By David Adamson, MD, Founder and CEO, ARC Fertility
The Postpartum Gap in U.S. Maternal Healthcare
High Costs, Low Coverage: A System Failing Mothers…and Fathers
The Data Behind the Crisis
In 2022, the United States recorded 22 maternal deaths for every 100,000 live births — the highest rate among high-income nations and more than two to three times higher than countries such as Norway, Australia, and the Netherlands. Mental health challenges play a significant role, with one in five women experiencing postpartum depression and a similar proportion facing anxiety or other mood-related conditions during pregnancy and after birth. Between 2010 and 2021, the prevalence of postpartum depression in the United States rose sharply, increasing from 9.4% to 19%.
Despite these facts, fewer than 50% of women are screened for depression during routine postpartum visits, and only 22% of those who screen positive receive treatment.
What’s Behind Paternal Postnatal Depression (PPND)?
Although postpartum depression is most often discussed in relation to mothers, studies show that roughly one in ten fathers may also experience it. In men, symptoms can appear anytime during the first year after a child’s birth, affecting mood, daily functioning, and emotional expression, and often presenting as irritability, emotional withdrawal, or depression.
Contributing factors can include a personal or family history of depression, financial strain, and hormonal shifts. Paternal PPD is sometimes linked to anxiety disorders and can negatively impact the father, the family dynamic, and the child’s development.
Treatment options typically involve therapy and/or medication. Health professionals are advised to screen fathers for depression within the first postpartum year and provide or refer them to appropriate care if symptoms are identified.
Experts also emphasize the need for more research to better understand prevalence, co-occurring conditions, and treatment effectiveness, with particular attention to diverse populations, including single fathers, two-father families, stepfathers, and men from varied economic, racial, ethnic, and geographic backgrounds.
Structural and Policy Barriers
Access to care is a major obstacle. Nearly seven million women in the U.S. live in counties with no hospitals, birth centers or OB providers offering obstetric care.
At the policy level, the U.S. is the only high-income country that does not guarantee paid maternity leave at the national level. Medicaid covers nearly half of all U.S. births but benefits often end 60 days after delivery unless extended by the state, even though the majority of maternal deaths occur during the postpartum period.
These structural and policy gaps make it difficult for mothers, especially those in lower-income or rural areas, to receive mental health support at the most vulnerable stage of recovery.
The Business Case for Postpartum Support
Why It Matters to the Workplace: Lost Productivity, Presenteeism and Turnover
Postpartum mental health conditions don’t just impact individuals, they ripple across teams, departments and entire organizations. When left untreated, perinatal mood and anxiety disorders (PMADs), including depression and anxiety, are strongly linked to absenteeism, presenteeism (working while unwell) and even long-term disability.
According to a national analysis, the cost of untreated PMADs is estimated at $32,000 per affected mother-child pair over five years. A recent study revealed untreated maternal mental health conditions cost the United States $14 billion for the 2017 birth cohort from conception to 5 years postpartum.
These financial losses are felt at the organizational level. One study estimated that postpartum depression costs employers approximately $6,200 per affected employee per year, primarily due to reduced productivity and extended leave. Even when employees return from parental leave, many are struggling, yet expected to resume full performance with little to no formal reintegration support.
Talent Retention and Workforce Stability
New parents are at high risk of exiting the workforce during the return-to-work period. A 2023 survey found that 40% of women considered quitting their jobs due to the emotional strain and lack of structured support during maternity leave reentry. Even more striking, 95% said they received no formal support, not from HR, not from managers and not from benefit programs.
These findings reflect a broader retention challenge. Postpartum conditions can cause emotional withdrawal, cognitive fog and decreased confidence, none of which are visible on paper but all of which erode long-term engagement. Without tailored benefits or coaching, employers risk losing valuable talent in the first year of parenting.
However, the inverse is also true. Companies that invest in postpartum care strategies, especially those that include flexible schedules, mental health access and personalized coaching, see improvements in satisfaction, loyalty and workforce stability.
Employers as Bridge-Builders: Filling the Gap in Postpartum Care
Designing Family-Forming Benefits That Don’t End at Birth
Beyond parental leave, employers should strive to provide real support. Traditional family-forming benefits tend to drop off after childbirth, exactly when many of the most serious health risks begin. Conditions like postpartum depression, anxiety, obsessive-compulsive disorder and PTSD can emerge anytime in the first 12 months and often persist for much longer. Yet most postpartum benefits consist of little more than short-term leave and a single follow-up visit.
