Maternal mental health is declining

For the study, researchers analyzed data from almost 200,000 mothers who participated in the National Survey of Children's Health, which is an annual study of households of children up to age 17, between 2016 and 2023. Of the participants, 89.8% were 30 years or older, and 51.1% were non-Hispanic white.

Overall, the researchers found that there were significant declines in maternal mental health during the study period. In 2016, 38.4% of mothers said they had "excellent" mental health, which decreased to 25.8% in 2023.

Reports of "good" and "fair/poor" mental health also increased during that time. In 2016, 18.8% of mothers said they had "good" mental health, which increased to 26.1% in 2023. Similarly, mothers reporting "fair/poor" mental health increased from 5.5% to 8.5%.

The researchers also found declines in maternal physical health, though they were smaller than the declines observed for mental health. From 2016 to 2023, the percentage of mothers who reported "excellent" physical health decreased from 28% to 23.9%, and those who reported "good" physical health increased from 24.3% to 28.1%. There was no significant change among those who reported "fair/poor" physical health.

"Mental health declines occurred across all socioeconomic subgroups; however, mental and physical health status was significantly lower for single female parents, those with lower educational attainment, and those with publicly insured children," the researchers wrote.

The researchers also examined changes in physical and mental health among male parents. Although fathers also experienced declines in "excellent" physical and mental health, they had better health scores overall when compared to mothers. For example, the prevalence of mothers reporting "fair/poor" mental health was four percentage points higher compared to fathers in 2023.

"[We] need to reframe maternal mental health to not only be focused on pregnancy and postpartum," said Jamie Daw, an assistant professor of health policy and management at Columbia University Mailman School of Public Health and the study's lead author. "American mothers who are parenting children of all ages are reporting worse mental health."

Commentary

Although more research is needed to identify specific causes of declining mental health among mothers, some potential theories include limited access to mental health care, social isolation, increases in substance use disorders, and broader stressors such as inflation, racism, gun violence, and climate change.

"We all got much more isolated during Covid," said Catherine Birndorf, founder of the Motherhood Center of New York. "I think coming out of it, people are still trying to figure out, 'Where are my supports?'"

Separately, Crystal Schiller, director of the Center for Women's Mood Disorders at the University of North Carolina at Chapel Hill, said the last few years have 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," Schiller said.

Worsening maternal mental health could also lead to a ripple effect across generations, health experts say. Poor maternal mental health has been associated with problems during childbirth, early childhood development, and children's long-term physical and mental health.

"We know that poor mental health contributes to maternal mortality, and it increases the risk of other poor health outcomes for both mom and baby," said Jade Cobern, a board-certified physician in pediatrics and preventive medicine. "As a pediatrician, I know firsthand that a mother's health is integral to a child's overall health and well-being."

In 2024, former U.S. Surgeon General Vivek Murthy issued an advisory on "the stress and mental health concerns facing parents and caregivers" and called for policy changes, community programs, and individual action to help parents' mental health.

"These are newer stresses that prior generations didn't have to contend with in the same way," Murthy said in the advisory. "I want to make sure that parents know that their well-being really does matter and that caring for themselves in some of the ways we lay out in this advisory is not selfish or indulgent, but it's necessary and important."

"As a society and medical community, we have to continue to protect and prioritize mental health resources for all parents so families can thrive," Cobern said. "There is no shame in speaking up about mental health. It’s a sign of great strength to seek help when needed."

Advisory Board's maternal health resources

To help you address issues related to maternal health, Advisory Board offers a library of resources on women's health, which includes:

Trends in women's health

We have several resources on the top drivers of change in the maternal and reproductive health market, as well as the outlook for the women's health service line.

These ready-to-use-slides can also help you understand the trends impacting maternal and reproductive care and how they will impact cross-industry stakeholders.

Ways to improve women's health

To learn more about ways to improve women's health in the United States, this report outlines six key factors to take into consideration, including the roles of various healthcare stakeholders and the importance of cross-industry collaboration.

For resources related specifically to maternity care, this research brief explains how Enhanced Recovery After Surgery protocol for C-sections can reduce patient length of stay for obstetrics, which can help with capacity constraints. In this white paper, we offer key tactics for launching a successful midwifery program and explain how to overcome common implementation challenges.

This expert commentary also outlines ways healthcare stakeholders can reduce maternity care deserts and improve pregnancy outcomes. Some examples include expanding outreach with mobile units/satellite clinics and using digital health to close gaps in maternity care. In addition, this insight details how health plans are taking steps to drive better outcomes for pregnant people.