2026 Trends Report: Policy, Peril, & Possibilities

An increasing rate of maternal morbidity—fueled in part by health disparities, as well as reproductive health restrictions and access. A rising infant mortality rate, plus high rates of preterm birth, low birthweight, and NICU admission. Persistent racial disparities in outcomes for both parents and infants. A lack of mental health care access. Hospital and NICU closures, maternity care deserts, and resulting gaps in care, driven or exacerbated by financial shortfalls across a strained healthcare system. The list goes on.

This year, changes in federal policy have challenged many sectors of healthcare. In the wake of the 2022 overturning of Roe v. Wade, the One Big Beautiful Bill Act (H.R.1., July 4, 2025), will significantly cut Medicaid funding and prohibit abortion-providing clinics from collecting Medicaid dollars for any services. The lapse of Affordable Care Act subsidies may result in untenable healthcare premiums for millions, many of whom may drop coverage. Doubt has been cast on the safety of long-accepted infant vaccine protocols and the use of acetaminophen in pregnancy, raising the incidence of preventable diseases. And between the proposed near-halving of the Centers for Disease Control and Prevention’s (CDC) budget and the removal of certain pregnancy-related topics from its website, a once vital source of health-related information is no longer available.

Amid this complex landscape, leaders within the space are charged with forging new paths, maximizing resources, countering disinformation, and mobilizing to meet public needs with fresh models of support. This includes leveraging AI-powered solutions aimed at optimizing resource allocation and predicting care gaps. The trends in these pages portend difficult times, but they also make it clear that these challenges offer opportunities to meet patients where they are, with vital on-the-ground solutions.

Paradoxically, while depression tends to be the maternal mental health condition clinicians focus on most, as many as 50% of perinatal depression cases still go undiagnosed and therefore untreated. In addition, healthcare professionals often overlook the high prevalence of Generalized Anxiety Disorder in pregnancy, which affects as many as 10.8% of patients—a figure that rises to a staggering 51.4% just after giving birth. Currently, the United States faces a shortage of mental healthcare professionals certified to provide perinatal and postpartum mental healthcare, known as perinatal mental health-certified professionals (PMH-Cs). To close the existing gap in care, researchers estimate that nearly 14,000 PMH-Cs are needed. At present, there are about 6,000 PMH-Cs across the U.S. With so few certified professionals available, many payers and providers are turning to technology to help close the gap. AI tools are starting to spot signs of depression and anxiety earlier, making it easier to connect people to care when providers are hard to find—but they are meant to support, not replace, clinical judgment.

With mental healthcare providers in short supply, pregnant and postpartum women may feel they have nowhere to turn. And while this deficit certainly contributes to the access barrier, a 2022 study from the Association of American Medical Colleges highlights the difficulties many health plan members experience simply in attempting to identify an in-network provider. With such an array of barriers and challenges, health plans would be well served by identifying a partner that addresses every aspect of the maternal mental health equation. ProgenyHealth takes a comprehensive approach to maternal mental health, proactively identifying potential mental health conditions and risk factors, and when appropriate, connecting those members with mental health services covered under their health plan as well as local support groups and additional services that may be free of charge.  

Numerous hospitals have shuttered their labor and delivery units due to staffing shortages, low reimbursement rates, and liability costs, leaving pregnant people to travel hours for birth or emergency care. In fact, roughly 35% of U.S. counties are now classified as maternal care deserts. To sustain safe and equitable outcomes, care models should consider shifting toward approaches that blend clinical oversight with hybrid support. 

Telehealth is clearly a critical part of that shift. Virtual prenatal visits, remote fetal monitoring, and video-based postpartum check-ins can extend the reach of scarce obstetric providers. AI-powered tools are also beginning to play a role—helping predict complications, personalize virtual care plans, and support remote monitoring for high-risk pregnancies. However, further investments are needed, in offerings such as telelactation services and virtual doula programs—the latter being of particular potential value to the rising number of parents pursuing home birth. While mobile apps have certainly taken a prominent role in this conversation, forward-looking organizations would be well served to take advantage of maternity apps leveraging human-centered case management. These hybrid models may mitigate isolation, improve outcomes, and can help families recognize early warning signs of complications. The closure of rural maternity wards signals the end of one era of birth care, but it also opens the possibility of one in which telehealth and remote monitoring extend the reach of providers.

