When Service Doesn't End at Discharge: Veteran Maternal Mental Health and the Birth Workers Who Can Help

May is Maternal Mental Health Awareness Month. This post is for birth workers, doulas, and perinatal providers who serve — or want to serve — military and veteran families.

The Numbers Birth Workers Need to Know

Most perinatal mental health statistics are sobering. The numbers for veteran and military-connected families are in a different category entirely.

As many as 46.7% of female veterans report perinatal depression, compared to roughly 1 in 7 civilian women. Military-connected mothers experience a mental health condition in up to 40% of pregnancies or within a year of giving birth.

The mortality picture is even more stark. Deaths from suicide or accidental overdose account for 39.4% of pregnancy-associated deaths among active duty service women, compared to 8.8–10.9% among civilian women.

These are not marginal differences. They represent a population in crisis that the standard perinatal care system was not designed to serve.

Why Military and Veteran Pregnancy Is Different

Active duty military, veterans, and their spouses are at higher risk of experiencing maternal mental health conditions than civilians due to many factors: military culture, stigma, frequent moves, and more.

For birth workers, understanding what that actually means on the ground matters. Here's the fuller picture:

MST (Military Sexual Trauma) is prevalent and underreported. Studies consistently find that between 38% and 44% of female veterans report MST — including sexual assault and harassment — compared to roughly 1 in 4 civilian women for sexual assault alone. And those numbers are almost certainly undercounts. Pregnancy and birth — with their inherent loss of bodily autonomy, unexpected touch, and exposure — can be significant trauma triggers for survivors. A provider who doesn't know this history can inadvertently cause harm without knowing it.

PTSD from combat or service doesn't pause for pregnancy. Women veterans with psychiatric histories often experience a relapse or worsening of symptoms during pregnancy and postpartum. The physical sensations of labor, the environment of a hospital, the presence of uniformed staff — all of it can land differently for someone carrying military trauma.

Isolation and frequent relocation mean veteran families often give birth far from their support systems. A military spouse who has moved three times in four years may have no local family, no established friendships, and no community network to fall back on in the postpartum period.

Stigma runs deep in military culture. Asking for help — especially mental health help — can feel like weakness in a culture that explicitly values strength and self-sufficiency. Standardized screening for military-specific trauma exposures and PTSD during the perinatal period is recommended for this population — but many families never get it because providers don't know to ask.

The MOMS Act is new. Congress passed the Maintaining our Obligation to Moms who Serve (MOMS) Act in December 2024, requiring the Pentagon to improve maternal mental health conditions across the services through screening, counseling, treatment, parenting support, and awareness campaigns. Implementation is still underway. The MOMS Act was signed into law by President Biden as part of the National Defense Authorization Act. It's still law. But the DoD was required to report to Congress by end of 2025 on what it had accomplished — and lawmakers and advocates are still waiting for those answers. When asked, the Defense Health Agency said it is "currently coordinating on a report to Congress." The gap between policy and practice is where families are living right now.

What Birth Workers Can Actually Do

You don't need to be a mental health clinician to make a meaningful difference for veteran and military families. You need to be informed, trauma-aware, and willing to ask.

Learn the basics of military culture. Rank matters. Chain of command matters. The language of "strong" and "resilient" is both a value and sometimes a barrier. Understanding how military identity shapes the way someone talks about struggle — or doesn't — changes how you support them.

Ask directly and without judgment. "Have you ever served in the military or are you connected to the military?" belongs in your intake process. So does "Have you ever experienced anything in your service that still affects you?" You don't need to be their therapist. You need to know enough to adjust your approach and make warm referrals.

Know your referral resources. Postpartum Support International has a Military and Veterans coordinator network. The Veterans Crisis Line (988, press 1) is available 24/7. TRICARE covers mental health services for eligible veterans and dependents. Having these in your back pocket matters.

Treat informed consent and bodily autonomy as non-negotiable. For survivors of MST or combat trauma, unexpected touch, lack of explanation, or feeling powerless in a clinical environment can be retraumatizing. Your job as a doula is always to help clients understand their options and maintain agency — with veteran families, that role is even more critical.

Show up postpartum. The fourth trimester is where veteran families often fall through the cracks — isolated, struggling to ask for help, and in a healthcare system that discharges them at six weeks and calls it done. Postpartum doula support, community connection, and regular check-ins can be lifesaving. Literally.

A Gap Worth Naming

The perinatal care system — at its best — was designed for relatively healthy civilian families with stable support systems. Veteran families don't always fit that template. They bring trauma histories, geographic instability, cultural barriers to disclosure, and a healthcare system (TRICARE, VA maternity benefits) that many civilian providers don't understand.

Birth workers who are trained to serve this population — who understand the culture, know the resources, and can provide trauma-aware perinatal support — are filling a gap the system hasn't closed.

That work matters. And right now, in most communities, almost no one is doing it deliberately.

Coming Soon: The Perinatal Veteran Wellness Initiative

BirthPro is developing a perinatal support program specifically for pregnant and postpartum veterans — bringing trauma-aware doula support, perinatal mental health resources, and community connection to veteran families in Rhode Island, Oklahoma, Arizona, and the U.S. Virgin Islands.

More details coming soon. If you're a birth worker interested in serving veteran families, or a veteran family looking for support, reach out at connect@birthpro.org.

This post is part of BirthPro's Maternal Mental Health Awareness Month content. Sources: PMC/MSMR 2025, The War Horse/19th News March 2026, Military Medicine 2023, PubMed scoping review 2024, MMHLA.