Massachusetts Gov. Maura Healey wants every family with a newborn to be offered a free home visit from a nurse, part of a postpartum mental health plan she announced Tuesday at Beth Israel Deaconess Medical Center in Boston.
Healey said she will ask lawmakers for $2 million to expand the state's Welcome Family program, which now serves about 3,000 births a year. The goal is to make visits available to families of the roughly 68,000 babies born in Massachusetts each year, according to the Associated Press.
"To every mom who has struggled with her mental health before, during or after pregnancy, I want you to know we see you," Healey said, adding, "I see you."
Inside the Governor's Postpartum Proposal
Welcome Family offers parents and caregivers a free, one-time home visit from an experienced maternal and child health nurse in the first few weeks after birth, WBUR reported. Participation would be voluntary. The nurse can answer questions about feeding, sleep, and newborn care, check on the mother's recovery, screen for depression and other mental health concerns, and offer referrals.
Healey said the funding would be the state's first investment in the federally funded program. State officials did not say exactly how many more families the $2 million would reach, but Public Health Commissioner Robbie Goldstein said he hopes it will allow the state to serve all families who opt in, The Boston Globe reported.
"This expansion by $2 million will let us go all across the state, every community, every delivery," Goldstein told CBS News Boston.
Healey also proposed $250,000 for the Massachusetts Child Psychiatry Access Program for Moms, known as MCPAP for Moms, which helps clinicians who treat pregnant and postpartum patients get psychiatric consultation. She directed the Department of Public Health to update state regulations on perinatal mental health screening. According to the governor's office, the updated rules are expected to cover a broader range of conditions than postpartum depression and to add more opportunities for screening during visits with obstetricians, primary care providers, pediatricians, and other health care workers.
The proposal builds on a 2024 maternal health law Healey signed that expanded access to doulas, midwives, and birth centers and required insurers to cover postpartum depression screenings.
Mental Health Leads Pregnancy-Related Deaths in Massachusetts
State data show why the months after birth matter. From 2019 through 2023, mental health conditions, most involving substance use disorder, were the leading underlying cause of pregnancy-related deaths in Massachusetts, accounting for 42%, according to the state's Maternal Mortality and Morbidity Review Committee. The committee considered 86% of pregnancy-related deaths preventable, and about 60% occurred between seven days and one year after the end of pregnancy.
That timing is the practical case for home visits. Many new mothers have fewer scheduled medical appointments in those weeks and months, and a nurse in the home can notice warning signs that may not come up during a short clinic visit.
The announcement follows the murder trial of Lindsay Clancy, a former labor and delivery nurse charged in the January 2023 deaths of her three children in Duxbury. Her attorneys argued she was suffering from postpartum psychosis. A judge declared a mistrial on Sept. 4 after jurors deadlocked, and Plymouth County District Attorney Tim Cruz said at the time that his office had not decided whether to seek a retrial.
Warning Signs New Parents and Partners Should Know
Postpartum depression is common and treatable. Postpartum psychosis is rare, affecting about 1 to 2 of every 1,000 births, according to published research, and is considered a psychiatric emergency.
Many new parents experience unwanted, frightening thoughts about harm coming to their baby. These intrusive thoughts are common and usually cause distress rather than action, but they are worth discussing with a clinician.
Symptoms that warrant a call to a clinician include persistent sadness, hopelessness, anxiety that interferes with daily life, trouble bonding with the baby, and inability to sleep even when the baby sleeps. Confusion, hearing or seeing things others do not, extreme suspicion, rapid mood swings, or thoughts of self-harm or harming the baby require urgent evaluation.
Partners and relatives are often the first to notice changes. Risk is higher for people with a personal or family history of bipolar disorder, prior psychosis, or previous postpartum depression.
People in crisis can call or text 988, the Suicide and Crisis Lifeline. The National Maternal Mental Health Hotline, 1-833-TLC-MAMA (1-833-852-6262), offers free, confidential support for pregnant and new parents.
Funding Still Needs Lawmakers' Approval
The $2 million and $250,000 requests will be part of a supplemental budget filing and still need approval from the Legislature. Healey did not set a date for when expanded visits would begin, and reaching many more households would require more nurses and scheduling capacity.
Families in other states can check whether their state or county offers home visiting. Many programs are free and prioritize first-time parents or families enrolled in Medicaid, and local health departments or hospital maternity units can often provide referrals.
Parents with private insurance can ask whether postpartum mental health visits, lactation support, and screenings are covered. Those facing long waits for a psychiatrist can ask their obstetric clinician whether a consultation service similar to the Massachusetts program is available.
Healey framed the plan as an effort to reduce stigma. "We need to talk more openly about this," she said.
Whether the proposal becomes reality now depends on lawmakers and on the state's ability to reach every household that wants a visit during the weeks after hospital discharge, when support often drops off.
Key Questions Answered
What did Gov. Healey propose? $2 million to expand free, voluntary nurse home visits through the Welcome Family program, $250,000 for MCPAP for Moms, and updated perinatal mental health screening rules.
Is the home visit required? No. Participation would be voluntary.
Why focus on the months after birth? State reviewers found that about 60% of pregnancy-related deaths from 2019 through 2023 occurred between seven days and one year after pregnancy ended, and most were considered preventable.
What are signs of postpartum psychosis? Confusion, hallucinations, extreme suspicion, rapid mood swings, or thoughts of harming oneself or the baby. These require urgent care.
Where can new parents get help now? Call or text 988 in a crisis, or call the National Maternal Mental Health Hotline at 1-833-852-6262.
When would the expanded program start? No start date has been announced. The funding must first be approved by the Legislature.
