Study finds sharp decline in US maternal mental health

Study finds sharp decline in US maternal mental health | Image Credit: © kieferpix – © kieferpix – stock.adobe.com.

Female parents have experienced significant declines in self-reported mental health, according to a recent study published in JAMA Internal Medicine.¹

Maternal health in decline

Significant increases in maternal mortality, alongside inequalities in death by race and socioeconomic status, have led to a maternal health crisis in the United States. This has led to increased parental stress and poor health in US parents. The new trial results indicate a significant impact on mental health as well.

“Although high rates of maternal morbidity and mortality have been well documented, national data on the health status of mothers beyond pregnancy and the first year postpartum is lacking.” said Jamie Daw, PhD, assistant professor of Health Policy and Management at Columbia Mailman School.²

Comparing health among caregivers

The cross-sectional study was conducted to address this gap in research. Data from 2016 to 2023 were obtained from the National Survey of Children’s Health.¹ Of caregivers completing the survey during this timeframe, 61% were biological female parents, 27% biological male parents, 8% other caregivers, and 4% of unknown relation or sex.

Demographics, health, and health care for children, as well as demographics and health of up to 2 caregivers, were reported in the survey. Self-reported physical and mental maternal health were reported as the primary outcomes.

General health data was obtained from survey items asking “In general, how is your physical health?” and “In general, how is your mental or emotional health?” Responses were measured on a 5-point Likert scale, including excellent, very good, good, fair, and poor.

Investigators converted responses to either a 4-point scale combining fair and good, or a binary measure of self-reported fair or poor health vs excellent, very good, or good health. Covariates included maternal age, education, and nativity; family structure; child age, race, and ethnicity; and health insurance status.

Participant characteristics and trends over time

There were 198,417 mothers aged a mean of 39 years included in the final analysis, 89.8% of whom were aged at least 30 years, 57.9% had a privately insured child, 35.7% had a publicly insured child, and 6.4% had an uninsured child. Of mothers, 0.6% were American Indian, 27.2% Hispanic, 3.4% Asian, 12.3% Black, 51.1% White, and 5.4% multiracial.

Changes in the demographics of the study population were observed over time, with the rate of non-Hispanic multiracial children rising from 4.6% in 2016 to 7.2% in 2023, and privately insured children from 56% to 58.7%. Additionally, the rate of mothers aged at least 40 years rose from 42.9% to 49%.

In 2016, an unadjusted prevalence of excellent physical health of 28% was reported, declining to 23.9% in 2023. Additionally, the prevalence of good physical health rose during this period, from 24.3% in 2016 to 28.1% in 2023.

When adjusting for sociodemographic factors, a decrease of -4.2% was observed for physical health during the study period. This indicated a decline of -0.6% per year. Similarly, good physical health increased by 4.4% overall, while significant changes were not observed for fair or poor physical health.

Significant shifts in mental health

In comparison, mental health underwent more significant changes, including a decline in excellent mental health from 38.4% in 2016 to 25.8% in 2023. Good mental health rose from 18.8% to 26.1%, and poor or fair mental health from 5.5% to 8.5%.

An adjusted decrease of -12.4% was reported between 2016 and 2023, indicating a decline of -2% per year. For poor or fair mental health, this trend was an increase of 3.5%, vs 7.5% for good mental health. Visual trends indicated these changes began before the COVID-19 pandemic.

Additionally, these changes occurred across nearly all sociodemographic subgroups, with the magnitude varying across populations. Mothers with lower educational attainment, uninsured or privately insured children, or who were single, experienced significantly worse physical and mental health.

“Our results highlight the rising tide of worsening mental health among parenting women as a key target for efforts to improve maternal and child health in the US,” said Daw.² “We found consistently worse health outcomes for mothers compared to fathers, suggesting that mothers may need additional consideration and attention.”

References

1. Daw JR, MacCallum-Bridges CL, Admon LK. Trends and disparities in maternal self-reported mental and physical health. JAMA Intern Med. 2025. doi:10.1001/jamainternmed.2025.1260
2. Study finds significant declines in maternal mental health across US. Columbia University’s Mailman School of Public Health. May 27, 2025. Accessed May 29, 2025.