Maryland's gains in maternal mental health stall as other states, nation advance, report finds
Maryland is slightly ahead of most states when it comes to supporting maternal mental health, but other states have been gaining ground in the last year while Maryland has been static, according to an analysis that assesses states on a A-F grading scale.
The 2025 Maternal Mental Health State Report Card, released Thursday, gave Maryland a 'C' this year, pushing the state just ahead of the national average score of a C-.
But health advocates note that 26 other states boosted their 'grades' over last year's report card, and say Maryland needs to increase mental health screening efforts to help improve its score for next year's report card.
'Maryland has a lot to be proud of in terms of its grade. It is performing better than most states on maternal mental health policies,' said Caitlin Murphy, one of the researchers who worked on the report. 'Maryland is doing better than the national average, which is great … There's a few key areas where Maryland could continue to improve.'
The Policy Center for Maternal Mental Health released its third annual report Thursday to update grades on states' accessibility to maternal mental health services.
'The good news is that the U.S. national grade has improved slightly from a D+ to a C- … We're also seeing 26 state grades improving this year alone, with five state's earning B's,' Murphy said. 'We know there's still a lot more work to be done on 19 states that are still earning D or F grades.'
This year, five states received B grades, 27 states received C grades, 17 states received D grades and 2 states received F's. That's an improvement from last year, when 24 states received D grades and 5 states receiving failing grades.
'Folks are realizing just how crucial it is to address this. And not only to destigmatize maternal mental health, but really put the policies in place at the state level and the health insurance level to get … all the things we know are needed to support mental health for moms,' Murphy said.
Report: Md. shows 'incremental' gains on maternal mental health, but still needs work
'Folks are very aware of postpartum depression, but this also includes postpartum anxiety, OCD (obsessive-compulsive disorder), psychosis – which is much rarer. But, there is starting to be more understanding around that,' she said.
The report focuses on several areas where states can improve maternal mental health access to services and health care coverage across the states. Some metrics considered include Medicaid coverage, access to maternal mental health providers, and data from insurance coverage and claims for services.
One category assesses whether Medicaid requires screenings and data collection for mental health concerns such as prenatal depression and post-partum depression. Last year's report card docked Maryland over not requiring data collection on mental health screening – an area that Maryland lost points on again this year.
'States can require their health plans to report on rates of maternal mental health screening,' Murphy said. 'Right now, Maryland does not require its health plans, and in particular its Medicaid health plans, to report on rates of maternal mental health screening.'
Dan Martin, senior director of public policy for the Mental Health Association of Maryland, said that the report card shows 'that there is room to improve in Maryland,' including in screening for maternal mental health needs.
'Screening and identification for perinatal mood and anxiety disorders really improves the likelihood for recovery of the mother. It supports healthy childhood development,' he said. 'It (maternal mental health) can have profound impacts on the health of the mother and her infant and her family.'
That doesn't mean that those screenings are not happening, Murphy noted, just that the state doesn't require collection of that data, which can make tracking statewide progress difficult.
'The more health plans that are reporting out the screening rates, the better idea we're able to have of if it's actually happening – and that's one of the biggest gaps right now in terms of data,' she said. 'We don't know yet if maternal mental health disorders are reducing, and part of that is the need for screening to be more universal and for screening to be required, so we can actually track this over time.'
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The Maryland Department of Health said in a written statement Thursday that the state is 'committed to all women in Maryland achieving and maintaining their highest level of physical, mental, and emotional health and well-being.'
The policy center added new metrics this year that measured whether states invested in group prenatal care for the Medicaid populations. Murphy said such programs help connect pregnant people and new mothers to peers and social supports.
Maryland earned a few extra points for programs such as the Medicaid CenteringPregnancy Program, which brings people with a similar due date together to will learn about what to expect during pregnancy as a community.
But it was not enough to boost the state's grade to a C+, Murphy said.
She noted that Maryland is ahead of other states when it comes to health care coverage for pregnancy through Medicaid, the joint federal-state health insurance program targeted for lower-income families and other specific populations.
But with members of Congress deliberating significant cuts to Medicaid, Murphy worries that states will backslide on progress made over the last few years.
State officials, advocates fear impact of expected Medicaid cuts in House bill
'Even though states are making this incremental progress on maternal mental health, we also know that right now Congress is putting forward proposed policies to cut Medicaid and Health and Human Services programs,' she said. 'If those kinds of cuts go through, we are going to see state scores and the overall national score backslide.'
