The Invisible Weight of Pregnancy report uncovered an urgent need for emotional care during pregnancy. Now that we know what’s wrong, how do we fix it? To start, Twill has created a blueprint for better emotional care.

Our research revealed how profoundly pregnant Americans suffer with unaddressed emotional stressors and mental health challenges. You can explore the full Invisible Weight of Pregnancy report here

Not only did 57% of Americans admit they felt difficult or dark feelings in their most recent pregnancy, 82% of pregnant Americans felt unable to discuss their negative feelings with their doctor. Explore the results.

Although 62% of pregnant Medicaid enrollees report feeling depressed, only about 35% of psychiatrists accept Medicaid—creating a gap that leaves many in dire need of emotional care. View Medicaid statistics.

The pregnant Americans we heard from surfaced tremendous honesty, strength, and resilience as they offered words of support to help guide others in need. Hear their words.

To turn these insights into action, we looked into the future of maternal health, and mapped three strategies to close vital gaps in emotional care.

1. Integrate therapists into OB-GYN practices

Ob-gyns are caught in a cascade of systemic pressures, and lack the support needed to provide compassionate emotional care. 

Our model is simple: Directly hire emotional care specialists, such as therapists, clinical social workers, or psychiatrists into the OB-GYN practice. This way, patients could have timely access to a range of insurance-based mental health services such as pregnancy therapy, for needs like pregnancy anxiety, postpartum depression, or stress. 

This integrated approach is still rare—but it doesn’t need to be. Some groups experimenting with this model include Women’s Mental Health @Ob/Gyn at Columbia University, Compass at Northwestern, and the Women’s Behavioral Health Service at the University of Rochester. 

2. Partner with outside emotional care specialists

Many OB-GYN practices partner with outside groups to offer birth, parenting, or child safety classes, but this focuses primarily on the brass tacks of pregnancy—not the emotional journey. There is a missed opportunity to bring in outside partners to run emotional preparedness classes, or to create support groups that can help with depression and pregnancy. 

We spoke with organizations, like the Motherhood Center of New York, that specialize in hosting these types of support groups. Imagine classes on “Navigating the Emotional Rollercoaster of Pregnancy,” or “Coping with Past Trauma During Pregnancy.” Organizations like the Motherhood Center would be ideal partners for these “emotional Lamaze” classes.

3. Use digital tools to fill gaps in emotional care

Through our research, we found that pregnancy-related apps were the most commonly used tools to improve emotional well-being. Their accessibility led to usage rates (47%) far above those of therapists, doulas, and midwives combined. These apps can be vitally important tools in closing gaps in access to emotional care specialists.

Despite the clear need, a majority of pregnancy-related apps and technology available today are still primarily focused on the baby or the logistics of pregnancy—not the emotional needs of the mother. 

A new approach to maternal mental health

This research is just the first step. Twill is on a path to close the gap in emotional care through our Pregnancy Sequence: an innovative solution that offers easy access to a breadth of mental health support throughout the pregnancy journey. 

Twill’s Pregnancy Sequence contains a range of highly personalized and scientifically designed digital-first tools—including digital therapeutics, coaching, and community support offered within Twill Care for Pregnancy.

By making emotional care more accessible, we can help guide more people toward healthier, happier pregnancies.

For more information about how Twill can support pregnant Americans, visit twill.health/pregnancy.


Nonfiction Pregnancy Study 2022 n=1,029 respondents

Source: Nonfiction Interviews & Monk C, Dimidjan S, Galinsky E, Gregory KD, Hoffman MC, Howell EA, Miller ES, Osborne C, Rodgers CE, Saxbe DE, D’Alton ME, The Transition to Parenthood in Obstetrics: Enhancing Prenatal Care for 2-Generation Impact. AM J Obstet Gynecol MFM. 2022 Sep; 4 (5)