A mental health hotline for new and expectant parents received more than 12,000 calls and texts in its first year, with a surge in January after Massachusetts mother Lindsay Clancy allegedly killed her children, according to data first shared with NBC News.
The federally funded National Maternal Mental Health Hotline launched last Mother’s Day and has averaged about 1,000 interactions per month, said a spokesperson for the Department of Health and Human Services’ Health Resources and Services Administration.
The HRSA spokesperson said that the average number of daily calls and texts to the free, confidential hotline increased by 73% in the week after Clancy allegedly strangled her three young kids and attempted to kill herself on Jan. 24 at her Duxbury, Massachusetts, home. Clancy’s attorney says she had postpartum depression and possibly postpartum psychosis at the time.
As her case made national headlines, the hotline received calls from stunned mothers and people worried about moms they knew.
“One of the first things we had to do was just say, ‘Yeah, this is really scary, and it’s hard,’” said hotline counselor Shanna Williams, a doula, lactation counselor and perinatal mental health therapist based in Pennsylvania. “‘But it’s important to know that there’s help out there, that this is not something that is a common experience for folks.’”
The first-of-its-kind hotline operates 24/7 and provides support before, during and after pregnancy. Postpartum depression occurs in about 1 in 8 mothers, the Centers for Disease Control and Prevention says, while postpartum anxiety affects approximately 1 in 10, according to Postpartum Support International.
Postpartum psychosis, meanwhile, occurs in 1 or 2 out of every 1,000 deliveries, according to Postpartum Support International. The rare condition can involve hallucinations that alter people’s sense of reality after childbirth, sometimes driving them to harm themselves or their children, and is considered a medical emergency that requires immediate treatment.
The hotline is part of a broader effort by Vice President Kamala Harris to improve maternal health and equity across the United States, which has the highest maternal mortality rate among wealthy industrialized countries.
"Every mother or mother-to-be, across our nation, should have access to the help and support they need to be healthy," Harris said in a statement first shared with NBC News.
The top reasons people dialed the hotline over the past year were depression, anxiety and feeling overwhelmed, the HRSA data showed. Phone calls made up about 70% of hotline interactions, while texts comprised about 30%.
All statistics were based on hotline interactions through March 31, the most up-to-date data available, the HRSA spokesperson said; at that point, the number of calls and texts was just under 12,000 in total.
In addition to pregnant people and new parents, including dads, the hotline welcomes people who have had pregnancy losses or infant losses. Callers are connected to a counselor in an average of under 30 seconds, the HRSA spokesperson said.
Officials hope to keep wait times low by increasing staffing using some of the $7 million that Congress appropriated for the hotline for the 2023 fiscal year.
It is currently staffed by more than three dozen call-takers, which include nurses, doulas and lactation consultants, said Wendy Davis, executive lead of the National Maternal Mental Health Hotline and executive director of Postpartum Support International.
Davis said she had postpartum depression and anxiety after giving birth to her first child in 1994. At the time, she did not know that her symptoms were temporary and treatable.
“I just thought I was failing, and I was terrified, and I was isolated,” she said. “I didn’t have any resources.”
Williams said calls come in at all hours, including in the middle of the night from mothers who are breastfeeding or are up with insomnia. The calls last anywhere from a few minutes to more than 45 minutes, she said.
Among those she and other counselors have helped are pregnant women who have decided they’re going to leave an abusive partner; women with histories of trauma whose anxiety has risen during pregnancy; and moms who call while pumping because it’s the only time they have a moment to themselves.
Hormonal changes, a history of mental health struggles and the psychological shift to becoming a parent can contribute to perinatal mood disorders, which are those that occur during pregnancy and up to a year after, said Dr. Nancy Byatt, a professor of psychiatry at UMass Chan Medical School and executive director of the university’s Lifeline for Families Center and Lifeline for Moms Program. Disparities in screening for and access to psychiatric treatment can also play a role.
These mood disorders are often compounded by the commonly held myth that having a new baby is supposed to be a time of pure joy, Byatt added.
“Our society expects this sort of idealized image around what can happen during pregnancy and postpartum.”
— Dr. Nancy Byatt, professor of psychiatry at UMass Chan Medical School
“Our society expects this sort of idealized image around what can happen during pregnancy and postpartum,” she said. “The reality is even if someone doesn’t experience postpartum depression, it is always challenging to have a baby.”
Addressing two national crises
Officials say the hotline is addressing dual crises. In addition to a recent surge in mental health issues, including maternal mental health issues, the U.S. has long had an abysmal maternal mortality rate that disproportionately affects Black people.
The problems are interconnected, data shows: Mental health conditions were the leading underlying cause of pregnancy-related deaths in the U.S. from 2017-2019, according to the CDC.
The connection the hotline offers is especially critical for people in maternity care deserts, said Dr. Michael Warren, associate administrator of the Maternal and Child Health Bureau at HHS’ Health Resources and Services Administration. A report by the nonprofit organization March of Dimes found that over 2.2 million women of childbearing age live in more than 1,100 U.S. counties without any hospitals or birth centers offering obstetric care, and that nearly 150,000 babies were born in them.
Residents in areas with ample maternity care can benefit from the hotline too, Warren said.
“The hotline gives them another avenue to be able to speak to someone in a confidential way,” he said, adding that one of the resources the hotline offers is to connect callers with a home visiting program that aims to improve the health of mothers and their children.
The hotline also provides recommendations for individual and group therapy.
Those types of ongoing services are often necessary for women struggling with perinatal mental health issues, said Dr. Atul Gawande, assistant administrator for global health for the U.S. Agency for International Development. He is not involved in the maternal health hotline.
“Call centers are not sufficient to solve this problem — you need to have a relationship with caregivers and in the community that allow you not to be lost in the system,” Gawande said.
Going forward, the hotline will have a new number that staff hope will be easier to remember in times of crisis: 1-833-TLC-MAMA. Its existing number will continue to work for one year.
The hotline is not intended to be an emergency response line for suicidal ideation or intimate partner violence. Such callers are referred to places like the National Suicide Prevention Lifeline that can offer more intensive and immediate support, Williams said.
But the maternal mental health hotline welcomes any inquiries, Davis said, adding that you don’t need a diagnosis to reach out.
“The most important thing for people to know is they’re not alone,” she said. “There’s help and there’s hope, any time of the day or night.”
If you are pregnant or a new mother and you are in crisis, the National Maternal Mental Health Hotline provides free, confidential support 24/7 in English and Spanish. Call or text the hotline at 1-833-TLC-MAMA (1-833-852-6262).
If you or someone you know is in crisis, call 988 to reach the Suicide and Crisis Lifeline. You can also call the National Suicide Prevention Lifeline at 800-273-8255, text HOME to 741741 or visit SpeakingOfSuicide.com/resources for additional resources.