Study finds significant declines in maternal mental health across US
Smaller but notable decreases also reported in physical health
Columbia University's Mailman School of Public Health
A new study published in JAMA Internal Medicine reveals a concerning decline in self-reported mental health among mothers in the United States between 2016 and 2023. Conducted by researchers at the Columbia University Mailman School of Public Health, the study also found modest but measurable declines in self-reported physical health during the same period.
This large-scale analysis examined data from 198,417 mothers who participated in the National Survey of Children’s Health (NSCH), a nationally representative annual survey of households with children aged 0–17. Most participating mothers were over age 30, and over half had a privately insured or a non-Hispanic white child.
“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.
The findings show that the percentage of mothers reporting excellent mental health dropped sharply from 38 percent in 2016 to 26 percent in 2023. Similarly, the proportion reporting excellent physical health declined from 28 percent to 24 percent.
Most notably, the percentage of mothers rating their mental health as fair or poor rose by 3.5 percentage points over the 8 year-period, representing a 63.6 percent increase from the baseline prevalence of 5.5 percent in 2016. Declines in maternal mental health originated prior to the COVID-19 pandemic and were observed in nearly every socioeconomic subgroup examined.
Among fathers, the percentage reporting excellent physical health declined as well—from 30 percent to 26.4 percent; the changes in mental health were less pronounced. However, fathers reported substantially better mental and physical health than mothers in all years of the study.
The authors also examined disparities in maternal mental and physical health and found that the prevalence of fair and poor mental and physical health was considerably higher among mothers of lower educational attainment, single mothers, and those whose children have Medicaid or are uninsured.
Daw and colleagues emphasize the intergenerational consequences of poor parental mental health, including increased risks for adverse birth outcomes, developmental delays, and mental health issues in children. “Maternal mood disorders, in particular, can have long-term effects on children, directly by affecting development, and indirectly, by increasing the chance of exposure to co-occurring risks such as parental substance use and lower household resources.” Daw explained.
“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 U.S.,”Daw said. “We found consistently worse health outcomes for mothers compared to fathers, suggesting that mothers may need additional consideration and attention in policies aimed at supporting parental health and especially mental health.
In all cases, our study underscores the need for more comprehensive research on the health and well-being of U.S. parents more broadly, and we urge support for more interventions that support prevention, diagnosis and treatment of mental health outcomes.”
Co-authors are Colleen L. MacCallum-Bridges, PhD, and Lindsay K. Admon, MD, MSc, University of Michigan.
The study was supported by the Agency for Healthcare Research and Quality (R01HS029159).
Columbia University Mailman School of Public Health
Founded in 1922, the Columbia University Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting New Yorkers, the nation and the world. The Columbia Mailman School is the third largest recipient of NIH grants among schools of public health. Its nearly 300 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as preventing infectious and chronic diseases, environmental health, maternal and child health, health policy, climate change and health, and public health preparedness. It is a leader in public health education with more than 1,300 graduate students from 55 nations pursuing a variety of master’s and doctoral degree programs. The Columbia Mailman School is also home to numerous world-renowned research centers, including ICAP and the Center for Infection and Immunity. For more information, please visit www.mailman.columbia.edu.
Journal
JAMA Internal Medicine
Article Title
Trends and Disparities in Maternal Self-Reported Mental and Physical Health in the United States, 2016-2023
Study quantifies the sleep loss and
disruption experienced by new mothers
Research analyzed Fitbit sleep data from first-time mothers in the months after giving birth
DARIEN, IL – A new study to be presented at the SLEEP 2025 annual meeting quantifies the amount of sleep loss experienced by first-time mothers in the weeks after giving birth and is the first to identify the unique type of sleep disruption that persists throughout the first months of motherhood.
