Bringing home a newborn is an exciting and overwhelming time for families, filled with sleepless nights, unconditional love and, for some, the anxiety that something could go wrong. Many families leave the hospital without clear connections to postpartum, developmental or mental health support, leaving caregivers vulnerable to preventable issues. Some do not know services exist until after a crisis is underway. Barriers are even steeper in under-resourced communities – nearly 60% of Illinois counties are considered maternity care deserts.
In 2025, Start Early released a request for proposals inviting communities across Illinois to assess the feasibility of implementing a Universal Newborn Support System (UNSS), which establishes free, voluntary home visiting and referral support for families with newborns. This strategy is designed to connect families to health care, early learning, mental health and basic needs resources. UNSS is already showing promise in places like Winnebago County, Peoria County, Stephenson County, Chicago and the Decatur area, but this project has illuminated the seemingly countless barriers to more communities following suit.
Applications from hospitals, municipalities, health departments and community-based organizations revealed common barriers regardless of geography or population size. From rural counties to suburban and urban communities, respondents consistently identified systemic gaps in coordination of prenatal-to-three services and resources, workforce capacity, funding and family access that make it difficult to launch and sustain universal supports for families with newborns.
Top barriers in rural, suburban and urban communities:
The strongest patterns across the 25 applicants were rural communities needing assistance with overcoming distance and provider shortages, suburban communities seeking help navigating complex systems and urban communities’ challenges with ensuring consistent access to quality care for all residents. However, applicants across all geographies in Illinois see UNSS as an opportunity to create a coordinated, universal entry point that connects families to supports before challenges become crises.
Fragmented systems and healthcare navigation
Illinois residents are often navigating disconnected health, early childhood and social service systems with no central coordination. This is made even more difficult for families already managing language barriers, transportation challenges or postpartum recovery. Applicants to the UNSS RFP reported that referral pathways are inconsistent, communication between systems is limited and families frequently fall through the cracks before receiving needed support.
Data and technology gaps
Many communities lack the shared data systems and technology infrastructure needed to coordinate referrals, track outcomes and identify service gaps. Organizations reported challenges with outdated systems, inconsistent data-sharing agreements and limited capacity to collect or analyze to understand where families are being reached or left behind.
Postpartum care and mental health
Communities also identified significant gaps in postpartum care and mental health support for caregivers. Families often face long wait times, provider shortages or limited insurance coverage for services after birth, especially in mental health care. In some regions, culturally responsive care and multilingual services are difficult to access, leaving many parents without support during one of the most vulnerable periods of early parenthood.
Transportation and birth center/hospital access
Transportation barriers and limited access to hospitals or birthing centers continue to impact families across Illinois, particularly in rural communities and maternity care deserts. Long travel times for prenatal appointments, labor and postpartum visits can make it difficult for families to stay connected to care and follow-up services. Communities noted that these challenges are compounded when public transportation options are limited or unreliable.
