Postpartum depression: where to get help and what it costs

If you're in crisis or thinking about harming yourself or your baby, get help now.

• Call or text 988, the Suicide & Crisis Lifeline, any time ^[1]. In an emergency, call 911 or go to the nearest emergency room.
• National Maternal Mental Health Hotline: call or text 1-833-TLC-MAMA (1-833-852-6262). It's free, confidential and open 24/7. TTY users can dial 711, then 1-833-852-6262 ^[2].
• Postpartum Support International HelpLine: call 1-800-944-4773 (press 1 for Spanish, 2 for English) or text "Help" to 800-944-4773. For Spanish, text 971-203-7773. Volunteers return messages every day. It isn't a crisis line ^[3].

Postpartum psychosis is an emergency that needs immediate help. Call 911 ^[4].

You don't have to wait until your postpartum checkup, and you don't need a diagnosis to ask for help. About 1 in 8 women with a recent live birth report symptoms of postpartum depression ^[5], and it can start any time in the first year after birth ^[6]. It's treatable ^[4], and most of the care is covered by insurance or Medicaid.

This guide covers where to get help, how to find a therapist who knows perinatal mental health, and what it costs.

Where can you get help today?

These options are free or covered, and you can use them before you have a therapist:

How to find a perinatal mental health therapist

A therapist or prescriber with perinatal training can help with questions specific to pregnancy and the months after birth, such as medication while breastfeeding. Here's how to find one:

1. Search the PSI directory. Postpartum Support International's directory lists therapists, psychiatrists, psychiatric nurse practitioners, other medical providers, clinics and support groups in the U.S. and Canada with specialized perinatal mental health training ^[9]. You'll find it at psidirectory.com.
2. Call the behavioral health number on your insurance card. Ask for in-network providers who treat perinatal or postpartum depression and anxiety, and which ones have openings.
3. Ask your OB, midwife or pediatrician for names. Their office may keep a referral list.
4. Call the PSI HelpLine. A volunteer will call you back with names of local resources ^[3].
5. Check the federal locator. NIMH points to SAMHSA's online treatment locator, FindTreatment.gov, for mental health services near you ^[4].

Questions to ask before you book

• Do you have training in perinatal mental health?
• Are you in network with my plan? If not, will you give me a superbill so I can file a claim?
• Do you offer telehealth or evening appointments?
• How soon can I get a first appointment?
• Can you work with my OB or a psychiatrist if I need medication?

If the first available appointment is weeks out, take it, and stay on a cancellation list with one or two other providers. Use the hotline or a PSI group while you wait.

What treatment usually involves

You and your provider decide this together, but it helps to know the main options:

• Talk therapy. Evidence-based therapies for perinatal depression include cognitive behavioral therapy and interpersonal therapy ^[4].
• Antidepressants. These can effectively treat perinatal depression, and they often take several weeks to work ^[4].
• Zuranolone (Zurzuvae). The FDA approved it on August 4, 2023 as the first oral medication for postpartum depression in adults. It's taken once a day for 14 days, and it carries a boxed warning: don't drive or do other hazardous activities for at least 12 hours after each dose ^[10].
• Therapy plus medication. Treatment usually includes therapy, medication or both ^[4].

If you're breastfeeding, ask your prescriber how each option fits. ACOG's patient guide covers how zuranolone and breastfeeding are handled ^[6].

Does insurance cover postpartum depression treatment?

Mental health care is a required benefit. All Marketplace plans must cover mental health services as essential health benefits, including psychotherapy and counseling ^[11]. Plans can't put stricter limits on mental health care than on medical and surgical care. That covers copays, deductibles, visit limits and prior authorization ^[11].

Screening should be free. Non-grandfathered private plans must cover USPSTF grade A and B recommendations and HRSA's women's preventive guidelines with no cost sharing ^[12]. That includes:

• Depression screening for adults, including pregnant and postpartum people (USPSTF grade B, 2023) ^[13]
• Counseling to prevent perinatal depression for pregnant and postpartum people at increased risk, such as those with a history of depression or current symptoms (USPSTF grade B, 2019) ^[14]
• Anxiety screening for women, including during pregnancy and postpartum ^[15]

Treatment visits usually have cost sharing. Once you're in treatment, therapy and psychiatry visits and prescriptions are normally subject to your plan's copay, coinsurance and deductible. Ask your plan for the exact amount.

Out-of-network therapists. Some therapists don't take insurance at all. If your plan has out-of-network benefits, pay the therapist and file a claim with their superbill. If you can't find an in-network perinatal provider with openings, ask your plan to cover an out-of-network one at in-network rates, and get the approval in writing.

Medicaid and postpartum mental health care

As of July 15, 2026, 49 states and DC keep Medicaid going for 12 months after pregnancy; Arkansas is the exception ^[16]. Our guide to postpartum Medicaid explains what the extension covers and what happens at month 12.

To find care, call your Medicaid health plan's behavioral health line, or ask your OB or midwife for a referral to a provider who takes Medicaid. When you contact providers from the PSI directory ^[9], ask whether they accept your Medicaid plan.

If you don't have insurance

• Use the free options above. The hotline, the PSI HelpLine and PSI support groups cost nothing ^[2][7].
• Check Medicaid. Use our benefits checker to see whether you might qualify, and see Medicaid for pregnancy for your state's income limits.
• Get a Marketplace plan. Having a baby qualifies you for a special enrollment period on HealthCare.gov. Coverage can start the day of the birth if you enroll within 60 days ^[17].
• Ask about sliding-scale fees. Some therapists and clinics lower their fees based on income. Ask when you call.

Practical help at home can also make treatment easier to stick with. A postpartum doula can cover feeding support and household tasks, which frees up time for appointments and sleep.

What to say at your postpartum visit

You can bring this up at any visit, with your OB, midwife, family doctor or your baby's pediatrician. If it's hard to start, read this out loud or hand it over:

"I haven't been feeling like myself since the baby was born. I've been feeling (sad, anxious, numb, irritable, overwhelmed) most days for (how long). It's affecting my (sleep, eating, ability to care for the baby, relationships). I'd like to be screened for postpartum depression and anxiety, and I want to talk about treatment options and a referral to someone who specializes in perinatal mental health."

Ask before you leave:

• What's the next step, and who will call me?
• Can you refer me to a therapist or psychiatrist who takes my insurance or Medicaid?
• If medication makes sense, what are my options if I'm breastfeeding?
• Who do I call if I feel worse before my next appointment?

If you're thinking about harming yourself or your baby, say so directly, or call or text 988 right away ^[1].