Why It Matters
A new national assessment of maternal mental health policy finds the United States falling significantly short on paid leave and childcare access — two factors researchers say are directly tied to postpartum recovery and overall maternal well-being. The annual report cards, now in their fourth year, are designed to help states identify gaps and benchmark progress against one another.
Untreated maternal mental health disorders carry a steep economic toll, estimated at $14.2 billion annually across the country. Beyond dollars, these conditions are identified as a leading driver of maternal mortality, with compounding stressors on families increasing their severity.
What Happened
The Policy Center for Maternal Mental Health, working with researchers at the George Washington University Milken Institute School of Public Health, released its 2026 Maternal Mental Health State Report Cards on May 28. The annual evaluation grades all 50 states and the District of Columbia across multiple domains of maternal mental health policy and support.
The overall U.S. grade edged up slightly — from a C-minus in 2025 to a C this year — reflecting incremental improvement at the state level. However, a newly added domain measuring parental support, which includes paid family leave and access to affordable childcare, dragged the national score down sharply. The United States received the equivalent of an “F” in that category.
Every year, roughly one in five mothers in the United States experiences a maternal mental health condition such as postpartum depression. The majority of those women do not receive adequate care or treatment, according to the Policy Center.
By the Numbers
- No states earned an A grade in 2026.
- 10 states earned B grades — six earning a B for the first time, including DC, Illinois, Indiana, Louisiana, Massachusetts, and New York.
- 26 states earned a C, making it the most common grade.
- Mississippi and Alabama, the only two states to receive Fs in 2025, each improved to a D in 2026.
- On the parental support domain, 31 states earned less than one star out of a possible five. Maine led all states with a rating of 3.5 stars.
Voices Behind the Data
“The U.S. is providing mediocre maternal mental health care at best,” said Joy Burkhard, CEO of the Policy Center for Maternal Mental Health. She emphasized that paid leave and affordable childcare are essential not just for workforce participation, but for mothers to attend medical and mental health appointments during recovery.
Caitlin Murphy, a research scientist at the George Washington University Milken Institute School of Public Health, noted that the pressures accumulating on American families are intensifying these conditions. “The stressors stacking up on U.S. families are contributing to the severity of these conditions,” Murphy said.
Zoom Out
The report cards, first released in 2023, are part of a broader national effort to make maternal mental health a measurable policy priority — similar to how states are scored on education or public health outcomes. The addition of the parental support domain in 2026 reflects a growing body of research connecting workplace and childcare policy to postpartum mental health outcomes.
The United States remains an outlier among developed nations in its lack of a federal paid family leave mandate, a gap that health policy researchers have long flagged as a structural barrier to maternal recovery. As healthcare workforce pipelines expand through programs like accelerated training partnerships, advocates argue that addressing maternal mental health at the policy level must keep pace with clinical and training investments.
What’s Next
The 2026 report cards evaluate states across 27 measures organized into four domains: screening and detection, providers and treatment, policy and payment, and the newly introduced parental support category. The full report cards and a summary of findings have been made publicly available by the Policy Center.
Researchers and advocates are expected to use the grades as leverage in ongoing state legislative conversations around postpartum care requirements, Medicaid reimbursement for mental health screenings, and paid leave policy. The report was funded through a grant from the Perigee Fund.