Perinatal Mood and Anxiety Disorders (PMADs), including postpartum depression (PPD) are the number one complication of childbirth, with prevalence rates of approximately 7-15% in the US; however, rates as high as 40-60% for women living in poverty have been reported. Though validated screening tools and effective treatment exists, it is largely unrecognized and untreated. Consequences impact not only the mother but her infant as well and can have long term deleterious effects. Multiple poor obstetric outcomes have been reported due to untreated PMAD’s including: low attendance at prenatal care, preterm labor, low birth weight, maternal suicide, decreased breastfeeding rate, impaired maternal/infant bonding, and short and long term behavioral and cognitive issues for the child including social and language delays, impulsivity, and poor academic performance. Due to the significant public health sequalae, Butte County, California First 5 has identified PMAD’s as a critical maternal health focus area.