Maternal Mental Health in Crisis: 84% of U.S. Counties Lack Resources

The Female Body
Jul 16
2 min read

The U.S. is facing a growing maternal mental health crisis—one that is quietly worsening beneath the surface of falling birth rates and rising postpartum challenges.

According to the 2025 Maternal Mental Health State Report by the Policy Center for Maternal Mental Health, the number of U.S. counties classified as “severe risk” for maternal mental health disorders has nearly tripled since 2023. Despite a promising rise in certified maternal mental health providers, the report reveals that 84% of pregnant and postpartum women still live in areas with critical shortages of care.

From rural “dark zones” in Texas and Tennessee to underserved urban hubs in Miami and Los Angeles, the data makes one thing alarmingly clear: maternal mental health support in the U.S. remains fragmented, inequitable, and dangerously underfunded. The result? Millions of women are slipping through the cracks.

Key findings

Counties facing severe risk of maternal mental health disorders have nearly tripled since 2023—from 24 to 92.
A staggering 84% of pregnant and postpartum women live in areas with a shortage of maternal mental health providers.
Around 150 "Dark Zone" counties are labelled as high‑risk with insufficient resources—locations in Texas, Alabama, Louisiana, Oklahoma, and Tennessee are most affected.

Risk Is Growing

The Risk Factor Score (RFS)—based on variables like poverty, domestic abuse, and isolation—reveals that 796 counties are now deemed high-risk (up from 700 in 2023), with 92 falling into the "severe-risk" category. While rural areas are hit hardest, dense urban counties such as Harris (Houston), Los Angeles, and Miami‑Dade now face alarming gaps.

Resources Rising—but Missing the Mark

Though the number of certified maternal mental health providers more than doubled—from 4,506 to 9,694—most increases occurred in lower-risk areas. Despite this, 84% of birthing-age women still reside in provider shortage zones.

Where Support Is Crumbling

Nearly 150 "Dark Zone" counties remain with high maternal mental health risk and scant access to care. These gaps disproportionately affect women in the South and parts of Appalachia and the West .

Why This Matters to Women—Especially Now

1 in 5 women experience a maternal mental health disorder such as perinatal depression or anxiety.
These conditions contribute to 20% of maternal deaths via suicide or overdose — yet only 20% are screened, and fewer receive treatment.
Untreated maternal mental health disorders cost the U.S. an estimated $14.2 billion per year.

What Needs to Change

The Policy Center for Maternal Mental Health and its partners recommend immediate action (womensmentalhealth.org):

Targeted federal and state interventions in high-risk areas, especially "Dark Zones."
Expand holistic services—community‑based programs, doulas, and mental health midwives.
Strengthen insurance coverage, including Medicaid, to support mental health care during and after pregnancy.
Implement screening standards across all states and reimburse providers for early detection.

Spotlight on State Progress

Thanks to this work, 26 states improved their MMH “report card” grades in 2025, with national performance rising from a D+ to a C–. Yet 19 states still earn D or F grades, signalling severe gaps.

Bottom Line

Even as more providers enter the field, maternal mental health risk is rising, and gaps in care remain entrenched. For women in pregnancy/or postpartum, this isn’t just data—it’s about access to timely mental health support when they need it most. The time for policy solutions, funding, and resource equity is now.