Shawna Bush had been blissfully ignorant during her pregnancy: happy, excited, and expecting the best out of motherhood. It took just two days for the wrecking ball of postpartum depression to demolish her joy and leave her sobbing on the couch.

“It hit me like a train,” Bush said. “I was not expecting any of it.”

Leading up to the birth of her daughter in 2015, the medical care Bush received was totally focused on what was going on in her belly, not the potential effects of pregnancy and parenthood on her brain.

Now here she was, her Coast Guard husband underway on his ship again, the searing pain she felt during breastfeeding triggering crying jags that lasted hours.

Instead of napping when her baby did, Bush would restlessly clean the house. At night, she was wracked with anxiety, constantly rushing in to make sure baby Ella was breathing.

When Bush was alone with her newborn, motherhood began to seem like a never-ending stretch of darkness. “It’s just gonna be terrible.” she thought.

A new baby can test any parent. But in military families, challenges are compounded by frequent moves that strip new mothers from their social support systems and deployments that leave them alone to figure things out on their own.

Ongoing stigma surrounding mental health and uncertainty about the ramifications of asking for help can make military mothers hesitant to seek it, lest it affect their loved ones’ careers or their own.

A coalition of advocates pressing for military mothers to get more help won a major victory in December 2024 when Congress passed The MOMS Act, which was incorporated into the National Defense Authorization Act of 2025. The legislation put the Pentagon on the hook for improving maternal mental health conditions across the services through mental health screening, counseling, treatment, parenting support, and awareness campaigns.

The law also mandated that the Department of Defense report to Congress by the end of 2025 on what it had accomplished and where it could improve.

Lawmakers and advocates are still waiting for those answers.

When asked whether the Defense Health Agency had taken any steps in implementing the MOMS Act, a spokesperson said the DHA “is currently coordinating on a report to Congress that details the Department’s activities to address perinatal mental health conditions.”

Rep. Chrissy Houlahan, who introduced the MOMS Act, told The War Horse the delays could reflect the military’s lack of interest in women’s and family issues.

“It’s hard not to interpret things like that that way,” said Houlahan, a Pennsylvania Democrat and Air Force veteran. “Especially when the narrative coming out of the DoD is so anti-women, to be honest.”

Bush agrees. “I don’t think moms are their priority,” she said. “I think they pretend like our mental health struggles just don’t exist.”

Impact on Mission Readiness

Mental health issues are some of the most common pregnancy complications in the U.S., with up to one in five mothers meeting criteria for a perinatal mood and anxiety disorder. Those rates are likely even higher in military families; a government report found that military-connected moms had a mental health condition in up to 40% of pregnancies or within a year of giving birth.

Click here if you can’t see the graphic above.

With half of recent mothers on active duty reporting feeling depressed during or after their pregnancy, and around 10% of American men also experiencing depression after the birth of their babies, these conditions are a clear detractor from mission readiness.

Who can really “leave your family at the brow,” as Michael Bush said the Coast Guard encourages its members? When Shawna was struggling at home with their newborn, he admits it was “heavy on the mind.”

“There were some days that she was a robot just going through the motions, and so I’d be thinking about that,” Michael Bush said. He worried about Shawna and her ability to bond with their daughter.

“Did it prevent me from doing anything at work? No, because you don’t really have a choice,” he said. “Was it consistently on my mind? Yes.”

When You Don’t Have a Village

A week after Holly Johnson delivered her first baby at Fort Wainwright in Fairbanks, Alaska, her active-duty husband left town for training, and she felt like she was being thrown to the wolves.

“You’re discharged from the hospital, and it was like, poof! There wasn’t really anything,” she said.

Her mom, sister, and best friend from high school were thousands of miles away. As for the postpartum depression she experienced, she doesn’t remember any provider bringing it up.

“It’s so weird that we’ve completely normalized having postpartum depression, postpartum anxiety, and all these things,” said Johnson, who is now a lactation consultant and certified birth doula with a master’s degree in public health.