Results show that the average daily sleep duration of new mothers was 4.4 hours during the first week after giving birth compared with a pre-pregnancy sleep duration of 7.8 hours. Their longest stretch of uninterrupted sleep also fell from 5.6 hours at pre-pregnancy to 2.2 hours in the first week after delivery. Nearly one-third of participants (31.7%) went more than 24 hours without sleep in the first week with a newborn.
The daily sleep duration of new moms increased to 6.7 hours across postpartum weeks 2 through 7 and 7.3 hours across weeks 8 through 13. However, their longest stretch of uninterrupted sleep remained significantly lower than pre-pregnancy levels at 3.2 hours in weeks 2 through 7 and 4.1 hours in weeks 8 through 13. This novel finding reveals that sleep discontinuity remains a problem for new mothers even as their total nightly sleep duration gradually returns to pre-pregnancy levels.
“The significant loss of uninterrupted sleep in the postpartum period was the most dramatic finding,” said lead author Teresa Lillis, who has a doctorate in clinical psychology and is an adjunct professor in the department of psychiatry and behavioral sciences at Rush University Medical Center in Chicago. “While mothers generally returned to their pre-pregnancy total nightly sleep duration after the first postpartum week, the structure of their sleep remained profoundly altered. These results fundamentally transform our understanding of postpartum sleep; it’s not the lack of sleep, but rather, the lack of uninterrupted sleep that is the largest challenge for new mothers.”
The study involved 41 first-time mothers between the ages of 26 and 43 years. They provided their wearable sleep data from their personal Fitbit devices for a full year before childbirth through the end of the first year after giving birth.
Lillis noted that these findings explain why new mothers continue to feel exhausted even when they get the recommended 7 or more hours of sleep per night. The study results also identify sleep discontinuity as a potential risk factor and intervention target for postpartum depression and other postpartum-related health issues.
“Our results validate the lived experience of new mothers’ exhaustion and provide a new target for sleep-related interventions,” she said. “Rather than simply encouraging mothers to ‘nap when the baby naps’, our findings show that mothers would most benefit from strategies that protect opportunities for uninterrupted sleep.”
This study was supported by trackthatsleep LLC, for which Lillis serves as CEO. The study was conducted at Washington State University’s Sleep and Performance Research Center with co-investigators Devon Hansen and Hans Van Dongen.
The research abstract was published recently in an online supplement of the journal Sleep and will be presented Monday, June 9, during SLEEP 2025 in Seattle. SLEEP is the annual meeting of the Associated Professional Sleep Societies, a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society.
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Abstract Title: Profound Postpartum Sleep Discontinuity in First-Time Mothers
Abstract ID: 0915
Poster Presentation Date: Monday, June 9, 11-11:45 a.m. PDT, Board #294
Presenter: Teresa Lillis, PhD, adjunct professor in the department of psychiatry and behavioral sciences at Rush University Medical Center
About the Associated Professional Sleep Societies, LLC
The APSS is a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society. The APSS organizes the SLEEP annual meeting each June (sleepmeeting.org).
About the American Academy of Sleep Medicine
Established in 1975, the AASM is a medical association that advances sleep care and enhances sleep health to improve lives. The AASM membership includes more than 9,500 physicians, scientists, and other health care professionals who help people who have sleep disorders. The AASM also accredits 2,300 sleep centers that are providing the highest quality of sleep care across the country (aasm.org).
About the Sleep Research Society
The SRS is a professional membership society that advances sleep and circadian science. The SRS serves its members and the field of sleep and circadian research through training and education, and by providing forums for the collaboration and exchange of ideas. The SRS facilitates its goals through scientific meetings and trainee specific programming, and by advocating for federal sleep and circadian research funding. The SRS also publishes the peer-reviewed, scientific journals SLEEP and SLEEP Advances (sleepresearchsociety.org).
Journal
SLEEP
Method of Research
Observational study
Subject of Research
People
Article Title
Profound Postpartum Sleep Discontinuity in First-Time Mothers
Article Publication Date
27-May-2025
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