The United States is facing a maternal mortality crisis. People in the U.S. who are pregnant and postpartum are at higher risk for complications and death than their peers living in comparable countries. In 2023, the maternal mortality rate – measured by the U.S. Centers for Disease Control and Prevention (CDC) during pregnancy and within 42 days postpartum – was 18 deaths per 100,000 live births. Black women are particularly vulnerable, as they are three to four times more likely to die during pregnancy or within a year postpartum.
Suicide and overdose are the leading causes of death in the first year postpartum, contributing to more than a fifth of pregnancy-related deaths. Every mental health-related maternal death is preventable and could be avoided with better care, more check-ups and stronger support from family and friends.
Approximately 1 in 5 people experience a mental health condition while pregnant or in the first year after childbirth, but less than 25% of women with perinatal mood and anxiety disorders receive treatment. In addition to impacting a parent’s health, untreated maternal mental health disorders can cause preterm birth and low birth weight and lead to negative early childhood development outcomes.
Maternal mortality and mental health in Missouri
In Missouri, an average of 70 women die per year while pregnant or within 12 months postpartum. The Missouri Department of Health and Senior Services and the Pregnancy-Associated Mortality Review (PAMR) Board collaborate to review these deaths and publish an annual report that summarizes findings and recommendations to reduce preventable maternal mortality.
The most recent report, published in July 2025, found that mental health conditions were the leading underlying cause of pregnancy-related deaths in Missouri between 2018 to 2022. Mental health conditions, including substance use disorder, accounted for 30% of the cases reviewed. Every one of these deaths was deemed preventable by the PAMR Board.
Resources for providers
SBIRT
Providers can implement Screening, Brief Intervention, and Referral to Treatment (SBIRT) for mental health concerns like depression, anxiety and substance use disorder at the initial visit, later in pregnancy and in the postpartum period. SBIRT provides opportunities for early intervention with at-risk individuals before more severe consequences occur.
Quality improvement tools
Clinicians in health care systems can implement quality improvement tools that standardize practices and procedures for addressing patient perinatal mental health conditions, such as the Alliance for Innovation on Maternal Health (AIM) patient safety bundle.
MHAP
Missouri providers across disciplines can register to participate in the Maternal Health Access Project (MHAP). MHAP offers provider consultations with a team of perinatal psychiatrists, care coordination support for patients and education and training materials on a wide range of topics related to perinatal mental and behavioral health.
PSI
Postpartum Support International (PSI) provides medical professionals and mental health providers with several resources to learn more about treating patients with perinatal mental health conditions, including a Provider Directory, Perinatal Psychiatric Consult Line and training resources.
Resources for pregnant and postpartum people
National Maternal Mental Health Hotline
The National Maternal Mental Health Hotline is a free, confidential resource that is available 24/7 in English and Spanish. If you are feeling overwhelmed, anxious or just need someone to talk to, you can call or text the hotline at 1-833-852-6262 to speak with a trained counselor. These counselors will listen to what you are going through, connect you with local support groups and organizations, and refer you to other health care professionals if you need more care.
PSI HelpLine
The PSI HelpLine is another free and confidential resource, available from 7 a.m. to 10 p.m. Central Time. The PSI HelpLine provides basic information, support and resources to callers who need support while experiencing perinatal mood and anxiety disorders. You can contact the HelpLine by calling or texting “Help” to 1-800-944-4773. Spanish speakers can text 971-203-7773.
PSI Online Provider Directory
The PSI Online Provider Directory can help with finding qualified perinatal mental health professionals in your area.
Final Thoughts
Anxiety and depression are among the most common symptoms that occur during pregnancy and up to one year postpartum. When perinatal mental health disorders remain undiagnosed and untreated, maternal suicide and overdose become more likely. Fortunately, there are resources available to providers and patients to increase awareness about perinatal mental health, improve access to treatment and save lives.
Want to learn more about maternal mortality in Missouri? Read the full report.