Grassroots advocacy efforts to increase awareness for maternal mental health have been on the rise. California joins several states in elevating this emerging issue. An aspect unique to the California-based model, however, is that it has been a decentralized, community-based approach rather than one coordinated by a central state entity. Instead, nine regional coalitions located throughout the state have conducted local activities, yet the extent of their collective efforts is not well understood. Initiatives to increase awareness for perinatal mental health in California had not heretofore been chronicled by healthcare practioners or participants in perinatal mental health advocacy groups. The established regional collations, coupled with a statewide taskforce in its nascent stages, served as the basis for this analysis. The study's purpose was to ascertain specific ways in which an organization providing direct healthcare or social support for perinatal mental health can increase public awareness and support to more fully address this public health problem. A qualitative, exploratory case study served to analyze information obtained via archival data (n=36) and a thematic coding analysis of 20 semi-structured interviews with providers, public health practioners, coalition leaders, and perinatal mental health experts. Study results highlighted five principal strategies to conduct perinatal mental health advocacy in California: trainings, issue-based awareness, legislative advocacy, capacity building and surveillance coupled with data generation. Based on the data collected, the regionally-based efforts have been considerable yet the decentralized approach has resulted in fragmentation with little coordination between entities. There are several opportunities to improve sustainability and increase awareness through better alignment and reduced duplicity across the regional coalitions. Data suggests that the regional coalitions could increase efficiency by developing advocacy plans that take into consideration (a) clearly articulated impact areas (b) narrowly defined intended outcomes. (c) recognition of contextual factors that affect efforts. (d) aligned strategies, (f) robust organizational development practices and (g) predetermined benchmarks.