The Primary Reason Maternal Mental Health is Declining

The mental health of mothers in the United States is in decline, driven by a variety of factors, but one stands out above all others. Certainly, the economic challenges of raising children in a household with a single income, alongside rising child care costs, are significant contributors. However, while these financial pressures can be debilitating, they are not—in my professional opinion—the primary cause.

Historically, studies have shown that mothers from lower socioeconomic backgrounds are more vulnerable to mental health challenges. Yet, it is not only mothers with fewer resources who are struggling; mothers with more economic means are also breaking down. Single mothers are especially vulnerable, as research consistently shows that married mothers tend to have better mental health outcomes, likely due to greater emotional, financial, and caregiving support. The more plausible cause of this mental health crisis is the relentless societal expectation—amplified by families, governments, and even mothers themselves—that women should be able to do everything, all at once. Raising children has always been demanding, but today, mothers are struggling in alarming numbers. Approximately one in five mothers experience postpartum depression or anxiety. Many require hospitalization, medication, and in some cases are unable to care for their newborns.

Women have long borne the primary responsibility for raising children, and with the rise of the second-wave feminist movement in the 1960s, a new expectation emerged: that women should not only care for their children but also pursue ambitious, high-achieving careers. For many women, it is indeed necessary to work outside the home to support their families. But the expectation that they should simultaneously excel at an intense, fulfilling career while raising young children has pushed many beyond their limits.

Mothering is more than a full-time job—it’s a lifelong commitment with no days, weeks, or months off. I remember the moment my husband and I brought our son home and placed him in our bed for the first time. We looked at each other, realizing the enormous responsibility ahead: ensuring his physical and mental well-being for the rest of our lives. From that point on, he was the center of our universe, and we were the center of his.

It’s not surprising, then, that many women find it easier to return to work, leaving their children in day care or with nannies, because working outside the home feels, in some ways, less overwhelming than the relentless demands of 24/7 caregiving. Yet what many women don’t fully grasp is that they remain mothers no matter where they are. The weight of responsibility doesn’t vanish at the office. In reality, it sets in that they’ve taken on two full-time roles, often in conflict with each other, while operating with finite time and energy.

Mothers also struggle when they realize that becoming a mother has changed them in ways they didn’t expect—that they want to stay home with their newborns but feel torn between that desire and the promises they’ve made to their partners, their jobs, and themselves. In my field of psychoanalysis, we define depression as a preoccupation with past and present losses, and anxiety as a preoccupation with potential future losses. Many mothers experience profound regret after giving birth because they did not anticipate this transformation. Instead of bonding with their babies in peace and joy, they’re consumed by internal conflict and arguments with their spouses about whether to return to work.

The more plausible cause of this mental health crisis is the relentless societal expectation—amplified by families, governments, and even mothers themselves—that women should be able to do everything, all at once.

We fail to prepare young women—and young men for that matter—for the deep, biological, and emotional transformation that can happen when a healthy woman becomes a mother. If you were raised by a nurturing, loving mother, the birth of your child often awakens a powerful, instinctual pull to stay close and care for your baby. And yet we don’t teach young men that they, too, play a vital role—as providers and protectors—at this vulnerable time, creating the safety and security that allows mothers to nurture. Instead, we send mothers the message that they should prepare to return to work as quickly as possible, that any caregiver will suffice, that financial success is more important than nurturing a child, and that if they feel discomfort, distress, or conflict, they should simply ignore it.

I write extensively about how modern parenting—detached, rushed, and designed to separate mothers and babies as soon as possible for the sake of economic productivity—harms not only children’s mental health but mothers’ mental health as well. For many, breaking down is not just inevitable; it’s a form of refuge from impossible demands. It’s not uncommon for the body to shut down under stress—a signal that it needs rest and recovery.

Not every woman experiences the birth of a child as a joyful transformation. For some, it reopens old wounds: painful memories of a neglectful, absent, depressed, resentful, narcissistic, or abusive mother. For these women, the defenses they’ve built over the years can crumble in an instant. The arrival of a baby can trigger feelings of resentment, envy, and rejection, leaving them unable to care for a vulnerable child when they themselves feel most vulnerable. For these mothers, returning to work may provide a welcome escape from unresolved pain.

The solution to this crisis is within reach. We must educate young women—and young men—about the potential for emotional transformation after birth. We need to prepare women for the possibility that they may want to stay home with their babies and that this desire is normal, healthy, and essential. We must encourage them not to make rigid promises to return to work immediately, but to leave space for the unexpected. Young men, too, must learn that their role as providers and protectors is critical—if mothers are to nurture, fathers must support that process. Pressuring a woman to return to work too soon harms not only the couple’s relationship but also their child’s development.

The expectation that mothers should simultaneously excel at an intense, fulfilling career while raising young children has pushed many beyond their limits.

We need to once again value the role of mothering in society—admire it, honor it, and prioritize it over external work. The harmful narrative that career success and material achievement are more important than nurturing must change. The feminist movement was intended to give women choices, but it has, in some ways, created an additional pressure: to pursue intense careers while raising young children. Many women feel judged or guilty for wanting to stay home with their infants.

Blaming the mental health crisis among mothers on economics alone is a shallow analysis. Unless we recognize the deeper internal and external conflicts women face, we will not reverse this troubling trend. But it's not too late to change the narrative. We must embrace the wisdom of nature: that nurturing comes first. Modern women can have it all—but not at the same time and not by denying their instincts or sacrificing their children’s well-being. By honoring our instincts, we can find our true path and build a more mentally healthy society for mothers, fathers, and children alike.

Erica Komisar, LCSW, is a psychoanalyst and author of Being There: Why Prioritizing Motherhood in the First Three Years Matters and Chicken Little The Sky Isn’t Falling: Raising Resilient Adolescents in the New Age of Anxiety.