Caring for a newborn can be one of the most overwhelming and transformative experiences of a parent’s life. Between sleepless nights, shifts in identity, and the physical demands of recovery, it’s no surprise that many new moms struggle with their mental health.
This time of change can sometimes lead to postpartum depression (PPD), a condition that deserves both understanding and support. Unlike the short-lived “baby blues,” which typically resolve within a few weeks, PPD involves persistent symptoms that interfere with daily life.
For mothers in rural states like Montana, Idaho, and Alaska, the strain of new parenthood can be even tougher due to long travel distances, provider shortages, and limited access to care. Yet even in the most remote communities, effective care is within reach.
What is PPD?
PPD is a common condition linked to the biological and environmental changes that come with new motherhood. Research shows that changes in hormone levels and the body’s stress response, particularly involving the hypothalamic-pituitary-adrenal (HPA) axis and the stress hormone cortisol, can contribute to PPD symptoms (2).
Some researchers believe these hormone changes may be an evolved response, helping mothers slow down during overwhelming times and signaling a need for support (9). Understanding the biological and emotional shifts for women before and after birth is key to helping mothers and families navigate this life-changing period with more compassionate care.
Understanding Perinatal and Postpartum Depression
If you hold your newborn and feel overwhelmed, numb, or unlike yourself, you’re not alone, and you’re not failing. These feelings are far more common than many people realize. About 1 in 7 mothers in the U.S. experience what’s known as perinatal depression—a term that includes depression during pregnancy (prenatal) and in the year after giving birth (postpartum) (2).
The symptoms of perinatal depression can include (2):
- Emotional Symptoms: Ongoing sadness, guilt, or unwanted intrusive thoughts of self-harm or child-harm
- Physical Symptoms: Sleep disturbances unrelated to infant care, or changes in appetite
- Cognitive Symptoms: Difficulty bonding with your baby or trouble focusing
Identifying these symptoms early can significantly impact outcomes. With prompt support, perinatal depression is highly treatable. If left unaddressed, it can lead to serious risks. Seeking help from your support system and a qualified professional is an essential step in safeguarding your health, your baby’s development, and your family’s well-being.
Postpartum Depression by State
Rural communities face significant barriers to mental healthcare, including geographic isolation and a shortage of providers. 65% of rural counties lack psychiatrists, and long travel distances further limit access (8). Mothers with PPD often encounter serious gaps in care across Montana, Idaho, and Alaska:
- Idaho
About 25% of mothers in Idaho report PPD symptoms, nearly twice the national average (3). This is worsened by a severe shortage of maternal mental health providers, with 84% of birthing-age Idahoans living in areas without adequate access (4). - Montana
Montana faces widespread “maternity care deserts,” contributing to over a third of the total U.S. counties lacking obstetric services (6). Mothers frequently travel over 100 miles for specialized prenatal care, delaying critical mental health screenings and interventions. - Alaska
American Indian and Alaska Native mothers experience PPD rates that are 1.5 times higher than those of white mothers (8). This disparity is exacerbated by historical trauma and underfunded tribal health services. Geographic barriers further complicate the situation, as many remote villages lack road access, making in-person therapy nearly impossible (8).
The statistics from these northwest states present a concerning reality: geographic isolation, severe shortages of healthcare providers, and systemic barriers create significant challenges for rural mothers dealing with PPD. Despite the glaring obstacles, there are innovative solutions that utilize technology to connect patients to vital healthcare services.
Telehealth: Expanding Access to PPD Care
Telehealth innovations of the last decade allow providers to deliver vital behavioral health services remotely through video, voice calls, and digital messaging. Recent policy changes have considerably expanded telehealth services available for rural mothers facing postpartum depression.
Federally Qualified Health Centers (FQHCs) and other local healthcare organizations can now offer Medicaid-reimbursed teletherapy, making mental health support more accessible without long-distance travel (5). Improved broadband infrastructure further removes barriers to video and phone sessions, turning telehealth into a lifeline for mothers in remote communities.
