The uncertainty, isolation, and economic strain of the COVID-19 pandemic had a prolonged negative impact on stress and mental health and exacerbated existing mental health inequities. A new brief from the Maternal and Infant Health Assessment (MIHA) examines rates of maternal depression and anxiety symptoms since the pandemic.
Key findings
- Rates are increasing: In 2024, 37% of birthing people reported depression or anxiety symptoms during or after pregnancy (up from 33% in 2020).
Disparities persist: Higher rates are seen among younger individuals (15-24), American Indian and Black birthing people, first-time parents, and those with lower incomes.
Stress drives risk: Experiences such as housing instability, food insecurity, job loss, and intimate partner violence are strongly linked to worse mental health.
Treatment gaps remain: Fewer than half of those with symptoms receive care, with lower access among Medi-Cal participants, immigrants, and Asian and Latine populations.
Calls to action
California’s worsening maternal mental health demands an urgent response.
- Work across sectors to promote policies that improve social and economic well-being, which form the foundation of mental health.
- Improve obstetric and behavioral systems of care to ensure equitable screening, referral, and treatment.
- Implement the AIM Perinatal Mental Health Conditions safety bundle and the DHCS Birthing Care Pathway for Medi-Cal providers.
- Incentivize screening and follow-up, and integrate mental health treatment into obstetric, pediatric, and primary care.
Provide timely access to mental health providers.
Strengthen California’s mental health workforce by providing support for provider training and peer providers.
The Maternal and Infant Health Assessment is an annual, statewide-representative survey of California residents with a recent live birth. MIHA is a collaborative effort of the Maternal, Child and Adolescent Health Division of the California Department of Public Health and the Center for Health Equity at the University of California, San Francisco. The MIHA project is supported by the California Department of Public Health using federal funds from the Title V Maternal and Child Health Block Grant and other CDPH funding sources.
Expansion and analysis of maternal mental health measures in MIHA was supported by the California Health Care Foundation.