In 2016, one in twenty mothers said her mental health was poor or fair.
By 2023, it was one in twelve.
The trend did not pause in the years between. It did not reverse. It did not plateau. It continued, steadily and measurably, in the wrong direction for seven consecutive years — across all socioeconomic backgrounds, all races, all ages, all regions. And then a landmark study published in JAMA Internal Medicine made it undeniable in the only language the medical and policy establishment tends to take seriously: data, at scale, in one of the most prestigious peer-reviewed journals in the world.
The study examined 198,417 female parents of children aged 0 to 17 and found large declines in self-reported mental health from 2016 to 2023, with the decline occurring across every socioeconomic subgroup. The percentage of mothers reporting excellent mental health dropped sharply from 38% in 2016 to 26% in 2023, while the proportion rating their mental health as fair or poor rose by 3.5 percentage points — a 63.6% increase from the 2016 baseline.
This is not a postpartum phenomenon. It is not a clinical condition that emerges in the weeks after delivery and resolves with treatment within months. This is a systemic, sustained decline in the mental health of American mothers happening across the full span of the parenting years — and the healthcare system, the policy environment, and the cultural conversation around motherhood are entirely inadequate to address it.
The drop in mothers reporting excellent mental health between 2016 and 2023, from 38% to 26%. By 2023, 1 in 12 mothers reported poor or fair mental health — among fathers in the same period, the figure was 1 in 22. These are not equivalent experiences.
What the research actually found
The JAMA study is not the first piece of evidence pointing toward a maternal mental health crisis in the United States. It is the largest and most comprehensive, and it arrives in a context where the evidence has been accumulating for years without producing an adequate policy response.
The Maternal Mental Health Leadership Alliance has documented that 75% of women impacted by maternal mental health conditions remain untreated, increasing the risk of long-term negative impacts on mothers, babies, and families — and that the cost of not treating these conditions is $32,000 per mother-infant pair, or $14 billion each year in the United States.
What the JAMA study adds to this existing evidence base is important: it shows that the problem extends far beyond the postpartum period that has been the primary focus of maternal mental health advocacy. The mothers in the JAMA sample are raising children of all ages, from infants to teenagers, and their mental health is declining across the full span of those years. This finding challenges the dominant clinical framing of maternal mental health as primarily a postpartum concern, and demands a much more expansive understanding of the conditions that produce and sustain maternal distress across the full arc of parenting.
Clinical child psychologist Robyn Koslowitz, author of Post-Traumatic Parenting, described the situation precisely in her interview with HuffPost on the JAMA findings: "Parenting is the perfect recipe for burnout. It demands round-the-clock emotional availability, regulation, flexibility, and decision-making — often while you're sleep-deprived and touched out. Add financial strain, lack of affordable childcare, no paid leave, and a mental health system that's inaccessible to many, and it becomes unsustainable."
Why it is happening: the structural causes
The JAMA study identifies the decline but does not fully explain its causes. For that, we need to look at the structural conditions that have changed over the period in question — because the timeline of the decline corresponds directly with several significant shifts in the lives of American mothers.
The childcare crisis and its cumulative cost
An average of 1 in 4 women exits the workforce during the first year of motherhood, and women who are not able to take adequate leave have a significantly increased risk of postpartum depression — with 1 in 4 mothers returning to work within ten days of giving birth. The cost of absorbing the childcare gap — in chronic stress, lost professional opportunity, financial strain, and the perpetual cognitive burden of care logistics — is a direct contributor to the decline the JAMA data documents. The Policy Center for Maternal Mental Health's research on paid leave and postpartum depression makes this connection explicit, as does reporting in Behavioral Health News on the workplace conditions that shape maternal well-being.
