Parental mental health is an essential sixth vital sign. Attention to parental mental health is critical for achieving optimal health outcomes for both parents and infants.1 It also helps advance the principles of family-centered care which has been shown to lead to better outcomes and experience of care.2 Perinatal mental health diagnoses are wide-ranging, including depression, anxiety, acute stress disorder, and post-traumatic stress disorder (PTSD), and are commonly referred to as Perinatal Mood and Anxiety Disorders (PMADs).3 They can occur during the antenatal, early postnatal (first 6 weeks), or in the late postnatal period up to one year after birth. A review of maternal deaths between 2017 and 2019 conducted by 36 Maternal Mortality Review Committees identified mental health conditions as the leading cause of pregnancy-related deaths (22.7%), with suicide being the most frequent occurrence.4 The economic burden on the US economy was estimated to be $14 billion for the 2017 birth cohort between conception and the 5-year postpartum period.5 The American College of Obstetrics and Gynecology (ACOG),6 the American Academy of Pediatrics (AAP),7 and the US Preventative Services Task Force,8 all advocate for routine assessment of parental mental health, yet consistent implementation in clinical practice is lacking. There is an urgent need for improved screening and treatment of perinatal mental health disorders in perinatal practice. In this article, we review the effect of PMADs on parents and their infants. Next, we discuss how quality improvement (QI) approaches can be used to increase screening, referral, and treatment of parents experiencing PMADs.