This misalignment is costly. Mental health conditions that go untreated during the postpartum period are more likely to escalate and impact not only maternal health but also family functioning, child development and career trajectory.
A comprehensive postpartum benefit strategy should address emotional, psychological and logistical needs. This includes:
- Therapy or counseling with providers trained in maternal mental health.
- Return-to-work coaching to support the transition back.
- Telehealth access, including virtual therapy and mental wellness apps.
- Peer support, whether through internal groups or third-party platforms.
These are not optional benefits. They are essential interventions supported by evidence and proven to prevent serious outcomes. Research confirms that early access to parental mental health care reduces long-term disability claims, improves job performance and decreases turnover.
Key Components of an Inclusive Postpartum Benefits Strategy
Mental Health Screening and Therapy Access
Make screenings for depression and anxiety a standard component of maternity coverage, not an optional extra. According to the CDC, at least 80–90% of mothers are not receiving the recommended mental health screening during or after pregnancy.
Although there is no universally agreed-upon definition for postpartum depression in men, it is often identified through a clinical interview guided by the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition(DSM-5). The DSM-5 describes depression “with peripartum onset” as a major depressive episode that occurs during pregnancy or within four weeks after delivery. The symptoms are generally similar to those experienced by women, but in men, they may also include indecisiveness, irritability, and emotional detachment, which can emerge anytime within the first year after birth.
Screening tools can assist in making a diagnosis. One commonly used measure is the Edinburgh Postnatal Depression Scale (EPDS), which evaluates symptoms of depression and anxiety in both mothers and fathers. Because men may be less likely to express emotions openly and may underreport symptoms, a lower cutoff score is applied for them. However, even with this adjustment, the EPDS has limitations due to unclear questions and reduced sensitivity in detecting depression and anxiety among men.
Digital mental health platforms can increase both access and participation, especially when confidentiality and flexibility are prioritized. Therapy options should be available in multiple languages, with culturally competent providers and inclusive of all parenting journeys.
Return-to-Work Coaching and Navigation
Returning to work after having a child is often one of the most complex and emotionally demanding stages for new parents. Support through coaching can ease this transition by helping parents clarify expectations, communicate their needs and rebuild confidence in their professional roles. When employers provide this kind of guidance, it helps working parents feel more supported and better equipped to stay engaged and productive as they adjust to their new routines.
Peer Support and Parenting Resources
Peer support reduces the isolation that many parents experience after birth. This can take the form of employee-led parenting networks, facilitated discussion groups or curated educational content. Group spaces not only foster connection but they also normalize the mental and emotional complexity of parenting.
In a 2025 study of over 500 mothers, 96% reported becoming more aware of mental health symptoms and 88% said they felt more comfortable opening up emotionally when part of a structured support group.
Flexible Work Accommodations and Paid Leave
One-size-fits-all return timelines are outdated. Flexible scheduling, gradual return plans, hybrid or remote options and phased reentry all play a role in easing new parents back to work while minimizing disruption.
Paid parental leave remains essential but what happens after leave is just as important. Without postpartum-specific support, employers may see higher absenteeism and lower engagement even after generous leave policies.
Implementation Best Practices for Employers
Practical Steps to Integrate Postpartum Care into Benefit Plans
Assess Existing Gaps and Employee Needs
Before launching new programs, employers must understand where current offerings fall short. While most companies track parental leave usage and general benefit engagement, few collect data on postpartum experiences specifically. This is a missed opportunity.
Anonymous employee surveys, listening sessions or post-leave check-ins can uncover real-time needs around emotional wellness, reentry struggles and access to care. Metrics like attrition rates among new parents, unpaid leave extensions or delayed returns can also serve as warning signs of unmet needs.
International studies indicate that nearly one-quarter of mothers exit the workforce within the first year after giving birth, and about 15% remain absent even ten years later. These long-term departures are frequently tied to rigid workplace policies, the pressures of caregiving, and the impact of mental health challenges.
A proper benefits audit should answer:
- Are mental health services available specifically for postpartum needs?
