Mississippi Today
Federal panel prescribes new mental health strategy to curb maternal deaths

For help, call or text the National Maternal Mental Health Hotline at 1-833-TLC-MAMA (1-833-852-6262) or contact the 988 Suicide & Crisis Lifeline by dialing or texting “988.” Spanish-language services are also available.
BRIDGEPORT, Conn. — Milagros Aquino was trying to find a new place to live and had been struggling to get used to new foods after she moved to Bridgeport from Peru with her husband and young son in 2023.
When Aquino, now 31, got pregnant in May 2023, “instantly everything got so much worse than before,” she said. “I was so sad and lying in bed all day. I was really lost and just surviving.”
Aquino has lots of company.
Perinatal depression affects as many as 20% of women in the United States during pregnancy, the postpartum period, or both, according to studies. In some states, anxiety or depression afflicts nearly a quarter of new mothers or pregnant women.
Many women in the U.S. go untreated because there is no widely deployed system to screen for mental illness in mothers, despite widespread recommendations to do so. Experts say the lack of screening has driven higher rates of mental illness, suicide, and drug overdoses that are now the leading causes of death in the first year after a woman gives birth.
“This is a systemic issue, a medical issue, and a human rights issue,” said Lindsay R. Standeven, a perinatal psychiatrist and the clinical and education director of the Johns Hopkins Reproductive Mental Health Center.
Standeven said the root causes of the problem include racial and socioeconomic disparities in maternal care and a lack of support systems for new mothers. She also pointed a finger at a shortage of mental health professionals, insufficient maternal mental health training for providers, and insufficient reimbursement for mental health services. Finally, Standeven said, the problem is exacerbated by the absence of national maternity leave policies, and the access to weapons.
Those factors helped drive a 105% increase in postpartum depression from 2010 to 2021, according to the American Journal of Obstetrics & Gynecology.
For Aquino, it wasn’t until the last weeks of her pregnancy, when she signed up for acupuncture to relieve her stress, that a social worker helped her get care through the Emme Coalition, which connects girls and women with financial help, mental health counseling services, and other resources.
Mothers diagnosed with perinatal depression or anxiety during or after pregnancy are at about three times the risk of suicidal behavior and six times the risk of suicide compared with mothers without a mood disorder, according to recent U.S. and international studies in JAMA Network Open and The BMJ.
The toll of the maternal mental health crisis is particularly acute in rural communities that have become maternity care deserts, as small hospitals close their labor and delivery units because of plummeting birth rates, or because of financial or staffing issues.
This week, the Maternal Mental Health Task Force — co-led by the Office on Women’s Health and the Substance Abuse and Mental Health Services Administration and formed in September to respond to the problem — recommended creating maternity care centers that could serve as hubs of integrated care and birthing facilities by building upon the services and personnel already in communities.
The task force will soon determine what portions of the plan will require congressional action and funding to implement and what will be “low-hanging fruit,” said Joy Burkhard, a member of the task force and the executive director of the nonprofit Policy Center for Maternal Mental Health.
Burkhard said equitable access to care is essential. The task force recommended that federal officials identify areas where maternity centers should be placed based on data identifying the underserved. “Rural America,” she said, “is first and foremost.”
There are shortages of care in “unlikely areas,” including Los Angeles County, where some maternity wards have recently closed, said Burkhard. Urban areas that are underserved would also be eligible to get the new centers.
“All that mothers are asking for is maternity care that makes sense. Right now, none of that exists,” she said.
Several pilot programs are designed to help struggling mothers by training and equipping midwives and doulas, people who provide guidance and support to the mothers of newborns.
In Montana, rates of maternal depression before, during, and after pregnancy are higher than the national average. From 2017 to 2020, approximately 15% of mothers experienced postpartum depression and 27% experienced perinatal depression, according to the Montana Pregnancy Risk Assessment Monitoring System. The state had the sixth-highest maternal mortality rate in the country in 2019, when it received a federal grant to begin training doulas.
To date, the program has trained 108 doulas, many of whom are Native American. Native Americans make up 6.6% of Montana’s population. Indigenous people, particularly those in rural areas, have twice the national rate of severe maternal morbidity and mortality compared with white women, according to a study in Obstetrics and Gynecology.
Stephanie Fitch, grant manager at Montana Obstetrics & Maternal Support at Billings Clinic, said training doulas “has the potential to counter systemic barriers that disproportionately impact our tribal communities and improve overall community health.”
Twelve states and Washington, D.C., have Medicaid coverage for doula care, according to the National Health Law Program. They are California, Florida, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, Oklahoma, Oregon, Rhode Island, and Virginia. Medicaid pays for about 41% of births in the U.S., according to the Centers for Disease Control and Prevention.
Jacqueline Carrizo, a doula assigned to Aquino through the Emme Coalition, played an important role in Aquino’s recovery. Aquino said she couldn’t have imagined going through such a “dark time alone.” With Carrizo’s support, “I could make it,” she said.
