In recent years, U.S. mothers have reported an alarming decline in mental health, a trend that predates the COVID-19 pandemic. A comprehensive survey conducted between 2016 and 2023, encompassing nearly 200,000 mothers, revealed a drop in the percentage of those rating their mental health as “excellent” from 38% to 26%. Concurrently, those rating their mental health as “fair” or “poor” rose from 5.5% to 8.5%. These findings, published in JAMA Internal Medicine, underline a significant and worsening mental health crisis among mothers in the United States, raising concerns among researchers and policymakers about the implications for both maternal and child health.
The perinatal period—surrounding childbirth—is critically linked to mental health challenges for mothers. According to Kara Zivin, a health policy researcher at the University of Michigan, mental health conditions are a leading cause of maternal morbidity and mortality, with 22.5% of pregnancy-related deaths attributable to mental health issues as of 2020. This grim statistic is compounded by the fact that the national maternal mortality rate, standing at approximately 19 deaths per 100,000 live births in 2023, often excludes mental health-related deaths and only extends to 42 days postpartum, which is inadequate for capturing the full extent of the issue. Comparatively, the U.S. has the highest maternal mortality rate among high-income countries, signaling a systemic problem that needs immediate attention.
The mental health struggles faced by mothers do not dissipate immediately after childbirth; in fact, conditions such as depression during pregnancy can lead to ongoing challenges postnatally. Research by Karen Tabb Dina, a perinatal social work expert, points out that the transition into motherhood does not provide a “switch” to turn off these mental health issues. Additionally, many mothers experiencing mental health symptoms go undiagnosed, and even those who do receive diagnoses may lack access to effective treatment. Zivin notes this persistent struggle emphasizes the need for enhanced mental health care frameworks for mothers, especially during the transitional period of becoming a parent.
Existing programs aimed at supporting maternal health, such as the Maternal, Infant, and Early Childhood Home Visiting Program, are vital in addressing these challenges. This initiative provides essential services, including mental health screenings for parents, allowing for early intervention and support. However, such programs face threats from political decisions, including potential cuts and reorganization pressures from the current administration. Concerns over changes to Medicaid, which covers approximately 40% of births and has been expanded in many states to offer postpartum coverage for one year, further exacerbate the risk for mothers, as proposed cuts could limit access to necessary health services.
The study analyzing recent trends in maternal mental health primarily focuses on self-reported measures. This is crucial as self-assessment can highlight issues that have not been clinically diagnosed, thus raising awareness about the mental health landscape mothers face. The findings indicate an increase in mothers reporting good mental health, but many continue to grapple with competing demands across family, work, and economic landscapes. Zivin suggests that understanding the factors contributing to these trends, including shifting societal pressures and the growing recognition of mental health issues, is imperative.
While mental health conditions present risks for both mothers and their children, Zivin emphasizes the importance of early and appropriate intervention. This perspective is fundamental; maternal mental health should not be viewed solely through a lens of risk, as timely support can mitigate negative outcomes for children. The ongoing focus must include understanding and addressing the mental health needs of mothers beyond pregnancy, ensuring both mother and child can thrive in their families and communities.