- Can employees access them easily, confidentially, and without long wait times?
- Are programs available to all parents, including part-time, contract or adoptive caregivers?
By centering the lived experience of working parents, organizations can move from policy-driven to people-centered design.
Partner with Reproductive Health and Mental Health Experts
Postpartum care is medically and emotionally complex. Employers should not rely on generic EAPs or one-size-fits-all solutions. Instead, partner with mental health professionals and organizations that specialize in perinatal care.
These partnerships ensure evidence-based interventions and improve outcomes. Services should include trauma-informed counseling, multilingual access and inclusive support for all family structures.
Telehealth plays a pivotal role in access. Studies confirm that virtual mental health services are just as effective as in-person therapy and often lead to higher participation due to reduced logistical burdens like transportation or childcare.
Normalize Conversations Around Parental Mental Health
Benefits alone aren’t enough, culture matters. Many employees struggle silently with postpartum depression or anxiety because mental health is still treated as taboo in the workplace.
That can change. Leadership must help shift the narrative. Employers can include maternal mental health resources in onboarding materials, internal newsletters and benefits education. Managers and HR teams should be trained to recognize common symptoms, such as emotional withdrawal, chronic fatigue or sudden changes in performance and to respond with empathy.
Storytelling also plays a powerful role. Peer spotlights and parent resource groups can help normalize postpartum challenges and encourage help-seeking. According to the Office on Women’s Health, simply being asked about their emotional health significantly increases the likelihood that new mothers will seek treatment.
Workplaces that promote vulnerability and openness reduce stigma and ultimately foster healthier, more connected teams.
Looking Ahead: Strategic Value Beyond Cost Savings
Stronger Families, Stronger Workplaces
Investing in parental mental health yields long-term returns that extend well beyond immediate productivity gains. When parents receive emotional and logistical support during the postpartum period, they are more likely to remain engaged, loyal and high-performing.
Research shows that 95% of new mothers report receiving no formal support during their return-to-work process and nearly 40% consider quitting altogether due to emotional and logistical strain. These statistics highlight the hidden vulnerabilities employers face when postpartum care is treated as optional.
In contrast, workplace support during the transition back from leave has been shown to improve retention, reduce absenteeism and increase long-term employee satisfaction.
This is not just about supporting parents, it’s about future-proofing your workforce. Parents who feel supported are more likely to return after leave, stay longer and speak positively about their employer. That kind of brand advocacy is especially valuable in today’s competitive labor market, where culture and flexibility matter more than ever.
Setting the Standard for Modern Family-Forming Benefits
As awareness of maternal health expands, the expectations placed on employers are rising fast. Several U.S. states have already extended Medicaid coverage for postpartum care and national policy discussions are increasingly focused on maternal mental health screening, access and equity.
Employers have an opportunity to lead—not follow—this change.
By voluntarily offering robust postpartum benefits, companies can set a new benchmark for reproductive health support in the workplace. This includes mental health therapy, peer resources, coaching and flexible reintegration plans. When done well, this approach recognizes the full arc of the parenting journey, not just conception and birth but recovery, identity and reintegration.
Employers who prioritize this phase signal that parenthood is not a disruption to be managed, it’s a life transition worth supporting—and that message matters.
It’s Time to Complete the Family-Forming Journey
Postpartum Support Isn’t Extra—It’s Essential
Despite growing investment in family-forming benefits, too many employer programs still stop short, ending precisely when support is most needed, after birth. The first year after childbirth is a particularly sensitive and high-risk period for new parents. Mental health conditions like postpartum depression, anxiety and exhaustion are common but support for recovery is often absent from employer benefit structures.
When companies incorporate postpartum therapy access, coaching, peer networks and phased return policies into their benefits, they reduce risk while improving recovery, performance and retention. It’s a practical investment with measurable upside.
Supporting parents through the entire parenting arc, from fertility through postpartum and into reentry, isn’t just compassionate, it’s strategic. It signals that employers understand the real needs of modern families and are willing to invest in their people accordingly.
As workplaces change, the systems that support them must adapt as well. Organizations that integrate postpartum care now will not only attract and retain top talent, they’ll help define what truly inclusive and forward-thinking family-forming support looks like.
This article originally appeared in the November/December 2025 issue of Journal of Compensation and Benefits.