Genetic and environmental factors, or a past mental health disorder, can increase the risk of depression or anxiety during pregnancy. But mood disorders can happen to anyone.
Teresa Martinez, 30, of Price, Utah, had struggled with anxiety and infertility for years before she conceived her first child. The joy and relief of giving birth to her son in 2012 were short-lived.
Without warning, “a dark cloud came over me,” she said.
Martinez was afraid to tell her husband. “As a woman, you feel so much pressure and you don’t want that stigma of not being a good mom,” she said.
In recent years, programs around the country have started to help doctors recognize mothers’ mood disorders and learn how to help them before any harm is done.
One of the most successful is the Massachusetts Child Psychiatry Access Program for Moms, which began a decade ago and has since spread to 29 states. The program, supported by federal and state funding, provides tools and training for physicians and other providers to screen and identify disorders, triage patients, and offer treatment options.
But the expansion of maternal mental health programs is taking place amid sparse resources in much of rural America. Many programs across the country have run out of money.
The federal task force proposed that Congress fund and create consultation programs similar to the one in Massachusetts, but not to replace the ones already in place, said Burkhard.
In April, Missouri became the latest state to adopt the Massachusetts model. Women on Medicaid in Missouri are 10 times as likely to die within one year of pregnancy as those with private insurance. From 2018 through 2020, an average of 70 Missouri women died each year while pregnant or within one year of giving birth, according to state government statistics.
Wendy Ell, executive director of the Maternal Health Access Project in Missouri, called her service a “lifesaving resource” that is free and easy to access for any health care provider in the state who sees patients in the perinatal period.
About 50 health care providers have signed up for Ell’s program since it began. Within 30 minutes of a request, the providers can consult over the phone with one of three perinatal psychiatrists. But while the doctors can get help from the psychiatrists, mental health resources for patients are not as readily available.
The task force called for federal funding to train more mental health providers and place them in high-need areas like Missouri. The task force also recommended training and certifying a more diverse workforce of community mental health workers, patient navigators, doulas, and peer support specialists in areas where they are most needed.
A new voluntary curriculum in reproductive psychiatry is designed to help psychiatry residents, fellows, and mental health practitioners who may have little or no training or education about the management of psychiatric illness in the perinatal period. A small study found that the curriculum significantly improved psychiatrists’ ability to treat perinatal women with mental illness, said Standeven, who contributed to the training program and is one of the study’s authors.
Nancy Byatt, a perinatal psychiatrist at the University of Massachusetts Chan School of Medicine who led the launch of the Massachusetts Child Psychiatry Access Program for Moms in 2014, said there is still a lot of work to do.
“I think that the most important thing is that we have made a lot of progress and, in that sense, I am kind of hopeful,” Byatt said.
Cheryl Platzman Weinstock’s reporting is supported by a grant from the National Institute for Health Care Management Foundation. KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
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Mississippi Today
On this day in 1903, W.E.B. Du Bois urged active resistance to racist policies
April 27, 1903

W.E.B. Du Bois, in his book, “The Souls of Black Folk,” called for active resistance to racist policies: “We have no right to sit silently by while the inevitable seeds are sown for a harvest of disaster to our children, black and white.”
He described the tension between being Black and being an American: “One ever feels his twoness, — an American, a Negro; two souls, two thoughts, two unreconciled strivings; two warring ideals in one dark body, whose strength alone keeps it from being torn asunder.”
He criticized Washington’s “Atlanta Compromise” speech. Six years later, Du Bois helped found the NAACP and became the editor of its monthly magazine, The Crisis. He waged protests against the racist silent film “The Birth of a Nation” and against lynchings of Black Americans, detailing the 2,732 lynchings between 1884 and 1914.
In 1921, he decried Harvard University’s decisions to ban Black students from the dormitories as an attempt to renew “the Anglo-Saxon cult, the worship of the Nordic totem, the disenfranchisement of Negro, Jew, Irishman, Italian, Hungarian, Asiatic and South Sea Islander — the world rule of Nordic white through brute force.”
In 1929, he debated Lothrop Stoddard, a proponent of scientific racism, who also happened to belong to the Ku Klux Klan. The Chicago Defender’s front page headline read, “5,000 Cheer W.E.B. DuBois, Laugh at Lothrup Stoddard.”
In 1949, the FBI began to investigate Du Bois as a “suspected Communist,” and he was indicted on trumped-up charges that he had acted as an agent of a foreign state and had failed to register. The government dropped the case after Albert Einstein volunteered to testify as a character witness.
Despite the lack of conviction, the government confiscated his passport for eight years. In 1960, he recovered his passport and traveled to the newly created Republic of Ghana. Three years later, the U.S. government refused to renew his passport, so Du Bois became a citizen of Ghana. He died on Aug. 27, 1963, the eve of the March on Washington.
