Suicide and overdose linked to mental health conditions accounted for 27.7 percent of pregnancy-related deaths in the US in 2022, according to the CDC's most recent report on maternal mortality prevention. That figure anchors "What's Her Secret?", a suite of public service announcements the Ad Council launched ahead of World Mental Health Day to push new and expecting mothers to prioritize their mental health.

The effort, known overall as The Secret to Motherhood, sits within the Council's wider "Love, Your Mind" campaign for mental health awareness. Mischief USA created the lead PSA pro bono.

The spot opens in a park. A group of women catch up, and one asks a new mom, "How do you make it look so easy?" The mother answers with consideration, citing her consistent routine and support system. Meanwhile, the sleepless nights and daily struggles play on a loop in her head. When the internal chaos peaks, the dialogue fades and a voice-over concludes: "There is no secret to motherhood. There are only secrets we're keeping about it."

The statistics behind the campaign are stark. At least one in five mothers report symptoms of depression or anxiety during the postpartum period, according to the Maternal Mental Health Leadership Alliance. Three-quarters of those women do not receive treatment. The consequences are often a matter of life and death.

The Ad Council aims to reach women in the often-vulnerable early stages of motherhood and direct them to expert-vetted resources at LoveYourMind.com/moms, a new hub for maternal mental health. From a creative standpoint, the campaign challenges the pressure many moms feel to be perfect. It invites them to speak up about the emotionally complex realities of pregnancy and early motherhood, and to seek support when needed.

Bianca Guimaraes, founding partner and executive creative director at Mischief USA, shared her own experience with postpartum depression in a press release for the project. She described pushing the stroller through the park for hours to pass the time, envying the freedom and independence of the childless people she saw along the way.

"Those were thoughts I didn't feel like I could say out loud," Guimaraes said. "That's what this work is about: the thoughts we hide because they don't sound like what a new mother is supposed to feel. I loved my children deeply. I was also struggling deeply. Both things can be true."

The campaign will run nationwide in both English and Spanish across broadcast TV, online video, out-of-home, radio and digital media platforms. Per the Ad Council's model, media outlets donated the time and space, with pro-bono support from Mischief USA, WPP Media and Datonics. Amazon Ads, Fuse Media, iHeartMedia, Kargo, Pinterest and Reddit join as additional media partners.

With donated inventory spanning linear and digital channels in two languages, the campaign's reach will test whether honest depictions of early motherhood — the screaming baby, the stretch marks, the crying in the shower — can move a population that three-quarters of the time goes untreated toward help.