Maternal mental health crisis worsens as pronatalists push for more babies

What you probably already know: The Trump administration is considering strategies to encourage more Americans to get married and have children. Proposed incentives include government-backed scholarships, women’s fertility educational programs, and even cash “baby bonuses” all in an attempt to boost the population. But these solutions fail to directly address a critical issue: The mental and physical health of parents. The U.S. birth rate has declined by 11% since 2000, reaching an historic low of 1.62 births per woman in 2023 — a 2% drop from the previous year. Pronatalists who are concerned with the falling birthrates believe the Trump administration will help, but the White House has not yet thrown its support behind any proposals. The pronatalist movement is gaining steam even as studies show parental mental health is plummeting.

Why? A new study published in JAMA Internal Medicine suggests a growing number of mothers are struggling with their mental and physical health. Researchers surveyed 198,417 mothers of children under 17 between 2016 and 2023, and found the percentage of mothers who reported “excellent” mental health dropped from 38.4% in 2016 to 25.8% in 2023. Those who described their mental health as “good” rose from 18.8% to 26.1%, and “fair/poor” increased from 5.5% to 8.5%. “Excellent” physical health also dropped from 28% to 23.9%. Fathers also reported declines in “excellent” physical and mental health during the same survey period, but they weren’t as severe as those experienced by their female counterparts.

What it means: It’s important to note that the study on mothers’ mental health was cross-sectional, which means it did not follow the same women year over year and relied on self-reporting. Still, the findings suggest the overall decline in maternal mental health began before the COVID-19 pandemic. All socioeconomic subgroups reported declines, particularly mothers who were single parents, born in the U.S., had lower educational attainment, or had children who were uninsured or on Medicaid. Concerns over parental mental health have been growing in recent years. The study’s authors said their findings aligned with upticks with depression and anxiety among pregnant and reproductive-aged women. Last August, then-U.S. Surgeon General Dr. Vivek H. Murthy warned that the demands of modern, “intensive” parenting are leaving families “exhausted, burned out and perpetually behind.” Murthy’s advisory called on lawmakers, employers, and health care providers to focus on providing better support for parents, and suggested that a cultural shift was needed to distribute child rearing across society. The surgeon general’s warning put parental stress on the same level of other health issues like cigarettes.

What happens next: Further analysis is needed to better understand the scope of the parental health situation, but these findings indicate a pressing need for policymakers to focus on improving health care, especially for mothers. The authors of this latest study think that limited access to mental health care, social isolation, rising substance use disorders, and broader stressors such as inflation, rising income inequality, and climate change are all contributing to declining maternal mental health. They suggested that a national data resource that’s already in place — the National Survey of Children’s Health — could help monitor parental health moving forward.