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I describe myself as an accidental advocate.

Twenty years ago — in the period of life referred to as “B.C.” or “before children” — I never would have anticipated that I would lead national conversations around maternal mental health. I had graduated from the U.S. Naval Academy and was an intelligence officer in the Navy. I went through rigorous psychological assessments to ensure that I was mentally stable and could handle top-secret information. I worked at the Pentagon and the White House, and I aspired to be the secretary of defense or the head of the CIA.

Then I had a baby, and my world changed. I experienced significant postpartum depression, which manifested as rage and feelings of being completely overwhelmed. I had a toddler and a newborn, and I felt like I was drowning. It took me six months to get the help I needed, and I decided during that dark time in my life that I would do something so that other new mothers did not suffer as I did. Thus, I became an advocate.

I learned that mental health conditions (including anxiety, depression and psychosis as well as obsessive-compulsive, posttraumatic stress, bipolar and substance use disorders) are the most common complications of pregnancy and childbirth, affecting 1 in 5 pregnant or postpartum people, or 800,000 families, each year in the United States. Tragically, suicide and overdose are the leading causes of maternal mortality, accounting for almost a quarter of deaths for women in the first year following pregnancy. Each year, 250 new mothers in our country will die by suicide in the months following childbirth — a sobering statistic.

I now serve as the executive director of Maternal Mental Health Leadership Alliance, a nonprofit organization launched in 2019 to focus on national policy around maternal mental health. Working with other organizations in the field, we have successfully championed three pieces of federal legislation addressing maternal mental health, which, if fully funded, will garner $200 million in federal funding over 10 years. All three laws — the Bringing Postpartum Depression Out of the Shadows Act of 2015, the Into the Light for Maternal Mental Health Act of 2022 and the TRIUMPH for New Moms Act of 2022 — were enacted the first time they were introduced, which is notable given that it typically takes seven years for a bill to become law. In the last Congress, over 10,000 bills were introduced and just over 300 were passed, including two laws (Into the Light and TRIUMPH for New Moms) addressing maternal mental health. How were we able to elevate these pieces of legislation? Here is a list of 10 things we learned along the way:

1. Think of advocacy as education. Many new advocates feel overwhelmed by the concept of advocacy and lobbying, and I have learned over the years that the best way to make them feel comfortable is to describe advocacy as education. I explain that everything we do as advocates — from telling our stories to writing articles to testifying before Congress — is focused on raising awareness and offering solutions.
2. Incorporate the voices of lived experience. Most advocates in the field of maternal mental health have lived experience with these conditions and can speak passionately about how they or their families were affected. Each year we bring together advocates from across the country for a virtual Advocacy Day, meeting with members of Congress and their staffers, and the personal stories are always the ones that have the greatest impact.
3. Don’t hesitate to be an advocate. Anyone can be an advocate. Along with individuals with lived experience, medical and mental health professionals who work in maternal mental health are effective advocates because they are subject matter experts and provide information, knowledge, perspective and experience.
4. Add facts and figures. While personal stories move hearts, data moves heads. We weave statistics in with stories and distill important facts into short sound bites that are both easy to say and easy to understand. For example, when explaining that 1 in 5 childbearing people are affected by mental health conditions, I say that we all know someone — whether that person is our mother, grandmother, aunt, sister, daughter, friend or neighbor — who has experienced maternal mental health conditions. The goal is to make information less abstract and more relatable.
5. Keep it brief. Practice telling your story. Hit the high points with a few facts and your “why.”
6. Take baby steps. Advocacy can be as simple as reposting an article on social media. Even small actions can make a difference.
7. Be nonpartisan. Our work focuses on mothers and babies, which are topics that everyone can support.
8. Choose congressional sponsors wisely. All the maternal mental health legislation that we have advocated for had bipartisan and bicameral sponsors on committees of jurisdiction. Lead sponsors in the House and the Senate were from both parties and were on relevant appropriations subcommittees.
9. Cultivate a broad range of advocates. Members of Congress always want to hear from their constituents, so we cultivate a broad range of advocates from across the country, including both individuals with lived experience (grassroots) and experts in the field (grasstops). We often tap our advocates to follow up with specific congressional offices so that members know what their constituents are thinking and how they are affected.
10. Focus on relationships. We stay in touch with our legislative champions and advocates throughout the year, ensuring they have the latest information about maternal mental health. This includes follow-up emails after Advocacy Day, in-person visits when we are on Capitol Hill, shout-outs on social media, newsletters with policy updates and advocacy tips, and organizational sign-on letters that bring additional voices to our cause.

If you are interested in learning more about maternal mental health or becoming an advocate, check out MMHLA’s website, sign up for our newsletter, follow us on social media or email us at info@mmhla.org. If you or someone you know needs support while experiencing a maternal mental health condition, contact the National Maternal Mental Health Hotline (1-833-TLC-MAMA), which provides 24/7 voice and text support in English and Spanish.  

Adrienne Griffen (agriffen@mmhla.org) is the executive director of Maternal Mental Health Leadership Alliance, a nonpartisan 501(c)3 nonprofit organization dedicated to improving mental health care for mothers and childbearing people in the United States, with a focus on national policy and health equity. Follow MMHLA on social media: LinkedIn, Instagram and X, formerly known as Twitter.

Opinions expressed and statements made in articles appearing in Counseling Today should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.