Telehealth’s Impact on Maternal Mental Health
Telehealth has emerged as a vital resource for rural mothers with PPD, offering both convenience and clinical results. Nearly half of rural adults receiving behavioral health services now utilize teletherapy, a testament to its accessibility and effectiveness in isolated regions (8). This shift has led to measurable improvements for patients. Studies show teletherapy reduced PPD screening scores by nearly 3 points, with results comparable to in-person treatment (8).
The real-world impact is especially telling in communities like Alaska’s Yukon-Kuskokwim Delta, where telehealth slashed assessment delays from three months to just two weeks (8). This acceleration enables earlier interventions that directly improve outcomes of those struggling with PPD. For mothers enduring the stressful isolation of rural PPD, these virtual connections transform solitary (and even life-threatening) struggles into supported healing journeys.
4 Mental Health-Focused Steps for Rural Mothers
Though the days can feel long, the early years with your baby pass by quickly. You deserve to enjoy them. If you’re finding it challenging to feel joyful or connected during this time, there is hope. Research shows that 80% of mothers with PPD achieve full recovery through treatment (2). Here are four steps that can connect you to clinically proven support without the need for long drives or waitlists.
1) Prioritize Screening: Your First Step Toward Healing
PPD often develops gradually, which makes proactive screening essential for protecting maternal mental health. Currently, suicide and overdose are the leading causes of maternal mortality in the U.S., and most of these deaths can be prevented through early intervention (1). Getting screened by a provider can offer relief and is an important step in safeguarding your overall health.
At your screening, you can expect:
- Simple Questionnaires: One common screener, the Edinburgh Postnatal Depression Scale (EPDS), assesses your mood, sleep, and ability to manage postnatal stressors.
- Honest Conversations: Evaluations provide you with the opportunity to discuss your experiences with a healthcare provider and a chance to talk about emotional and physical changes like fatigue, irritability, or intrusive thoughts.
- Partner Inclusion: Screening is encouraged (but not required) for partners, as they can also experience PPD, and healing is often a process for the entire family.
How to Seek Screening
If you are a new parent experiencing symptoms or with health concerns, speak with your healthcare provider to seek an assessment for PPD. You can request an evaluation during prenatal visits, postpartum checkups, or pediatric appointments, as many pediatricians now also screen mothers during their baby’s visits.
If you’re experiencing thoughts of harming yourself or your baby, call 988 or visit the nearest emergency room immediately. These intrusive thoughts are not uncommon or a sign that you are going crazy, but it’s important to talk about them with a provider to offer relief and a way forward.
2) Build Skills with the Free Mothers and Babies Web Course
The Mothers and Babies Online Course (eMB) is a free, evidence-based program designed to prevent and manage PPD. It offers eight self-paced lessons that teach skills for coping with stress, reframing negative thoughts, and strengthening support systems, all without requiring therapist interaction.
Research shows that eMB programs prompt positive results. Participants have reported lower depression scores after completing modules, with 89–93% rating the course as helpful (9). As a self-paced online tool, eMB eliminates common barriers like transportation, childcare costs, or stigma tied to seeking therapy, making it an easy option for prioritizing your mental health.
How to Access eMB
For direct enrollment, visit www.mothersandbabiesprogram.org for easy registration and to start right away.
3) Seek Guidance Through Therapy & Psychiatry
If you’re dealing with PPD and live in a rural area, accessing quality care can feel daunting. However, just because you’re in a remote location doesn’t mean you can’t find therapeutic support. Thanks to today’s telehealth options, paths to healing are available right where you are.
Individual Therapy Through Telehealth
Professional one-on-one teletherapy addresses core PPD symptoms using structured, evidence-based approaches. During 45 to 60-minute sessions, therapists use tools/modalities like:
- Cognitive Behavioral Therapy (CBT): This technique helps reframe negative thought patterns.
- Interpersonal Therapy (IPT): This approach focuses on resolving relationship challenges that may affect your mood.
- Regular EPDS Assessments: These evaluations track your progress and allow therapists to adjust treatment as needed.
