Does your facility provide tablets or phone access for people in custody? The National Maternal Mental Health Hotline is a great way to help pregnant and postpartum women reach free, potentially lifesaving resources.

Pregnancy, Postpartum, and Mental Health
The U.S. faces a worsening maternal mortality crisis, with the highest rate of maternal deaths of any high-income country in the world. According to the CDC’s Maternal Mortality Review Committees, the leading causes of pregnancy-associated deaths are mental health conditions and substance use issues, conditions that are extremely common among women in U.S. prisons and jails. Research has shown that tens of thousands of pregnant people enter U.S. jails and prisons annually and, considering that 60% of incarcerated women are mothers to young children, many also enter during the postpartum period (defined as the 12 months after giving birth). Notably, over half of all maternal deaths occur during that postpartum period.

For someone who is pregnant or postpartum, incarceration can be deeply traumatizing due to isolation, stigma, lack of support, uncertainty over childbirth, and impending or actual separation from their newborn. With baseline high rates of substance use disorders and mental health conditions, such trauma creates deep psychological distress and compounds the risks of perinatal depression, which is strikingly high in custody (35% as compared to 12-20% in the general population, according to a 2021 study).

Reducing preventable maternal deaths, whether in custody or after release, starts with optimizing mental health and substance use care in jail—and making full use of free, trusted resources already available.

Introducing the National Maternal Mental Health Hotline
In 2022, the U.S. Health Resources and Services Administration (HRSA) launched the National Maternal Mental Health Hotline (1-833-TLC-MAMA), a 24/7, free and confidential resource for anyone who is pregnant or postpartum. The hotline connects callers with trained counselors who provide emotional support, crisis intervention, and referrals. The service is available in over 60 languages and requires no insurance, diagnosis, or documentation. The hotline also accepts toll-free calls, making it especially well-suited for correctional settings where paid phone access can be a barrier. Counselors can help connect callers to local resources in preparation for reentry.

In correctional settings, phone use is limited or expensive, and many facilities may struggle to consistently provide the timely, trauma-informed responses that pregnancy and postpartum care require. Without intentional effort, important resources like the National Maternal Mental Health Hotline may never reach those who need it most. Yet for someone navigating grief, depression, anxiety, or trauma, speaking with a compassionate professional can be transformative.

Grant County Detention Center in Silver City, New Mexico, found an effective solution. Through a research partnership with Johns Hopkins University focused on improving pregnancy and postpartum care in jails, researchers introduced the HRSA National Maternal Mental Health Hotline to the facility. Staff recognized its potential and, working with their tablet provider, added the hotline number to the jail’s free call list, ensuring that any resident could reach out at no cost.

“We want the best for the pregnant and postpartum women in our custody,” said jail Lt. Michael Bonenfant. “We had no idea this mental health hotline existed. Once we learned about it, it was a no-brainer for us to give the mothers in our jail free access to the phone number.”

This change required no new funding or infrastructure— just a small technical adjustment with potentially lifesaving reach.

Important Maternal Health Screenings
Another important practice is screening all women for postpartum status at intake by adding a question like “Have you given birth in the last 12 months?” This identifies individuals who are still at risk for pregnancy-related complications. Grant County Detention Center is working with their medical vendor to add the 12-month postpartum question to their intake screening form. For those who are postpartum, medical staff can then ask if they are breastfeeding—and provide appropriate pumping accommodations—and screen for postpartum depression and perinatal anxiety using validated tools like the Edinburgh Postnatal Depression Scale and Perinatal Anxiety Screening Scale.

Correctional health professionals are uniquely positioned to advocate for these solutions. If you work in a facility with tablets or a telephonic infrastructure, consider partnering with your communications provider to make the National Maternal Mental Health Hotline (1-833-TLC-MAMA) easily accessible. This small change aligns with national maternal health priorities, suicide, and overdose prevention initiatives, as well as the fundamental principles of patient-centered care.

Maternal mental health support should not depend on incarceration status. Thanks to the thoughtful leadership at Grant County Detention Center, we are one step closer to ensuring it doesn’t. As more jails and prisons adopt tablets and digital communication platforms, they can follow their lead and have a positive impact on new moms and their babies.

Pregnancy and the postpartum period are times of profound vulnerability. Access to timely, empathetic mental health care can make all the difference. More broadly, this initiative demonstrates what’s possible when correctional health systems commit to dignity-centered innovation.

By Camille Kramer, MPH, Alvina Pan, and Carolyn Sufrin, MD, PhD, Johns Hopkins University School of Medicine

National Maternal Mental Health Hotline: 1-833-TLC-MAMA