The United States maternal health crisis has long been quantified through devastating mortality statistics. Yet, data points alone cannot capture the complex, lived experiences of those walking through our broken maternity care and larger broken healthcare system. 

The National Partnership for Women & Families, in collaboration with MomsRising and the Black Mamas Matter Alliance, released a critical piece of the puzzle: Listening to Mothers IV. As the largest and most comprehensive national survey of birthing experiences in a decade, it captured the voices of 3,857 mothers across all 50 states and D.C. who gave birth between 2023 and 2025. 

Across the board, the survey reveals a maternal care infrastructure rife with gaps in access, a troubling disregard for birthing autonomy, and massive, unmet medical and psychological needs.

A Maternity System Driven by Intervention, Not Agency

A staggering 40% of mothers reported not feeling heard or listened to by their healthcare providers.

The survey findings illustrate that births are overwhelmingly shaped by medical interventions such as scheduled inductions and cesareans, which frequently take place before natural signals of labor readiness occur. To make matters worse, when patients are not properly informed or involved in non-emergency decisions about their births, it creates a cascade of interventions that all strip them of their agency.

These failures do not affect everyone equally. 

The report underscores deeply entrenched structural racism within our healthcare systems: 1 in 3 Black women reported experiencing mistreatment during their maternity care, compared to 1 in 5 women overall. Whether it is having their concerns ignored, receiving inadequate communication, or facing outright discrimination, marginalized birthing people continue to bear the heaviest burdens of a failing system.

The Perinatal Mental Health Reality Check

The Policy Center recognizes that psychological well-being cannot be separated from physical care. The Listening to Mothers IV findings on maternal mental health are deeply alarming, validating the true scale of the perinatal mental health crisis:

  • High Prevalence of Symptoms: Perinatal mental health conditions are the most common complications of childbirth, and the survey data bear this out.
    • Between 35% and 45% of mothers reported experiencing symptoms of anxiety. Perinatal depression affected 20% to 25%. 
    • In the early postpartum weeks specifically, 35% reported anxiety and 24% reported depression.
  • A Staggering Treatment Gap: Despite these high rates of treatable conditions, the system is failing to connect individuals to care.
    • More than half of postpartum women experiencing mental health symptoms did not receive any form of counseling or treatment.
  • The Intersection of Race and Mental Health Equity: This treatment gap is heavily racialized. While those who are Black reported higher rates of depressive symptoms, they were significantly less likely to seek and receive treatment.

Connecting Disrespectful Care to Psychological Trauma

We cannot isolate high rates of perinatal anxiety and depression from the fact that nearly half of all mothers feel ignored by their care teams, which can exacerbate mental health conditions.

Turning Data Into Action: The Policy Solutions We Need

To reverse these troubling trends and build a maternal care framework that heals rather than harms, policymakers must pursue comprehensive, systems-level reforms:

  1. Strengthen and Expand Medicaid Coverage: Given that Medicaid covers an enormous share of births in the U.S. and that Medicaid recipients in the survey frequently reported worse experiences, Medicaid must provide robust, sustained reimbursement for comprehensive perinatal mental health screenings, preventative counseling, and continuous postpartum care.
  2. Integrate and Fund Team-Based Care Models: We must scale up models of care that integrate midwives, doulas, and community health workers alongside Ob/Gyns. These professionals are proven to lower intervention rates, bridge cultural divides, and establish the emotional safety and trust that birthing people desperately need.
  3. Mandate Accountability for Respectful Care: Health systems must be held accountable for the way patients are treated. We need standardized, transparent mechanisms for mothers and families to report instances of disrespectful care and discrimination, tying obstetric provider and hospital quality metrics directly to patient-centered outcomes.
  4. Establish a Robust Social Support Infrastructure: Maternal and mental wellness requires passing a national paid family leave law to ensure new parents have the time to attend prenatal and postpartum visits, physically recover from birth, bond with their infants, and access mental health care while maintaining their jobs.

The data is clear: advancing maternal mental health and birth equity requires urgent, coordinated action across the health system to ensure every mother is screened, connected to care, and supported throughout the perinatal period.

To read the full findings and view the comprehensive data, access the Listening to Mothers IV: First Questionnaire Report.