By the Policy Center for Maternal Mental Health Policy Team

This month the National Governors Association (NGA) released a policy playbook for governors to address the U.S. maternal and infant health crisis, including racial disparities, in their states. Maternal Mental Health is addressed in the playbook thanks to education efforts by organizations like the Policy Center.

Our work shaping and reporting on national mental health policy is made possible through a 2020-2023 capacity grant from the Perigee Fund. 

The “Tackling the Maternal and Infant Health Crisis: A Governor’s Playbook” effort was led by New Jersey First Lady Tammy Murphy. She is the first to develop a Chair’s First-Lady Initiative for gubernatorial leadership. This playbook builds off of First Lady’s Nurture NJ Maternal and Infant Health Strategic Plan, launched in 2021 and first shared with our network in 2019. She released the new playbook at the opening session at the NGA’s Annual Meeting in July 2023. This is a complementary playbook, or policy roadmap to “Strengthening Youth Mental Health: A Governor’s Playbook,” which was issued by NJ Governor Phil Murphy as a part of the NGA Chair’s Initiative. 

The maternal and infant playbook was developed after four round tables were held in Salt Lake City, Utah; Santa Monica, California; Detroit, Michigan; and Philadelphia, Pennsylvania. The roundtables incorporated diverse participants with a focus on health equity and lived experiences. National organizations, including our partner, The Kennedy Forum, and our policy team at the Policy Center for Maternal Mental Health, were also involved in helping to shape the recommendations. 

The First Lady explained that “The Maternal and Infant Health Initiative Playbook is designed to make transformational change in a system that has historically failed our mothers and babies – especially our Black, Hispanic, and American Indian and Alaskan Native mothers and babies. Ultimately, working together with our voices, resources and commitment is the only way we will make the United States the safest nation to deliver and raise a baby.”

This playbook is made up of 32 feasible policy recommendations and state program highlights. The playbook outlines pathways to achieve these policy recommendations and encourages states to adapt the policies to their state-specific contexts. 

The Maternal and Infant Health Playbook focuses on four areas: 

  • Centering Women’s Voices in Maternal Health Policy
  • Improving and Utilizing Maternal Health Data
  • Expanding Access to Quality of Care
  • Elevating Innovative Maternal Health Policies, Programs, and Technologies

This policy roadmap outlines the following facts in relation to maternal mental health:

  • Maternal mental health disorders affect one in five women 
  • 75% of women affected by mental health conditions up to one year postpartum do not receive treatment 
  • There are high financial costs correlated with high rates of maternal morbidity and untreated maternal mental health conditions
  • Federal Medicaid benefits do not have a standard comprehensive mental health benefit and there are few maternal quality or equity measures  
  • The majority of maternal deaths are preventable, and mental health conditions including are the leading cause of death (suicide and overdose) during pregnancy and up to one year postpartum.

Following are the playbook recommendations that address maternal mental health:  

  • “Develop a proposal for a state Maternal Health Innovation (MHI) program through the federal Health Resources and Services Administration (HRSA) to support state planning and infrastructure. MHI programs promote quality services, skilled workforces, and improved data quality and capacity in order to improve maternal health. These programs also engage key players through state-led Maternal Health Task Forces that review state-specific maternal health data and implement evidence-based interventions.
  • Fund and Prioritize integrated screening, referrals, and care for perinatal mood and anxiety disorders, perinatal substance use disorders, and intimate partner violence. Integrated care models allow for routine screenings, interventions, and referrals and allow for women to access treatment throughout the care continuum.
  • Strengthen the Community Health Worker (CHW) workforce through certification and increased access to training. CHWs are “lay members of the community who work either for pay or as volunteers in association with the local health care system in both urban and rural environments.” Strengthening the CHW workforce is vital to increasing access to culturally competent perinatal education and care. Developing a certification program in each state and expanding training opportunities allows states to create a clear career path for CHWs.” 

Read the full maternal and infant health policy roadmap here.

The Policy Center is grateful for the work First Lady Murphy and the NGA are doing to improve maternal mental health nationwide and is looking forward to continuing to collaborate on these initiatives. 

Join the conversation by adding your thoughts below or engaging on social media by tagging the Policy Center and using the following hashtags: #MaternalMentalHealth #MaternalHealth #HealthEquity