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A mother in Maryland gave birth to a healthy baby boy in August 2023. She loved him deeply. She wanted to be well for him. She asked for help, but the system did not move quickly enough. Three months later, she died by suicide — one day after her 35th birthday. Her name was Andrea.
Her sister, Kyra, testified before the Maryland Senate Finance Committee about the gaps Andrea fell through — a system that can screen without guaranteeing connection to care, without urgent referral pathways, without coordinated follow-up. Andrea’s story is devastating. It is also not rare.
In the United States, one in five mothers experiences a mental health condition during pregnancy or in the year after birth. More than 75% go untreated. In Maryland, behavioral health conditions are the leading cause of pregnancy-associated deaths, accounting for nearly a quarter of preventable maternal deaths in 2020. The majority of those deaths were considered preventable.
Behind those statistics are real women — professionals, stay-at-home moms, first-time parents, experienced parents — who are quietly battling postpartum depression, anxiety, obsessive-compulsive disorder, post-traumatic stress disorder, bipolar disorder or psychosis. Many assume what they are feeling is simply exhaustion. Many are ashamed. Many are afraid to speak up. And when they do speak up, the response is not always clear, coordinated or timely.
That is why I sponsored Senate Bill 891, cross-filed in the House of Delegates by Delegate Jennifer White Holland. SB 891 strengthens Maryland’s framework for identifying and treating perinatal mental health conditions. It requires screening not only during pregnancy and at the postpartum visit but also throughout the baby’s first year of life — including at well-child visits, where parents are already interacting with trusted providers. Early detection is not a formality; it is often the entry point to lifesaving intervention.
But screening alone is not enough. This bill requires insurers to provide a standing referral to a mental health provider during pregnancy and for one year after birth. That means when a mother screens positive, she does not have to start from scratch by navigating approvals and paperwork. The pathway to care is already open.
The legislation also strengthens insurance protections when timely in-network mental health care is unavailable. If access does not exist within a reasonable timeframe, families should not be penalized for seeking help elsewhere. Delays during the postpartum period can be dangerous. Weeks matter. Sometimes days matter — as Andrea’s family so painfully reminds us.
SB 891 also ensures that women receive written, evidence-based information about perinatal mental health from their providers and through WIC offices. Many parents simply do not know what postpartum depression or anxiety can look like. Education reduces stigma and empowers families to recognize warning signs early.
Finally, the bill strengthens provider education requirements so clinicians are equipped with updated screening tools and response protocols. Maryland recently received an F for screening and reimbursement in a national maternal mental health report card. That is not a grade we should accept, especially when the consequences are measured in lives.
The mental health of a mother is inseparable from the health of her child. From birth to age 3, a child’s brain forms 1 million neural connections per second. That development depends on a stable, healthy attachment to a caregiver. When a mother is overwhelmed by untreated depression or psychosis, that bond can be disrupted — not because she does not love her child but because she is suffering.
SB 891 is about ensuring that when a mother says, “I’m not OK,” the system responds with urgency, clarity and care. Andrea’s son will grow up knowing his mother through stories. Her family will always wonder what might have been different if stronger systems had been in place.
We cannot change what happened to Andrea. But we can change what happens next for Maryland mothers. I am grateful to the advocates, clinicians and families who have shared their expertise and, in many cases, their heartbreak in support of this legislation. Their courage is shaping policy that can save lives.
It is an honor to represent you. If you have questions or concerns, please contact my office at dawn.gile@senate.maryland.gov or 410-841-3568.
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