This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.
Mississippi Today
Jim Hood’s opinion provides a roadmap if lawmakers do the unthinkable and can’t pass a budget
On June 30, 2009, Sam Cameron, the then-executive director of the Mississippi Hospital Association, held a news conference in the Capitol rotunda to publicly take his whipping and accept his defeat.
Cameron urged House Democrats, who had sided with the Hospital Association, to accept the demands of Republican Gov. Haley Barbour to place an additional $90 million tax on the state’s hospitals to help fund Medicaid and prevent the very real possibility of the program and indeed much of state government being shut down when the new budget year began in a few hours. The impasse over Medicaid and the hospital tax had stopped all budget negotiations.
Barbour watched from a floor above as Cameron publicly admitted defeat. Cameron’s decision to swallow his pride was based on a simple equation. He told news reporters, scores of lobbyists and health care advocates who had set up camp in the Capitol as midnight on July 1 approached that, while he believed the tax would hurt Mississippi hospitals, not having a Medicaid budget would be much more harmful.
Just as in 2009, the Legislature ended the 2025 regular session earlier this month without a budget agreement and will have to come back in special session to adopt a budget before the new fiscal year begins on July 1. It is unlikely that the current budget rift between the House and Senate will be as dramatic as the 2009 standoff when it appeared only hours before the July 1 deadline that there would be no budget. But who knows what will result from the current standoff? After all, the current standoff in many ways seems to be more about political egos than policy differences on the budget.
The fight centers around multiple factors, including:
- Whether legislation will be passed to allow sports betting outside of casinos.
- Whether the Senate will agree to a massive projects bill to fund local projects throughout the state.
- Whether leaders will overcome hard feelings between the two chambers caused by the House’s hasty final passage of a Senate tax cut bill filled with typos that altered the intent of the bill without giving the Senate an opportunity to fix the mistakes.
- Whether members would work on a weekend at the end of the session. The Senate wanted to, the House did not.
It is difficult to think any of those issues will rise to the ultimate level of preventing the final passage of a budget when push comes to shove.
But who knows? What we do know is that the impasse in 2009 created a guideline of what could happen if a budget is not passed.
It is likely that parts, though not all, of state government will shut down if the Legislature does the unthinkable and does not pass a budget for the new fiscal year beginning July 1.
An official opinion of the office of Attorney General Jim Hood issued in 2009 said if there is no budget passed by the Legislature, those services mandated in the Mississippi Constitution, such as a public education system, will continue.
According to the Hood opinion, other entities, such as the state’s debt, and court and federal mandates, also would be funded. But it is likely that there will not be funds for Medicaid and many other programs, such as transportation and aspects of public safety that are not specifically listed in the Mississippi Constitution.
The Hood opinion reasoned that the Mississippi Constitution is the ultimate law of the state and must be adhered to even in the absence of legislative action. Other states have reached similar conclusions when their legislatures have failed to act, the AG’s opinion said.
As is often pointed out, the opinion of the attorney general does not carry the weight of law. It serves only as a guideline, though Gov. Tate Reeves has relied on the 2009 opinion even though it was written by the staff of Hood, who was Reeves’ opponent in the contentious 2019 gubernatorial campaign.
But if the unthinkable ever occurs and the Legislature goes too far into a new fiscal year without adopting a budget, it most likely will be the courts — moreso than an AG’s opinion — that ultimately determine if and how state government operates.
In 2009 Sam Cameron did not want to see what would happen if a budget was not adopted. It also is likely that current political leaders do not want to see the results of not having a budget passed before July 1 of this year.
This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.
Mississippi Today
1964: Mississippi Freedom Democratic Party was formed
April 26, 1964

Civil rights activists started the Mississippi Freedom Democratic Party to challenge the state’s all-white regular delegation to the Democratic National Convention.
The regulars had already adopted this resolution: “We oppose, condemn and deplore the Civil Rights Act of 1964 … We believe in separation of the races in all phases of our society. It is our belief that the separation of the races is necessary for the peace and tranquility of all the people of Mississippi, and the continuing good relationship which has existed over the years.”
In reality, Black Mississippians had been victims of intimidation, harassment and violence for daring to try and vote as well as laws passed to disenfranchise them. As a result, by 1964, only 6% of Black Mississippians were permitted to vote. A year earlier, activists had run a mock election in which thousands of Black Mississippians showed they would vote if given an opportunity.
In August 1964, the Freedom Party decided to challenge the all-white delegation, saying they had been illegally elected in a segregated process and had no intention of supporting President Lyndon B. Johnson in the November election.
The prediction proved true, with white Mississippi Democrats overwhelmingly supporting Republican candidate Barry Goldwater, who opposed the Civil Rights Act. While the activists fell short of replacing the regulars, their courageous stand led to changes in both parties.
This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.
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