The mental health of mothers in the United States declined significantly from 2016 to 2023, according to a large new study published in JAMA Internal Medicine on Tuesday.
The percentage of mothers who rated their mental health as “excellent” dropped sharply during the study period. At the same time, the percentage of mothers who said their mental health was poor increased — particularly among those who were single parents, or whose children had Medicaid or were uninsured.
The findings come at a fraught moment in the national conversation around parenting and declining birthrates. The Trump administration is said to be weighing strategies to persuade more Americans to get married and have children. But just last year, Dr. Vivek H. Murthy, who was then the surgeon general, warned about declining parental mental health in an advisory that described many who were raising children as “exhausted, burned out and perpetually behind.”
The surgeon general’s report led the researchers behind the new study to begin analyzing data from nearly 200,000 mothers who participated in the National Survey of Children’s Health — an annual survey of households with children up to age 17. Researchers found that one in 20 mothers reported her mental health was poor or fair in 2016; by 2023 the ratio was about one in 12. In contrast, one in 22 fathers surveyed reported fair or poor mental health in 2023.
There are limitations to the study, which was cross-sectional — meaning it looked at snapshots in time but did not follow the same women year over year. It also relied on self-reporting. Still, the findings are not surprising to experts in the field of maternal mental health, who have been observing the decline in emotional well-being for years.
Dr. Tamar Gur, endowed director of the Soter Women’s Health Research Program at Ohio State University, said that if nothing else, the new findings would help reassure the mothers she treats that they are not the only ones struggling.
“I now I have something I can point to when I’m seeing a patient and say, ‘You’re not alone in this,’” Dr. Gur, who was not involved in the study, said. “This is happening nationally, and it’s a real problem.”
It’s not just about Covid.
The new study was not designed to address the question of why maternal mental health seems to be on the decline, but one of its authors, Jamie Daw, an assistant professor of health policy and management at the Mailman School of Public Health at Columbia University, has some theories.
Dr. Daw and others pointed to a number of factors that may have hurt maternal mental health over the past decade or so, including the high costs of housing, increasing child care costs and soaring food prices — which can each put financial and emotional pressure on families.
Those stressors exist on top of longstanding concerns, like the fact that women continue to carry a heavier burden at home and the continued lack of national paid parental leave.
Other experts pointed to the Covid 19 pandemic as a cause of the decline in mental health, but Dr. Daw said the drop predated the pandemic.
“This is about broader trends that extend beyond the pandemic,” Dr. Daw said, while acknowledging the pandemic had given declines in mental health a “boost.”
Some mental health experts say the women they see in their practices continue to reel from the effects of the pandemic.
“We all got much more isolated during Covid,” said Dr. Catherine Birndorf, founder of the Motherhood Center of New York, who was not involved in the new study. “I think coming out of it, people are still trying to figure out, Where are my supports?”
Crystal Schiller, director of the Center for Women’s Mood Disorders at the University of North Carolina at Chapel Hill, said that the past few years had been a “perfect storm for women’s mental health.”
“The stress of the pandemic kicked off a mental health crisis for many people that has never fully recovered, in large part because most Americans can’t access high-quality mental health care,” she said.
The United States has long faced a shortage of therapists, and many of those who would benefit from therapy cannot afford it. Dr. Schiller and other experts also noted that mothers may face particular challenges in carving out time for therapy when they are balancing work and raising children.
While the new findings build on years of escalating warnings about the state of American mothers’ mental well-being, experts said one potential bright spot from the new study was that it may reflect the fact that mothers had become more vocal about their mental health struggles, and more comfortable disclosing them with friends, family members and health care providers and on social media.
“I do think people are becoming more outspoken about what’s happening to them,” Dr. Birndorf said.
Catherine Pearson is a Times reporter who writes about families and relationships.
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