“We’re not finding the root cause of why so many women are struggling: Because no one has a village, no one has help.”

New moms in the military often must find resources in a new community on their own. Military and family support centers are supposed to ease the transition. But it’s tough to know where to start when moms can’t even get to the grocery store without GPS. And even tougher if they are dealing with a mental health condition.

“These people we’re working with are very capable, but they’re also tired,” said Annalisa Galenski-Rimer, a social worker with the Army Community Service’s New Parent Support Program at Fort Carson in Colorado. “They’re busy, you know, they’re taking care of a new human. And sometimes it’s hard to just take that next step.”

Where help for new moms does exist, it isn’t always accessible. There might be a stroller group or a support group nearby, said Johnson, but “none of these programs meet moms where they are.”

“I have to get in my car, I have to drive there, I have to shower, I have to look like I have my shit together,” Johnson said. “And then it’s led by somebody who says, ‘Oh, isn’t mothering so beautiful?’ … Well, yeah, it is, but I was crapped on yesterday, and I haven’t taken a shower, and this sucks at the moment, and I don’t have any help.”

Just a Piece of Paper

Patience Riley found that the best place to cry was in the shower, where her toddler and 4-month-old baby couldn’t hear her. It was winter, it was COVID, her family was back in Alabama, and her active-duty Air Force husband was deployed. Riley was isolated, irritable, and overwhelmed.

She was able to laugh when a friend came over and pointed out that coffee didn’t count as a meal, but Riley wasn’t getting good sleep at night, and she was white-knuckling it through the days of solo parenting, willing herself to be resilient, only breaking down and sobbing as the hot water coursed over her shoulders in the shower.

“The military did this to me,” she remembers thinking bitterly, as she let her husband’s short-notice deployment roll around in her mind and considered the distance it had put between her and her friends and family.

She’d been screened for postpartum depression at her son’s pediatric visits. But on those days at those times, she was OK enough not to raise any eyebrows or red flags.

Someone could have asked Riley a follow-up question about how she was doing. Or mentioned that if things felt hard, there were people who could help. Maybe given her the number of a caring professional so she wouldn’t have to figure it out herself.

But for Riley, like many moms, no one did.

In 2022, only 52% of active-duty servicewomen who delivered at a military hospital or clinic got the recommended three screenings for postpartum depression and anxiety. That puts the military well ahead of most civilian health systems where screening rates below 10% are common.

Screening only leads to help for around half to two-thirds of them.

At an appointment at Fort Carson in Colorado Springs, six weeks after delivering her son Mason, Katelyn Malcuit told a provider she was struggling a bit but didn’t get much of a response.

“It was just kind of like, ‘Reach out if you need anything,’” she said. “I don’t think I really knew what I needed.”

Riley, who is now a support group leader with Postpartum Support International, said that without follow-up, the screenings don’t do much to address maternal mental health anyway.

“If you’re just going to hand people a piece of paper, you might as well not even hand it to them. There needs to be some type of conversation as well.”

What Happens After the Mental Health Screening?

Amanda Morales, an Air Force spouse and clinical social worker, was worried providers would judge her for not having it all together if she filled out the screening honestly after having her third child at Brooke Army Medical Center in San Antonio, Texas.

She had not been prepared for the emergency cesarean section, the sudden transfer to the operating room for what would be her first surgery—a “splash and dash,” as it’s sometimes called, when doctors spill Betadine over the abdomen to save precious minutes before cutting the baby out.

For three months after her daughter was born, Morales experienced flashbacks nearly every day. The cold of the operating table would tingle up her spine, the bright lights would pierce her vision, and she’d be back in that hospital room, hearing the beeping of the monitors as her blood pressure dropped, remembering her own screams as she panicked, semi-conscious, over the terrifying silence that filled the moments following her baby’s delivery.

But she wasn’t sure what would happen if she admitted that.

“I remember sitting in the lobby and filling it out and laughing to myself and then turning to my husband to laugh and be like, ‘I wonder what would happen if I answered this literally the way that I feel right now?’” Morales said.