The return-to-office wave and the elimination of flexibility
Fortune's 2025 investigation found that the historic surge in employment among working mothers seen during the pandemic has reversed sharply, with the labor force participation rate for women ages 25 to 44 with children under 5 falling nearly three percentage points between January and June 2025 — its lowest level in over three years. Since January 2025, 212,000 women ages 20 and older have left the workforce, a trend coinciding with a rise in full-time office mandates at Fortune 500 firms, which climbed to 24% in Q2 2025 from 13% at the end of 2024. The flexibility that briefly made paid work and motherhood compatible for many women is being withdrawn — and the exodus is the result.
The absence of paid leave and its long-term consequences
The United States remains one of the only developed nations without a federal paid parental leave policy. A systematic review published in the Archives of Women's Mental Health found that more restrictive maternity leave policies are consistently associated with higher rates of postpartum depression, while paid and longer leaves tend to be associated with a reduction in postpartum depression symptoms in high-income countries (the full review is available through the NIH's PubMed Central). The absence of paid leave does not merely create financial hardship in the immediate postpartum period — it establishes, from the first weeks of a child's life, the template of inadequate structural support that continues to shape maternal experience for years.
The mental load and the erosion of identity
Research published in Frontiers in Psychiatry in 2025 argues for an expanded understanding of how the ongoing developmental demands of matrescence and the chronic structural stressors of the parenting years affect maternal mental health — well beyond the postpartum window. The mental load — the perpetual cognitive and emotional work of managing a household that falls disproportionately on mothers — is a specific and chronic stressor that has no clinical diagnosis and therefore receives no clinical treatment, even as research consistently identifies it as one of the primary mechanisms through which maternal mental health deteriorates.
Beyond the postpartum diagnosis: why the clinical framing is failing mothers
The mental health system's primary framework for maternal mental health has been postpartum depression and anxiety — conditions that emerge in the weeks after delivery and are treated as time-limited episodes. This framework matters, and the clinical infrastructure for it, while still inadequate, is more developed than at any previous point. The Edinburgh Postnatal Depression Scale, explained by ACOG, is widely used for screening. Postpartum Support International maintains a comprehensive directory of treatment resources.
But the JAMA data reveals a larger problem the postpartum framework entirely misses: the decline in maternal mental health is not concentrated in the postpartum period. It is distributed across the full span of the parenting years. A clinical system oriented toward postpartum screening is simply not designed to detect or address this broader, longer-term pattern of decline.
The 2025 Frontiers in Psychiatry paper on matrescence and maternal mental health argues for a fundamental expansion of how the field is conceptualised — one that incorporates the ongoing developmental demands of motherhood rather than treating maternal mental health as a postpartum concern alone. It is a reframe that the JAMA numbers make not just intellectually defensible but urgent.
The treatment gap: why knowing is not enough
Seventy-five percent of women impacted by maternal mental health conditions remain untreated, with the cost of not treating these conditions reaching $14 billion each year in the United States. The barriers are multiple and mutually reinforcing: cost, stigma, provider shortages, the logistical impossibility of attending appointments with a newborn and no reliable childcare, and a cultural narrative that positions maternal struggle as either normal and inevitable or a personal failure to be managed privately.
Dr. Ariadna Forray, associate professor of psychiatry and director of the Center for Wellbeing of Women and Mothers at Yale School of Medicine, told HuffPost: "Mothers are feeling more isolated, and the 'village' that once helped raise children feels increasingly absent for many." That isolation is itself a measurable health variable, not a soft one — and it compounds every other barrier in the list.
What has to change at the structural level
The declining mental health of American mothers is a policy failure as much as it is a public health crisis. Research from the Policy Center for Maternal Mental Health confirms that access to paid family and medical leave is associated with lower rates of postpartum depression and improved maternal well-being, and that the United States remains one of the only nations without a universal paid maternity leave policy despite the well-documented impact on maternal and infant health outcomes. The countries where maternal mental health outcomes are better than in the United States share common features: more generous paid parental leave, more affordable and accessible childcare, and more robust mental health systems.