Psychiatry Through Telehealth
Developing an ongoing relationship with a psychiatrist, psychiatric nurse practitioner, or psychiatric physician assistant can help you stay on top of your mental health and flag any needs for medicine or additional support that may arise. During 15 to 60-minute sessions, your psychiatric provider will typically:
- Discuss changes in your environment, stressors, and self-care
- Conduct evaluations on your mood and symptoms
- Discuss current or potential medication, psychotherapy, and/or lifestyle interventions to support your mental health goals
Finding a new psychiatric professional can feel tricky. At Frontier, we believe that good psychiatrists should work as a team with their patients - prioritizing overall health, discussing but not pushing medication, and creating a treatment plan for healing that feels doable for the patient.
4) Online Support Groups: Community as Medicine
Group therapy and support groups bring individuals together to share their experiences, support one another, and foster healing in a safe environment. Postpartum Support International (PSI) utilizes this approach to address the profound isolation experienced by rural mothers facing PPD.
PSI’s Idaho chapter, along with national networks, offers virtual support groups that feature free, therapist-guided video sessions on platforms that protect your privacy. These groups cater to various needs, including (4):
- NICU Parents
- Perinatal Loss Survivors
- BIPOC Mothers
- Perinatal OCD
If the idea of opening up to new people feels intimidating, that’s understandable. It can be helpful to remember that shared experiences in supportive spaces can help lessen feelings of shame and self-blame. Participants who have walked a similar path have the opportunity to discuss valuable coping strategies that benefit everyone in the group.
Commitment to Wellbeing
Healing from PPD happens when you take sustainable steps that fit within the rhythms of new motherhood. These accessible care options work together as essential tools for your personalized care and recovery. Whether you seek individual telehealth sessions, support groups, or other web-based tools, your commitment to your mental health will have lasting benefits.
Specialized Care for Rural Mothers: Your Path to Healing Starts Here
If you’re a mother in Montana, Idaho, or Alaska dealing with PPD, you may be feeling the effects of isolation and the shortage of healthcare providers. Fortunately, these challenges no longer have to limit your access to expert care. At Frontier Psychiatry, we believe that geography should never be a barrier to life-saving mental health support.
Our telepsychiatry services deliver specialized PPD treatment directly to you, combining clinical expertise with a deep understanding of the unique challenges faced by those living in rural areas.
Don’t let location delay your healing. Frontier Psychiatry is ready to walk this path with you because every mother deserves expert care, regardless of zip code. Call or text us at (406) 200-8471 or schedule an appointment through our provider matching tool to start today.
Sources
- U.S. Centers for Disease Control and Prevention (2024, May 28). Pregnancy-Related Deaths: Data From Maternal Mortality Review Committees in 38 U.S. States, 2020. CDC. https://www.cdc.gov/maternal-mortality/php/data-research/index.html
- Langdon, K., MD (2024, April 2). Postpartum Depression Statistics. PostpartumDepression.org. https://www.postpartumdepression.org/resources/statistics/
- U.S. Department for Health and Human Services (2021). Postpartum Depression Statistics in Idaho. America’s Health Rankings. https://www.americashealthrankings.org/explore/measures/postpartum_depression/ID
- Postpartum Support International (n.d.). PSI-Idaho. Retrieved July 28, 2025, from https://psichapters.com/id/
- U.S Department of Health and Human Services (2025, March 20). Telehealth Policy Updates. Telehealth.HHS.gov.
https://telehealth.hhs.gov/providers/telehealth-policy/telehealth-policy-updates - The Century Foundation (2025, April 10). State of Maternal Health 2025. https://tcf.org/content/report/state-of-maternal-health-2025/
- CDC Foundation (2022, November 17). New Resources Support Maternal Health For American Indian And Alaska Native Communities. https://www.cdcfoundation.org/blog/new-resources-support-maternal-health-american-indian-and-alaska-native-communities
- Rural Health Information Hub (25, July 9). Telehealth and Health Information Technology in Rural Healthcare. https://www.ruralhealthinfo.org/topics/telehealth-health-it
- Barrera, A. Z., Morris, S. Y., & Ruiz, A. (2022). Mothers and Babies Online Course: Participant Characteristics and Behaviors in a Web-Based Prevention of Postpartum Depression Intervention. PubMed Central. https://doi.org/10.3389/fgwh.2022.846611
