peer support specialists, and childbirth educators. Since its inception, the Maternal Mental Health Hotline responded to over 12,000 calls and texts. 

Of the 12,000 calls and texts, 76% were from individuals looking to support themselves, and 5% of individuals were calling on behalf of someone else. The hotline seems to prioritize immediate access—the average speed to answer both calls and text messages was below 30 seconds. At the very least, the hotline provides a sense of social support, which is incredibly valuable for people struggling with perinatal depression. Without policy changes and other intentional efforts to support our nation’s birthing people, however, the hotline will stand as an ostensible mark of progress in the fight to improve maternal health conditions in the United States. 

We cannot deny the significance of emotional support, especially during the fourth trimester. The top reasons for reaching out to the National Maternal Mental Health Hotline were feelings of overwhelm, depression, and anxiety—all of which commonly shape the postpartum experience. Connecting new parents with resources and lending a listening ear is a valuable step, and yet, it is only one step in the promotion of maternal mental health and wellness. Largely absent from this approach is the acknowledgement of the root of these feelings. Hormonal changes are only one among many causes of the feelings of anxiety and depression new parents often experience. We must go a step further and examine the entanglement of our nation’s systems with the parenting journey to promote structural changes. 

In the United States, workers are not guaranteed paid leave of any kind—including parental leave. Paid leave policies are left to the discretion of employers, and unfortunately, many employers neglect to consider birthing people. According to the Bureau of Labor Statistics, about 1 in 4 employees (24 percent) in the private sector workforce have access to paid family leave. More than 3 in 4 (76 percent) of public sector employees do not have access to paid family leave. Under these conditions, it is quite easy for new parents to feel overwhelmed, as many have to juggle the demands of work and the responsibilities of caring for their child(ren). 

In addition to establishing paid leave policies, refining our family planning programs can assist in creating an environment that is conducive to feelings of safety and security, and not stress, for new parents. In the United States, the objective of family planning services is to enable people to decide how many children they want to have and the optimal spacing of the births. The model of family planning can go beyond this approach to hold space for new parents. If our family planning programs went beyond centering effective contraception for people who do not want children, to embracing a framework that assists families in establishing their families after the birth of a child, parents would most likely feel more comfortable, as our nation would treat this support as a baseline.

Lastly, we must take better care of the birth workers and counselors propping the National Maternal Mental Health Hotline up. Despite messaging regarding the integral role of doulas in supporting reproductive health initiatives, our nation’s disregard for birth workers creates the issue of burnout, which threatens to turn them away from our labor force completely. Without doulas to support the hotline and connect people with resources as necessary, the foundation on which the hotline is built will be incredibly weak. 



Call or text 1-833-TLC-MAMA (1-833-852-6262) to connect with counselors at the National Maternal Mental Health Hotline.

Pregnancy and a new baby can bring a range of emotions. In fact, many women feel overwhelmed, sad, or anxious at different times during their pregnancy and even after the baby is born. For many women, these feelings go away on their own. But for some women, these emotions are more serious and may stay for months.

The National Maternal Mental Health Hotline’s counselors provide real-time emotional support, encouragement, information, and referrals. Pregnant and postpartum women can get the help and resources they need when they need it.

Are you a new parent and feeling sad, worried, overwhelmed, or concerned that you aren’t good enough? You aren’t alone. You aren’t to blame. With help, you can feel better. Call or text 1-833-TLC-MAMA (1-833-852-6262) to connect with counselors at the National Maternal Mental Health Hotline. Learn more about the National Maternal Mental Health Hotline.

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