For generations, women have relied on informal networks of friends, family and neighbors to navigate the complexities of birth and motherhood. Today, research is finally catching up to what generations of women have known: Peer support can be a lifeline.
Despite growing evidence, the unique wisdom and strength that arise when mothers help mothers has been surprisingly under‑explored in the scientific literature, but that’s beginning to change. Peer-delivered programs are beginning to bring together long-standing community traditions and structured, evidence-based approaches to support the mental health of new and expectant moms.
We are clinical psychologists at the University of Colorado Boulder Renée Crown Wellness Institute. Our work and research weaves together psychological science and the wisdom of mothers supporting mothers. Our program, Alma, supports women in restoring well-being in ways that are community-rooted, evidence-based and scalable.
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Pressure on parents
Nearly 50% of parents report feeling overwhelmed by stress on most days. An even larger share, about 65%, experience feelings of loneliness, according to a 2024 report from the U.S. Department of Health and Human Services. These feelings hit mothers especially hard, the report says.
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In 2025, mothers in the United States continue to shoulder most of the caregiving of children while also managing work, personal health and household responsibilities. The transition to motherhood is often marked by emotional and psychological strain. In fact, 10% to 20% of women experience depression during pregnancy, the postpartum period or both. Depression is one of the most common complications of childbirth. A similar number of women also face significant anxiety.
In many communities, mental health resources are scarce and stigma around mental health issues persists; therefore, many mothers are left to navigate such challenges alone and in silence. Antidepressants are widely prescribed, but research suggests that many women stop using antidepressants during pregnancy – yet they don’t start therapy or an alternative treatment instead.
Psychotherapy is the most preferred care option among new and expectant mothers, but it is often inaccessible or nonexistent. This is due in part to a workforce shortage of mental health providers.
The shortage has contributed to long wait times, geographic disparities and cultural and language barriers between providers and patients. This is especially true for underserved populations. In fact, more than 75% of depressed mothers do not receive the care they need.
Science of peer support
The science of peer support is part of a larger field exploring community health workers as one way to address the shortage of mental health providers. Peer mentors are trusted individuals from the community who share common experiences or challenges with those they serve. Through specialized training, they are equipped to deliver education, offer mental health support and connect people with needed resources.
A study that analyzed 30 randomized clinical trials involving individuals with serious mental illness found that peer support was associated with significant improvements in clinical outcomes and personal recovery. Researchers have proposed that peer support creates space for learning and healing, especially when peers share lived experience, culture and language.
As clinical psychologists, we heard from mothers in our work and communities that wanted to help other moms recover from depression, navigate the challenges of motherhood and avoid feeling alone. This insight led us to co-create Alma, a peer-led mental health program based on behavioral activation.
Behavioral activation is a proven method for treating depression based on decades of randomized clinical trials, including in new and expectant mothers. It helps new and expectant mothers reengage in meaningful activities to improve mood and functioning.
The Alma program
Alma is based on the principle that depression must be understood in context and that changing what you do can change how you feel. One strategy we use is to help a mother identify an activity that brings a sense of accomplishment, connection or enjoyment – and then take small steps to schedule that activity. Mothers might also be guided on ways to ask for help and strengthen their support networks. Alma is offered in English and Spanish.
Peer mentors typically meet with moms once a week for six to eight sessions. Sessions can take place in person or virtually, allowing flexibility that honors each family’s needs. Traditionally, peer mentors have been recruited through long-standing relationships with trusted community organizations and word-of-mouth referrals. This approach has helped ensure that mentors are deeply rooted in the communities they serve. Alma peer mentors are compensated for their time, which recognizes the value of their lived expertise, their training and the work involved in providing peer mentoring and support.
“This was the first time I felt like someone understood me, without me having to explain everything,” shared one mother during a post-program interview that all participants complete after finishing Alma.
To date, more than 700 mothers in Colorado have participated in Alma. In one of our studies, we focused on 126 Spanish-speaking Latina mothers who often face significant barriers to care, such as language differences, cost and stigma. For nearly 2 out of 3 mothers, symptoms of depression decreased enough to be considered a true, measurable recovery — not just a small change.
Notably, most of the depression improvement occurred within the first three Alma meetings. We also observed that peer mentors delivered the Alma program consistently and as intended. This suggests the program could be reliably expanded and replicated in other settings with similar positive outcomes.
A second study, conducted through a national survey of Spanish-speaking Latina new and expectant mothers, found that peer-led mental health support was not only perceived as effective, but also highly acceptable and deeply valued. Mothers noted that they were interested in peer-led support because it met them where they were: with language, trust and cultural understanding.
Supporting mothers works
Supporting mothers’ mental health is essential because it directly benefits both mothers and their children. Those improvements foster healthier emotional, cognitive and social development in their children. This interconnected impact highlights why investing in maternal mental health yields lasting benefits for the entire family.
It also makes strong economic sense to address mood and anxiety disorders among new and expectant mothers, which cost an estimated US$32,000 for each mother and child from conception through five years postpartum. More than half of those costs occur within the first year, driven primarily by productivity losses, preterm births and increased maternal health care needs.
Beyond the impact on individual families, the broader economic toll of untreated mood and anxiety disorders among new and expectant mothers is substantial. For example, it’s estimated that $4.7 billion a year are lost to mothers who have to miss work or reduce their job performance because of symptoms like fatigue, anxiety and depression.
Together – as individuals, families, communities and institutions – we can cultivate a world where the challenges of parenting are met with comprehensive support, allowing the joy of parenting to be fully realized. Because no one should have to do this alone.
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