18 Jul Maternal Mental Health Is Declining. Parenting Is Hard.
Written by Dr Carla Pulliam, Clinical Psychologist, PMH-C
As Chrysalis clinicians, we don’t specialize in one type of person or disorder but instead choose to address the dilemmas of “humanness” in all its manifestations— strengths, wellness, searches for purpose and meaning, and of course, the problems and disorders that arise for many of us as we negotiate life’s complexity. Over the years, however, certain groups find us more consistently than others, and as we accumulate experience and joy from working with these groups we become known for this specialization.
I have developed a specialization in working with women across the lifespan. I very much enjoy treating those identifying as women through the teen years — full of exploration and differentiation — into early adulthood when women undergo the life choices of leaving home, partnering, having children (should they choose), and balancing family and professional endeavors. So, while my practice is currently comprised of almost half men, I spend many hours of my day sitting with women exploring the dilemmas of being human and how these dilemmas are expressed through the lens of womanhood.
Link HERE to learn more about two therapy support groups we offer: Rhythms and Rattles for pregnant and new parents, and a Professional Women’s Group.
It is from this perspective that I write to highlight the findings of a recent JAMA Internal Medicine article (May 2025; see references) which confirms what many of us in the mental health field have been observing for years: maternal mental health in the United States is steadily declining. The researchers, using self-reported data (two Likert scale questions, which is one drawback of the study) from over 198,000 demographically diverse mothers surveyed between 2016 and 2023, found that the percentage of mothers reporting excellent mental health decreased by 12.4 percentage points per person, while the proportion reporting fair or poor mental health increased by 3.5 percentage points per person.
The authors found that these mental health declines are affecting all types of mothers—across age, race, education, and insurance status. However, certain groups are disproportionately impacted: single mothers, those with lower education levels, and those raising children on public or no insurance report far worse mental and physical health than their more privileged peers. No surprise here– those with fewer resources fared less well, highlighting the need for us to think more broadly about supports to families at local AND systemic levels. More on this later.
Interestingly, this trend began before the COVID-19 pandemic and continued through it, suggesting that the pandemic merely accelerated a trend with mothers’ mental health that was already trending negatively.
Why Does Maternal Mental Health Matter?
A pivotal part of my work as a psychologist involves showing up for families when children are born, so much so that I pursued additional training in the peripartum period (PMH-C: Peripartum Mental Health Certification). Copious amounts of data show that the newly forming attachment between parent and baby is THE window of opportunity for impacting all kinds of important metrics. Here we can prevent the intergenerational transmission of trauma. Here we can promote the formation of secure attachments between children and caretakers, which pays forward over the lifespan in numerous ways (self-worth, resilience, emotional regulation, healthy relationships, social and cognitive skills, to name just a few examples). The data are incontrovertible. And mothers who are struggling with their own mental health are statistically less able to show up for their children in ways that promote secure attachment.
So while maternal mental health affects everything from birth outcomes, child development, partner relationships, and even mortality (in fact, according to CDC data, mental health conditions are now the leading cause of pregnancy-related death in the United States: see reference), the message I’d like to impart is that ignoring maternal mental health doesn’t just fail mothers—it puts families, communities, and future generations at risk. It seems hyperbolic perhaps, but from my perspective the way we make our communities, societies, and world better is to help children grow into kind, resilient, responsible, relationally oriented adults, and an unwell mother struggles to teach and nurture her child in maximally productive ways.
But Wait- It’s Not Just About Moms.
The same JAMA Internal Medicine article cited above also found decreases in self-reported excellent paternal mental health. While not as significant a decline as for those identifying as mothers, those identifying as fathers are also struggling, and the gap between the two is closing. The broader dilemma is that ALL parents are struggling.
In 2024 the Surgeon General issued an Advisory entitled, “Parents Under Pressure: The U.S. Surgeon General’s Advisory on the Mental Health & Well-Being of Parents”. This is an accessible and user-friendly document that I highly encourage interested parties to read (linked in references). It beautifully describes what I firmly believe about the role of parenting in our society. An example:
“The work of parenting is essential not only for the health of children but also for the health of society” and “in modern society, parenting is often portrayed as a less important, less valued pursuit. Nothing could be further from the truth.”
The Advisory acknowledges the joy, meaning, and wonder of parenting. But it additionally points out that “the complexity of managing social media, parents’ concerns about the youth mental health crisis, and an epidemic of loneliness that disproportionately affects young people and parents” are relevant in new and impactful ways to the parents of today, and that the culture of comparison faced by parents and their children exacerbates normative stressors (financial and physical security, sleep deprivation, peer and social dilemmas, etc.) in ways that profoundly compound their impact.
Helpfully, the Advisory recommends concrete interventions at ALL levels, including governmental, professional workplace, communities and schools, health and social service systems, researchers, families and friends, and parents and caregivers.
As a society, we’ve been focused on educational and professional metrics of success for our children. While clearly important and relevant, we must pivot towards relational goals that enable us to raise good humans, who are prepared to move into our world with curiosity about others, perspective, responsibility, and humanity. Trust me- these children WILL be successful educationally and professionally, but they stand to improve our societies in ways outside of purely educational and professional metrics that I believe represent the key to change at this stage in our evolution.
Here’s the Good News.
Thus far I’ve emphasized the bad news because it’s important, and because circumstances surrounding parental stress and wellbeing are concerning. Embedded in the JAMA Internal Medicine article, however, are also hopeful indicators. The article reports an INCREASE in good maternal and paternal mental health, and a decrease in poor paternal mental health. Things are going well for some, particularly the more privileged of us, and I’m fully invested in understanding more about these factors so that we can strategically implement timely interventions and maximize our capacity to intervene preventatively.
The groups for women that I mentioned above (HERE) are vibrant, impactful, and a joy to facilitate. Incidentally, both groups have openings, so please inquire!
More broadly at Chrysalis, however, we all share the mission of empowering families. We work systemically, collaboratively, and with a variety of modalities to empower those identifying as parents of all identities. We enjoy talking about parenting issues, teaching about parenting issues, and intervening clinically with parenting issues everywhere it’s helpful and applicable!
Get in touch. I’d love to tell you more.
References
Daw, J. R., MacCallum-Bridges, C. L., & Admon, L. K. (2025). Trends and Disparities in Maternal Self-Reported Mental and Physical Health. JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2025.1260
Trost, S., Beauregard, J., & Chandra, G. (2022). Pregnancy-Related Deaths: Data From Maternal Mortality Review Committees in 36 U.S. States, 2017-2019. US Centers for Disease Control and Prevention. https://www.cdc.gov/maternal-mortality/php/data- research/mmrc-2017-2019.html
US Department of Health and Human Services. (2024). Parents Under Pressure: The U.S. Surgeon General’s Advisory on the Mental Health & Well-Being of Parents. US Department of Health and Human Services. https://www.hhs.gov/sites/default/files/parents-under-pressure.pdf