New York held its first hearing devoted to maternal mental health on Monday, November 9, bringing more than 40 speakers before state lawmakers to describe a system that still misses too many mothers in trouble. The hearing, arranged with the legislature and facilitated by the Postpartum Resource Center and other advocates, put the focus on screening: finding mental health conditions during pregnancy and through the year after birth, instead of waiting until a crisis.
Joy Burkhard, chief executive of the Policy Center for Maternal Mental Health, told the hearing that the field is starting to treat the obstetric provider as the home base for this care. Midwives, obstetrician-gynecologists and family practice doctors who provide maternity care see patients through pregnancy and the months after birth, and Burkhard said they are the right clinicians to screen, diagnose and plan treatment, with referral and management built in.
Maternal mental health conditions affect about one in five women during pregnancy or the year after birth, making them more common than gestational diabetes. They are also among the leading causes of pregnancy-related deaths in the United States. Yet screening is still patchy: many mothers are never asked, and many who are asked receive no follow-up when a screen comes back positive.
Maternal mental health screening starts in pregnancy
Burkhard’s testimony centered on moving screening earlier, into pregnancy and through the postpartum period, rather than limiting it to a single check after delivery. The American College of Obstetricians and Gynecologists has recommended screening for some time and issued the first clinical practice guidelines in the United States in 2023, one on screening and diagnosis and another on treatment. The guidelines give clinicians a standard to follow, but Burkhard said the standard only helps if maternal mental health screening is paid for and tracked.
New York moved early on payment. In 2022, it was one of the first states to reimburse obstetric providers for postpartum depression screening, using billing codes for positive and negative screens. That step let clinics charge for the work instead of absorbing it. Burkhard said the state now has a chance to go further by requiring payers to reimburse obstetric providers with pay-for-performance incentives, and by monitoring whether screening and follow-up actually happen.
The hearing also heard about a change coming from Washington. Just last week, the Centers for Medicare and Medicaid Services approved ending the bundled payment codes in the 2027 physician fee schedule, effective December 31, 2026. Obstetric providers are now generally paid a single bundled rate for care from pregnancy through six weeks after birth, a model that never included mental health. With the bundle ending, screening, detection, preliminary diagnosis and treatment planning can be built into routine obstetric care from pregnancy through 12 months after birth, starting in 2027.
Payment rules that held maternal mental health back
The 30-year-old payment model is one reason the gap lasted so long, Burkhard said. Because mental health was never part of the bundle, providers had little reason to take it on, and the work went unpaid when they did. The Policy Center, a nonprofit policy and research group, tracks state and federal policies and produces analysis of payment and quality measures that can push change. Its report cards grade states on screening and reimbursement; New York has scored poorly there, in part because it does not require Medicaid managed care plans to report maternal mental health screening rates.
Other speakers at the hearing took up different pieces of the same picture: psychosis and the factors that should count in sentencing, and the need to train more behavioral health providers in perinatal mental health. Burkhard said she strongly agreed with both. Her own remarks stayed on screening, diagnosis, reimbursement and measurement, the levers she said would reach the most mothers the fastest.
What New York plans to do next
The state has already laid out a plan for maternal mental health. In December 2025, the New York State Office of Mental Health released its first Maternal Mental Health Report, with recommendations drawn up by a workgroup created under 2023 budget legislation. The report calls for wider behavioral health integration in obstetric clinics, universal screening with validated tools, more training and consultation support for obstetric providers, and public campaigns against stigma. The state also made 850,000 dollars available to help obstetric and family medicine practices add behavioral health support, with up to 17 awards statewide.
Burkhard closed by saying New York has the chance to lead the country in making the obstetric provider the home base for maternal mental health care. The hearing was one of the few dedicated state hearings ever held in the United States on the subject. Lawmakers have not yet said which of the proposals they will take up.