One in five women nationally will experience a perinatal mood or anxiety disorder. In Atlanta, poverty, childcare costs, and gaps in culturally responsive care push that risk even higher for many mothers. Here’s what the research shows, and what still has to change.

Becoming a mother changes everything about a woman’s life, including her mental health. For a significant share of mothers, that change includes depression, anxiety, or both. For mothers in metro Atlanta, the conditions that shape daily life (income, housing, childcare, access to care) make that risk harder to manage and easier to miss.

The Atlanta Women’s Foundation’s research assessment, The Status of Women and Youth Mental Health in Metro Atlanta, looked at what’s driving mental health outcomes for women and girls across Clayton, Cobb, DeKalb, Fulton, and Gwinnett counties. Maternal mental health emerged as one of the clearest, most urgent findings in that research. This is what it shows, and why AWF believes the response has to support mothers and children together.

The Scope of the Problem: PMADs by the Numbers

Perinatal Mood and Anxiety Disorders, or PMADs, are the most common complication of pregnancy and childbirth. As we mentioned earlier, they affect 1 in 5 women, and roughly 20% of mothers are affected during pregnancy or in the postpartum period.

Georgia’s numbers are more serious than the national picture. The state has one of the highest maternal morbidity rates in the country, and mental health conditions are now the leading underlying cause of maternal mortality in the United States.

69% of respondents in our provider and community survey named support for postpartum depression and anxiety as a top unmet need for women.

Despite that need, postpartum mental health services remain scarce across the region, a gap our research identifies as a priority for investment.

Why Atlanta Mothers Are Especially at Risk

Maternal mental health doesn’t exist apart from the rest of a mother’s life. Our research points to several conditions in metro Atlanta that exacerbate the risk of a PMAD going unaddressed.

Economic insecurity is the clearest driver. Poverty rates for female-headed households across the five-county region range from 12.9% to 23.6%, and climb above 30% in some counties when children under five are in the home. 

Childcare adds another layer of strain. Families in the region spend between 21% and 36% of their income on childcare for two children. According to our provider survey, 92% identified high childcare costs as a direct mental health stressor, and 74% of grantee organizations said mothers need childcare or time to rest as a top, unmet need.

And when mothers do seek help, the system isn’t built to meet them. Only 46% of provider organizations surveyed offer maternal-specific mental health services, meaning most don’t. For many mothers in metro Atlanta, the support that exists on paper isn’t the support that’s actually available.

The Disproportionate Toll on Black Mothers in Atlanta

The disparities in AWF’s research make clear why a BIPOC focus matters for maternal health specifically. Black women face the compounding effects of racism and sexism — pressures that raise mental health risk while simultaneously making it harder to access care.

The provider interviews in our research describe a specific barrier: stereotyped assumptions about what distress is supposed to look like can lead providers to underestimate how much a Black mother is struggling unless her distress is visibly acute. The effect, described repeatedly by providers and clients in the research, is that some Black mothers feel they have to prove they need help before they receive it.

That gap is exactly what culturally concordant, trauma-informed care is designed to close. In metro Atlanta, that care remains hard to find.

What Happens When Mothers Don’t Get Support

Untreated maternal depression rarely stays contained to one person. National research cited in our assessment shows it can affect a child’s academic performance, social development, and long-term health. When a mother struggles, her whole family feels the effects.

The cost is measurable in dollars, too. Researchers estimated the economic cost of untreated perinatal mood and anxiety disorders among just the 2017 birth cohort in the U.S. at $14.2 billion, with costs extending five years past birth.

That’s the case for treating maternal mental health as urgent, not incidental: the cost of inaction builds across a generation.

AWF’s Two-Generation Approach: Supporting Mothers and Children Together

Our research points to a specific model as the most promising response: two-generation and three-generation approaches that support caregivers and children at the same time, rather than treating a mother’s mental health and her child’s well-being as separate problems.

Across metro Atlanta, grandmothers frequently serve as primary caregivers, often while managing their own exhaustion and isolation. In fact, 46% of organizations said they support three-generation models but don’t have the resources to implement them fully.

Through the Two-Generation Initiative, AWF funds organizations working to close that gap: pairing maternal mental health support with services for children, so that treating one doesn’t mean neglecting the other.

What Still Needs to Change

Our research points to two concrete gaps that stand between mothers and the support they need. The first is capacity: with only 46% of provider organizations offering maternal-specific mental health services, most mothers in the region don’t have a dedicated place to turn. The second is culturally concordant care: with fewer than 100 Spanish-speaking providers statewide and documented barriers for Black mothers seeking care, the providers who exist often can’t reflect the communities they serve.

Closing both gaps requires sustained investment, not a single program. Every mother deserves access to the support she needs to thrive – not only during pregnancy and the postpartum period, but throughout her caregiving journey. AWF’s research makes clear that expanding maternal mental health services, investing in culturally responsive care, and supporting whole families through two-generation approaches are essential steps toward a healthier future for women, children, and communities across metro Atlanta.

Frequently Asked Questions

What is a PMAD (Perinatal Mood and Anxiety Disorder)?

A PMAD is a mood or anxiety condition — including depression, anxiety, and related disorders — that can develop during pregnancy or in the first year after childbirth. PMADs are the most common complication of pregnancy and childbirth, affecting about 1 in 5 women nationally.

How common is postpartum depression in Atlanta?

Nationally, roughly 20% of mothers experience depression or anxiety during pregnancy or postpartum. Our research shows metro Atlanta mothers face added risk from poverty, high childcare costs, and limited maternal-specific care. Georgia also has one of the highest maternal morbidity rates in the nation, and mental health conditions are now the leading underlying cause of maternal mortality in the U.S..

What is AWF doing about maternal mental health in Atlanta? 

AWF funds two-generation and three-generation models that support mothers and their children together, rather than treating a mother’s mental health and a child’s well-being as separate problems. This work is guided by AWF’s research assessment and carried out through the Two-Generation Initiative.

How can I help support maternal mental health programs in Atlanta? 

The clearest ways to help are funding AWF’s Two-Generation Initiative directly, or supporting the community-based organizations AWF grants to — many of which offer maternal-specific mental health services that are otherwise scarce in the region. [Donate / Two-Generation Initiative]

Where does a donation to AWF’s Two-Generation Initiative go? 

AWF invests in organizations across metro Atlanta that are closing two specific gaps: the shortage of maternal-specific mental health providers, and the shortage of culturally responsive care for Black and Spanish-speaking mothers. Rather than running programs directly, AWF funds and coordinates the organizations already doing that work and acts as a catalyst for the systems-level change the research shows is needed.

Read more about AWF’s Mental Health & Wellbeing research and approach, or learn how the Two-Generation Initiative supports mothers and children together.