She had a feeling no one would even notice.

Other women fear the opposite: that admitting to mental health struggles would result in child protective services involvement or hospitalization.

Morales said over the course of multiple pregnancies, no one ever explained to her how providers score those questionnaires or what the potential outcomes are.

The Cost of Asking for Help

Nearly 25 years ago, when Adrienne Griffen was serving as a Naval intelligence officer, she knew requesting antidepressants to treat her postpartum depression could be career suicide.

More than two decades later, that concern still plagues military moms today.

“We know that mental health in the military is still very highly stigmatized,” said Griffen, who now serves as executive director of the Maternal Mental Health Leadership Alliance, the nonprofit that spearheaded advocacy for the MOMS Act.

Whispers follow servicewomen who become pregnant, feeding rumors they were trying to avoid deployment. Military spouses remain afraid of the implications for their spouse’s career if they admit they need help.

“In the back of your mind, you’re like, … ‘will his command begin to look down upon him because he’s not prioritizing his service over his family?’” said Shawna Bush. “I think a lot of spouses don’t go about trying to find the resources because they are afraid of possible repercussions.”

These include being added to the military’s Exceptional Family Member Program, which can limit which bases they can move to. Despite the prevalence of perinatal mental health conditions, the DOD classifies women experiencing them as having “special medical needs.”

From Full Service to ‘Figure It Out’

At Fort Carson, Galenski-Rimer teaches new mom “boot camp” and goes on home visits to families with young children through the military’s New Parent Support Program.

Here, licensed counselors facilitate playgroups, infant massage classes, and parenting workshops most days of the workweek. Hundreds of parents come each month and even more flock to special events like the annual egg hunt or fire truck visit.

Not all military moms can benefit from the New Parent Support Program, which is available at 169 of the 234 U.S. installations with Family Advocacy Programs. The services vary from location to location.

“Here at Fort Carson we have more to offer than most other posts,” said Katie Hopkins, one of the licensed counselors. “That’s what we’ve heard, anyway.”

Riley was at Offutt Air Force Base in Nebraska when she got pregnant for the first time. She got a roadmap of resources from pregnancy to postpartum at a mandatory orientation session, and saw how professionals from mental health to medical to family readiness communicated and referred to one another like a well-oiled machine. “I feel like Offutt got it right,” she said.

But when Riley became pregnant again at Tyndall Air Force Base in the Florida panhandle, she said there was nothing. She even had to ask a nurse whose sister had recently had a baby where to go for care.

“When I went to Florida, it was like, figure it out,” she said.

With passage of the MOMS Act, the military will have to fill some of the knowledge and support gaps it creates through frequent moves and deployments.

The Maternal Mental Health Leadership Alliance has offered recommendations, including providing group prenatal care, integrating mental health care into primary care settings, doubling down on screening, and increasing awareness of the resources that are already out there.

Military moms have plenty of ideas too, from equipping more providers to be proactive to creating “buddy” programs that would pair mothers who’ve been through the struggle with those who are just starting out.

Shawna Bush is already using her experience with postpartum depression to help other military moms.

It took a year of support groups, therapy, and medication to get Bush back to feeling like herself, and another seven for her to successfully get off antidepressants. Now, she leads support groups and serves as the Coast Guard coordinator for Postpartum Support International.

But whether consistent, accessible help for mothers can also be available inside the military health system remains to be seen.

Maybe the DOD report on the MOMS Act will reveal progress. Or maybe it will confirm Griffen’s hunch: “If I were a betting person,” she said, “I would say absolutely nothing has been done.”

If you or someone you care about is experiencing perinatal mental health issues, visit Postpartum Support International for help finding resources and support. Or, the National Maternal Mental Health Hotline at 1-833-TLC-MAMA.

This War Horse story was edited by Mike Frankel, fact-checked by Jess Rohan, and copy-edited by Mitchell Hansen-Dewar. Hrisanthi Pickett wrote the headlines.