Doctor and Mom of 4 Weighs In on Decline in Moms’ Mental Health

While the world puts mothers on a pedestal—praising their strength and sacrifices—real support, and even visibility as human beings in need of care, is often painfully absent. “Mothers often feel unseen as the focus is on the children,” says Beth Oller, MD, FAAFP, a Kansas family physician, maternal mental health expert and mom of four. The result? A growing number of women struggling to keep up with demands and suffering in silence.

Now, a new study published in JAMA Internal Medicine confirms what many already knew—maternal mental health is declining at a concerning rate. For Oller, who has personally faced depression and anxiety while parenting, the findings are far from surprising. Below, she helps unpack what’s driving this mental health crisis, what the data reveals and what it will take to truly show up for mothers.

What The Study Reveals

To get a better picture of how maternal mental health has changed over the past decade, researchers from Columbia and University of Michigan analyzed self-reported health data from nearly 200,000 mothers between 2016 and 2023. After adjusting for income, education level, or geographic location, researchers found a sharp decline in all mothers’ mental health.

In 2016, just 1 in 20 mothers reported their mental health as “fair” or “poor.” By 2023, that number had nearly doubled to 1 in 12. Meanwhile, the percentage of moms who rated their mental health as “excellent” dropped dramatically—from 38.4% to just 25.8%. While declines could be found across the board, certain groups were hit especially hard. Single parents, mothers with less education and those with public health insurance saw some of the most dramatic increases in poor mental health. The rates of fair/poor mental health among mothers of preschool-aged children more than doubled.

The study also found that the gender gap in parental mental health is still present. Looking at fathers’ responses, while men also experienced a decline in mental health, mental health was consistently worse among mothers, with moms nearly twice as likely as dads to report fair or poor mental health.

Researchers note that these declines in maternal mental health aren’t happening in isolation—they mirror public health trends. Rates of depression, anxiety, suicide and overdose are all on the rise among pregnant and reproductive-aged women. In fact, mental health conditions are now the leading cause of pregnancy-related death in the US, accounting for nearly one in four maternal deaths. The study’s authors say their findings support the assertion that maternal mental health may be “a canary in the coal mine for women’s health more broadly.”

What’s Behind The Decline in Maternal Mental Health

The study offers a sobering look at just how much maternal mental health has eroded—but what’s behind it? Researchers point to a combination of contributing factors: limited access to mental healthcare, rising substance use, social isolation and bigger societal stressors like inflation and gun violence. Among younger parents, some experts suggest that growing up with social media may also play a role.

For Oller, the decline reflects what she sees every day in both her patients and what she’s experienced as a mother. Below, she shares why a few of these stressors may be hitting moms especially hard.

Systemic stressors

There’s no denying the role of real-world instability. “There have been so many societal stressors in the past few years that are mentioned in this study as leading theories, and I agree strongly with them,” Oller says. “Social isolation, rising substance use disorders, and broader stressors such as inflation, rising income inequality, racism, and gun violence as listed in the study cannot be overlooked as factors that contribute to worsening mental health not just for mothers but for the population as a whole.”

Social media

The impact of social media on mental health has been widely studied, and for moms, Oller believes the harm is particularly acute. Platforms often present a highlight reel of motherhood that can feel impossible to live up to. Instead of feeling supported, many moms end up feeling like they’re falling short. “The idealized images of motherhood, of someone who can balance it all—work, home life, playdates, parties—with ease, lead to comparison and can easily lead to feelings of inadequacy,” Oller says.

And the problem isn’t just about comparison, it’s about connection. Oller points out that as our lives have become more digital, our real-world support systems have started to fray. “Social media has also decreased true in-person social interactions in many cases,” she adds. “Which can lead to isolation and lack of feelings of support.”

Gaps in mental healthcare

Even recognizing the need for support doesn’t always lead to getting it. Oller sees this firsthand in her Kansas community, where care is often out of reach. “Limited access to mental health care continues to be an issue throughout the country and is heightened in rural areas like the one I practice in (Stockton, Kansas) as well as in marginalized patient populations,” Oller says.

Why moms of preschoolers are especially struggling

One of the study’s most striking findings was the sharp increase in mental health challenges among moms of preschool-aged children. For Oller, that makes perfect sense. “Preschool children bring with them stressors that are very different from those of an infant,” she explains. “They often seem like they never stop from the time they wake up until they go to bed.”

This nonstop physical energy is only part of the equation. “Preschoolers are very emotionally demanding… learning to navigate society and emotional regulation,” Oller says. “It’s a time of huge developmental changes, which leads to the need for frequent adjustment of parenting strategies.” Among all these developments, comparisons often ramp up around milestones too. “It is often a time of heightened worry of ‘is my child keeping up and doing as well as the other children?’ which leads to stress and anxiety.”

Why moms are more affected than dads

The gender gap in parenting may be closing, but many physical and societal pressures still prevail. “The physiologic demands of pregnancy and childbirth weigh much more on the female than the male parent, bringing physical and hormonal changes that can affect a female parent’s well-being,” she explains. “Also, female parents generally carry a heavier mental load—managing, planning, organizing, making appointments. This mental load can worsen mental health, especially if someone does not have a support system in place with either a partner or family.”

What Moms (and Their Support Systems) Can Do

Addressing the maternal mental health crisis isn’t just about awareness—it’s about action. Oller says lasting change must begin with the healthcare system. That means better screening, more accessible care in rural and underserved communities and better training for providers in maternal mental health.

“All major medical organizations recommend screening from the first prenatal visit throughout the first year postpartum,” Oller notes. “But this still isn’t done consistently. Providers need to do better in asking about, screening for, and treating maternal mood disorders.” Beyond the doctor’s office, Oller believes support can start at home. Here are her key strategies for moms and their support networks:

Create a postpartum self-care plan

“My biggest piece of advice to expectant mothers and those who love them to preserve their mental health is to have conversations and make plans BEFORE the baby arrives,” Oller says. “The initial postpartum period is a whirlwind of sleep deprivation, and it’s difficult to remember to care for yourself or ask for help.” She encourages moms-to-be to create a postpartum plan during pregnancy. This plan should identify go-to support people and outline practical help needed in the early weeks.

Assign roles

Who’s doing meals? Helping with older kids? Don’t wait until you’re overwhelmed to figure out logistics. Whether it’s someone helping with meals, childcare for older kids, or rides to appointments, clarify who’s doing what in advance. “Most of us don’t ask for help because we don’t want to be seen as a bother, but there are often people around us who would like to help if just asked,” Oller says. “ Make the asks before the baby comes, to relieve some stress after.”

Be open about your mental health

“Have a discussion with those around you about mood changes that can happen during pregnancy or after giving birth and have them help you assess when mental health may be declining, ” Oller advises. By involving your partner, family or close friends, they can help point out when you may be struggling when you are too close to see it yourself. Don’t hesitate to enlist professional help either. Talk with your healthcare provider about concerns you have and have a plan for how to contact them if issues arise.

Use resources

Knowing where to turn can ease social isolation and make all the difference in times of stress. Oller recommends having support groups, therapists or maternal mental health hotlines ready in case you need them. “Postpartum Support International provides online support groups, a helpline, information about maternal mental health and can help you find providers in your area,” she says. “The National Maternal Mental Health Hotline is also available 24/7 and is a confidential hotline for pregnant and new mothers in English and Spanish at 1-833-9-HELP4MOMS.”

“We need to normalize mothers advocating for their mental health and being seen,” Oller says. “Providers need to do better in asking about, screening for and treating maternal mood disorders, and friends, family and society need to do better in prioritizing maternal mental health and support.” Only this way can we move forward.