KFF, a nonpartisan health research organization, reports that in 2023, 41% of births in the United States were financed by Medicaid. In Maryland, about 42% of births were supported by Medicaid coverage that year.
'That statistic is often surprising to folks, but it reflects the fact that this is a really important source of coverage,' Murphy said.
She said that interest in maternal mental health has been increasing over the last few years and hopes that increased awareness of the issue will help deter Congress from cutting supports for maternal mental health services.
'It's been wonderful that over the past several years, I think people have started to understand the depths of how important maternal mental health is and also how far we have to go,' Murphy said. 'This is a real failure of our health care systems to support our moms and families … It's really a matter of life or death.'
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Read more Map shows states with best—and worst—early education systems Map shows states with best—and worst—early education systems Scouras acknowledged having prior concerns about Nico's future, but believes he's ready to tackle kindergarten after conversations with his pediatrician and preschool staff. "When he was less than 2 years old and we were still trapped inside and not knowing when the next wave was going to hit, there was a lot of those nights of, like, 'Oh my God, is this going to stunt his development forever?" she recalled. "But I also kind of remind myself: Are they all going to be OK? They're all in it together." Scouras noted another upside for those born into the teeth of the pandemic: they didn't have to endure missed milestones, like proms or graduations, that older children dealt with. "I felt more for those kids who were older, who knew what was going on," she said. 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AP Photo/LM Otero "And I would imagine that would continue in kindergarten," Peeks said, adding that more early educators have also reported being burnt out from managing their post-pandemic classrooms. "I think it's the fact of dealing with these challenging behaviors, but the adults themselves were also having high levels of stress during the pandemic," the former kindergarten teacher said. "So, their own mental health, their own stress, combined with having to care for these children who were having really big behavioral and emotional challenges ... that is something that these educators have had to deal with more so than pre-pandemic." Peeks also cited researchers at Columbia University who conducted a study of 255 infants born between March and December 2020 that revealed they scored slightly lower on a screening test of social and motor skills at six months compared to their counterparts just before the coronavirus outbreak. "Yes, they might've still gone to preschool in higher numbers, but those are still delays that are going to have to be addressed over time," Peeks said. "It'll be really interesting to see the data and do surveys of kindergarten teachers of this cohort on what they've noticed compared to other class years." The Covid Generation Dr. Dani Dumitriu, the lead investigator of Columbia's ongoing study, said it's too early to understand exactly how being born in the middle of a pandemic will impact those children into adolescence and beyond. "These kids are just aging into 5, we are just starting our assessment," Dumitriu told Newsweek. "I will be able to answer that question in a couple years, but right now, I can tell you with certainty that any academic who tells you that they know something about this generation at age 5 is flatly wrong. You just simply cannot." Within the next year, Columbia expects to finish collecting data from approximately 500 4- and 5-year-olds and then spend another year analyzing those key outcomes, according to Dumitriu, an associate professor of pediatrics and director of Columbia University's Center for Early Relational Health. "In that initial paper, we showed an effect of the pandemic — not an effect of the virus, but just pandemic stress," Dumitriu said last week. "I also really want to stress the fact that six-month data does not predict five-year outcomes. The brain up until about three years of age is so plastic that you simply cannot make any inferences about the future from six-month-old data." 'Kids Are Resilient' Kentucky Lt. Gov. Jacqueline Coleman accompanied her daughter Evelynne to her first day of kindergarten on Wednesday and acknowledged having a tough time processing the bittersweet milestone. "She's fine," Coleman wrote on X. "Mom? Not so much." Coleman, a Democrat who took office in December 2019, gave birth to Evelynne in February 2020, just weeks before the World Health Organization declared the coronavirus a pandemic and states began issuing stay-at-home orders. Kentucky Lt. Gov. Jacqueline Coleman attends the first day of kindergarten with her daughter Evelynne on Wednesday. Kentucky Lt. Gov. Jacqueline Coleman attends the first day of kindergarten with her daughter Evelynne on Wednesday. Courtesy Jacqueline Coleman "There is no question that babies born during COVID, and their parents, faced very unique challenges during an already challenging time for families," Coleman told Newsweek in a statement. Similar to Nico, who was born in July 2020, Evelynne had issues with delayed speech, Coleman said. "Which made sense because she didn't have peer interaction and she was surrounded by adults who were often speaking to her through masks," Coleman said. "But once she was enrolled in daycare, she rebounded, and pre-K helped even more so. Now, we cannot get her to stop talking. I say that half-jokingly, but it also proves what we already know: kids are resilient."