For many employers, maternity care is among the largest healthcare expenditures. For insurers, it’s a line item that directly reflects system inefficiency: too many C-sections, unwarranted NICU admissions and preventable hospital readmissions, and unmanaged postpartum conditions. As inflation persists and budgets tighten, both sectors are seeking savings through value-based contracting, negotiated rates, and high-tech/high-touch models that deliver savings while improving quality and outcomes.

Meanwhile, patients, hospitals, and providers are feeling the pinch as well, and the downstream effects of these pressures are consistently landing at the feet of insurers. As patients delay care to avoid out-of-pocket costs, they often invite a more acute—and costly—health episode down the line, and as changes to social safety net programs such as SNAP and WIC continue to be enacted, overall health decreases, leading to more chronic conditions. Providers, too, are negotiating higher reimbursement rates, with an anticipated price inflation of 2.1% in the coming year. And as hospitals continue to absorb partial reimbursements from Medicare and Medicaid—eating an estimated $130 billion in 2023, for example—the practice of aggressive billing—especially with NICU claims—is already impacting insurers across the spectrum. 

Financial pressures across the continuum of care could accelerate a shift toward preventive and community-based solutions that may reduce the need for high-cost interventions. Health plans are beginning to cover remote support programs that can prevent complications and shorten hospital stays. Employers, too, are turning to maternity management programs that emphasize early and regular engagement, ongoing risk assessments, targeted care plans, and behavioral health support as cost-containment strategies. The mandate for savings is not only economic, but a need for better solutions that move away from reactive, hospital-centered care toward continuous, tech-enabled, human-centered models that can improve outcomes while reducing overall spend. In ProgenyHealth’s experience, timely identification of pregnancy means earlier assessment of risk and corresponding interventions. Over the course of a pregnancy, this upstream work makes a substantial difference in health outcomes.  

Into that vacuum, state health departments, regional alliances, and clinicians are organizing around common goals and working together to provide clearer direction on immunizations for pregnant people and infants. Recent narratives about vaccines speak to a broader backdrop of medical disinformation that has undermined confidence
in numerous aspects of reproductive and infant health. 

Online debates over acetaminophen use during pregnancy, the viral spread of unverified supplement regimens, and the removal of information from public health websites have left patients without a clear reference point. In this environment, clinicians and health systems may find themselves translating evolving science into practical guidance.  

Today, the once hypothetical premium crisis is now a reality for millions of Marketplace enrollees and members of employer-sponsored commercial health plans. As temporary federal subsidies expire and hospitals and drug manufacturers implement price increases, analysts have noted that these factors may contribute to challenges within the U.S. insurance market, describing the convergence of these trends as creating significant pressures on affordability and coverage. Marketplace premiums have jumped sharply, driven by higher medical loss ratios and reduced federal premium support. At the same time, commercial plans are facing significant cost growth that may flow to employers and employees through higher contributions and deductibles. What was once a gradual uptick in health spending is tipping toward a systemic affordability crisis.

In this environment, health plans and employers would benefit from considering strategic partners to help them contain costs without compromising quality. By coordinating care for high-risk pregnancies and premature infants, ProgenyHealth helps reduce inpatient costs, unnecessary hospital days, prevent readmissions, and connect families to post-discharge resources that stabilize outcomes. It also helps reduce the chances of patients being saddled with crippling co-payments and out-of-pocket expenses. A data-driven approach gives insurers and employers a clearer view of where dollars are spent and where interventions can deliver both clinical and financial value. As premiums climb, targeted programs like these offer a rare alignment between compassion and cost control: improving maternal and infant health while buffering plans and employers from the worst effects of the coming premium surge. 

The statistics are unflinching, and the pressures and disparities are real. Yet within that reality, something else is taking root: a reimagining of what care can look like when it’s community-led, data-informed, and anchored in dignity. 

Across the country, small but significant shifts are gathering momentum. Telehealth doulas and lactation consultants are reaching families once cut off by distance; Medicaid is embracing continuous, preventive care; employers and insurers are finally learning that supporting healthy births is not just the right thing to do, but economically wise. The crisis, in other words, has forced clarity—and with it, collaboration. The work ahead is immense, but the path is visible: a system rebuilt from the ground up, where every birth is treated as a beginning worth investing in.