Study Finds Sharp Decline in Self-Reported Maternal Mental Health in Recent Years

WASHINGTON — A new study from researchers at Columbia University and the University of Michigan has found a substantial decline in self-reported mental health among U.S. mothers between 2016 and 2023. 

The percentage of women claiming to be in excellent mental health after childbirth plunged 12.4 points during that time.

At the same, the researchers said, those claiming to be experiencing fair to poor mental health jumped 3.5 percentage points.

Meanwhile, those claiming to be in excellent physical health also declined, though by a relatively less severe 4.2 percentage points.

The study was published in this week’s edition of JAMA Internal Medicine.

Of course, concern over what’s been called a maternal health crisis in the U.S. is nothing new, though it has largely been defined in the past by recent increases in maternal mortality and stark inequities in pregnancy-related deaths by race, geography and socioeconomic status.

Last year, the U.S. Surgeon General issued an advisory, “Parents Under Pressure,” identifying parental mental health and well-being as another critical public health challenge requiring immediate national attention.

The advisory highlighted rising levels of parental stress and the intergenerational public health impact of poor health among U.S. parents.

Despite the critical importance of the issue, few studies have examined the general health status of mothers in the U.S., and those that have focused on specific subpopulations, such as mothers of young children or children with special health care needs.

While the recent surgeon general’s report compiled data on rising levels of stress and certain physical and mental health conditions among mothers, it also underscored the need for more comprehensive research on the health and well-being of U.S. parents more broadly. 

During the study, the trio of researchers conducted a cross-sectional analysis of national survey data, looking to fill this gap of information by examining recent national trends and disparities in self-reported physical and mental health among female parents.

Overall, they said, the decline in mental health among the study population — 198, 417 female parents of children from birth to 17 years — was even greater than they had expected.

Though mental health declines occurred across all socioeconomic subgroups, they found that “mothers with lower education levels and publicly insured or uninsured kids, as well as single mothers, had higher odds of self-reporting worse physical and mental health.”

Among mothers in the study, 89.8% were 30 years and older; 57.9% of mothers had a privately insured child, 35.7% had a publicly insured child and 6.4% had an uninsured child. 

The unadjusted prevalence of excellent physical health declined from 28% to 23.9%, while good physical health rose from 24.3% to 28.1%, and fair/poor physical health did not significantly change. 

The unadjusted prevalence of excellent mental health declined from 38.4% to 25.8%, while good mental health rose from 18.8% to 26.1%, and fair/poor mental health rose from 5.5% to 8.5%. 

After adjusting for secular changes in the sociodemographic characteristics of mothers, excellent physical health decreased by 4.2 percentage points, excellent mental health decreased by 12.4 percentage points , and fair/poor mental health increased by 3.5 percentage points, over the eight-year study period. 

“Our findings are supportive of the claim made by some scholars that maternal mortality may be a canary in the coal mine for women’s health more broadly,” the researchers wrote.

“Our results offer more specificity to this argument, highlighting the rising tide of worsening mental health among parenting women as a key target for efforts to improve maternal-child health in the U.S.,” they continued, adding. “Our results are consistent with documented increases in depression and anxiety diagnoses and suicidality among pregnant and reproductive-aged women, as well as the general U.S. adult population.”

They noted that their findings are consistent with rising mental health–related mortality including suicide, overdose, and their co-occurrence among reproductive-aged women and the documented principal causes of pregnancy-related mortality.

“Our findings suggest that mothers may warrant special consideration in efforts to improve parental health, and mental health in particular,” the researchers said. 

“Research is urgently needed to identify the causes of lower and declining mental health among parents and to develop interventions that support prevention, diagnosis and treatment of mental health conditions,” they added.

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