The argument that these structural supports are not affordable is not supported by the economics. The cost of not treating maternal mental health conditions is $32,000 per mother-infant pair, or $14 billion each year. The question is not whether the country can afford to support the mental health of its mothers. The question is whether it will choose to.
What you can do now, in the system that exists
While structural changes are advocated for, there are evidence-backed actions available now.
Seek support before the crisis. The most effective mental health support is accessed early, before chronic stressors have accumulated into something significantly harder to treat. You do not need to be at a breaking point to be entitled to help.
Name what you are experiencing. Whether the name is matrescence, burnout, depression, anxiety, or simply exhaustion that has gone on too long without adequate support — having a name for the experience reduces its emotional intensity and increases your sense of agency in relation to it. (This is part of why the identity shift of motherhood hurts more when it goes unnamed.)
Build the community the system does not provide. Peer support — being in community with other mothers navigating the same territory — is one of the most consistently effective and most accessible supports available. It is also the thing the modern arrangement of motherhood most reliably strips away.
For mothers who are currently struggling, the most important first step is talking to someone. The National Maternal Mental Health Hotline offers free, confidential support 24/7. You can also call or text 988 to reach the Suicide and Crisis Lifeline at any time.
One in twelve
One in twelve American mothers is currently reporting that her mental health is poor or fair. Not one in twelve mothers struggling with postpartum depression. One in twelve mothers, at every stage of the parenting journey, reporting that the basic condition of their mental health is fair or poor.
That number has been growing for seven years. It has grown through economic expansions and contractions, through pandemic and recovery, through every political cycle and every public health campaign mounted in the name of supporting mothers. It has grown because the structural conditions that produce it have not changed at the scale required to change it.
The data is now impossible to ignore. What happens next depends on whether the people with the power to change those structural conditions choose to do so — and, in the meantime, on whether the mothers inside those numbers know that what they are experiencing is not their failure, is not an indication of inadequacy, is not something to be endured alone in silence.
One in twelve. And every single one of them deserves better than what the current system is offering.
Frequently asked questions
What did the 2025 JAMA study on maternal mental health actually find?
Published in JAMA Internal Medicine, the study examined 198,417 mothers of children aged 0 to 17 and found that the share reporting excellent mental health fell from 38% in 2016 to 26% in 2023, while the share rating their mental health fair or poor rose 3.5 percentage points — a 63.6% increase from the 2016 baseline. The decline occurred across every socioeconomic subgroup and across the full span of the parenting years, not just the postpartum period.
Is this just about postpartum depression?
No — and that's the central point. The mothers in the JAMA sample are raising children of every age, from infants to teenagers, and their mental health is declining across all of those years. The dominant clinical framework treats maternal mental health as a postpartum concern, which means a system built around postpartum screening is not designed to detect or address a decline that is distributed across the entire arc of parenting.
Why are mothers' mental health outcomes getting worse?
The study identifies the decline but not its causes; the structural shifts over the same period point to the answer. Chief among them: a childcare crisis that pushes 1 in 4 women out of the workforce in the first year of motherhood, a return-to-office wave that has withdrawn pandemic-era flexibility, the continued absence of any federal paid leave policy, and the chronic, undiagnosed stressor of the mental load. Each is associated in the research with worse maternal mental health.
How does the lack of paid leave affect mental health?
A systematic review in the Archives of Women's Mental Health found that more restrictive maternity leave policies are consistently associated with higher rates of postpartum depression, while paid and longer leaves are associated with reduced symptoms in high-income countries. The United States remains one of the only developed nations without a federal paid parental leave policy, which establishes a template of inadequate structural support from the first weeks of a child's life.
Where can a mother who is struggling get help right now?
The National Maternal Mental Health Hotline offers free, confidential support 24/7, and you can call or text 988 to reach the Suicide and Crisis Lifeline at any time. Postpartum Support International maintains a directory of support groups, peer mentors, and providers. The most effective support is accessed early — you do not need to be in crisis to be entitled to it.
