When the Policy Center for Maternal Mental Health and George Washington University's Milken Institute School of Public Health released their 2026 Maternal Mental Health State Report Cards last week, they marked a quiet but meaningful milestone: for the first time since the evaluation began in 2023, no state earned a failing overall grade.
This progress matters because one in five mothers in the United States experience maternal mental health conditions, yet the barriers to care remain formidable. Untreated maternal mental health disorders cost the U.S. an estimated $14 billion annually — a figure that captures only the financial toll, not the human cost of mothers struggling to heal, bond, and thrive under systemic pressure that too often fails them.
The national picture showed modest improvement. The U.S. overall grade climbed from a "C-" in 2025 to a "C" in 2026, driven by consistent movement upward among states since the report cards launched. No longer are entire states left behind: Alabama and Mississippi, both marked with "F"s in 2025, improved to "Ds." The number of states earning "B" grades more than doubled from the previous year, reaching 11 states. Currently, zero states hold an "A," 11 earn "B"s, 25 score "C"s, and 15 hold "D"s.
The 2026 report cards evaluate 27 measures across four domains: Screening and Detection, Providers and Treatment, Policy and Payment, and a new addition called Parental Support. This latest domain represents a significant expansion of how maternal mental health is measured — one that reveals a stark gap in American family policy.
The Parental Support domain grades states on six critical metrics: whether public paid parental leave exists and lasts at least eight weeks, whether it extends to twelve weeks or more, whether wages are fully covered for the lowest-income families during leave, and whether states offer accessible and affordable childcare with subsidies reaching families at or above 85 percent of state median income. These measures recognize what research increasingly confirms: mothers cannot heal from birth, attend medical and mental health appointments, or return to work without foundational family support.
The results were sobering. Maine led the nation with just 3.5 stars out of five in Parental Support — a respectable score that feels thin when considered against what families need. Thirty-one states earned less than one star.
"While we applaud the progress states are making, the U.S. is providing mediocre maternal mental health care at best," said Joy Burkhard, CEO of the Policy Center for Maternal Mental Health. "It's critical that mothers and families have adequate paid leave and child care, which is not only necessary for families to return to work if they choose to, but for women to heal from birth, attend medical and mental health appointments."
The 2026 report cards tell a story of genuine movement on maternal mental health — states are listening, policies are shifting, and awareness is growing. Yet they also reveal how much further America must go. The elimination of blanket failing grades is progress worth acknowledging. The new Parental Support domain, meanwhile, holds up a mirror to a harder truth: that supporting mothers' mental health requires more than screening and treatment. It requires a society willing to provide the concrete support that allows healing to happen.