Many New Moms Suffer from Anxiety and Depression. What About Their Partners?

NYU Steinhardt Professor Erin O’Connor’s new research finds mental health screening lacking for parents who have given birth—and nonexistent for other caregivers, who also struggle.

While postpartum depression has received more attention in recent years as a common complication of new parenthood, there’s a broad spectrum of perinatal mood and anxiety disorders (PMADs) that often go unnoticed, both in public conversation and in doctor’s offices. And it’s not just mothers whose mental health can decline during this transition.

“We know birthing caregivers aren’t being screened enough,” says Erin O’Connor, professor of education and director of Steinhardt's Early Childhood Education program. “But non-birthing caregivers are almost never screened at all—and that’s not just true for partners, it’s true for adoptive parents, LGBTQ+ caregivers, and other family structures that get left out of the conversation entirely.”

Last year, O’Connor and her co-author, Institute for Human Development and Social Change Research Associate Robin Neuhaus, published Missed Screenings, Missed Support, a national study of caregivers with PMADS revealing that 40 percent of caregivers who experienced a PMAD were never screened during a follow-up appointment. The researchers also found that even when caregivers were screened, they were often afraid to share mental health concerns for fear of judgment or being separated from their children.

O’Connor is the co-founder (along with Neuhaus) of the Nested Institute for Families, a nonprofit that promotes family well-being through research and advocacy.

She’s now expanding her research to include a specific focus on non-birthing parents (including biological fathers, same-sex partners, adoptive parents, and others), a group O’Connor says is often overlooked in research and policy, yet who are critical partners for birthing parents and their children’s development.

NYU News spoke to O’Connor about the effects of PMADs on both parents and children, and some ideas for overcoming the shortcomings in the healthcare system that can leave them untreated.

What led you to study caregivers’ experiences with PMADs?

My early work as a developmental psychologist focused on children’s relationships with the adults around them, and particularly how teacher-child relationships shape children’s social, emotional, and academic development. Across that work, one lesson became increasingly clear: children’s well-being cannot be separated from the well-being of the adults caring for them.

That realization led me to look more closely at the transition to parenthood. It is a period of enormous emotional, relational, and practical change, yet many families receive surprisingly little sustained support. Perinatal mood and anxiety disorders are common and treatable, but caregivers often struggle to recognize what they are experiencing, talk about it honestly, or find appropriate care.

We founded the Nested Institute for Families to better understand those gaps and help build systems that support the whole family, rather than waiting until a caregiver or child is already in crisis.

What are the biggest challenges for caregivers with PMADs?

One of the biggest challenges is that screening does not always feel like a genuine invitation to receive help. In our national study of more than 1,000 birthing caregivers, 48 percent of those who recalled being screened said they did not feel able to answer the questions completely honestly.

Some caregivers feared being judged as a bad or incapable parent. Others worried that disclosing intrusive thoughts or severe distress could trigger involvement from child protective services. Whether or not those fears reflect what a provider would actually do, they shape how parents respond and can prevent screening from identifying people who need support.

The other major problem is fragmentation. Professional guidelines recommend screening at multiple points during pregnancy and after birth, but screening practices and follow-up vary considerably. Symptoms may also emerge or intensify months after delivery, when regular contact with the birthing parent’s healthcare providers has decreased.

Even when a caregiver does disclose symptoms, a screening tool is only useful if there is a clear and accessible path to care. Too often, parents are left trying to navigate provider shortages, insurance barriers, inadequate paid leave, childcare demands, and healthcare systems that do not communicate well with one another.

What are the most common risks for children whose mothers have PMADs?

It is important not to suggest that a child whose mother experiences a PMAD will inevitably have developmental difficulties. Many parents recover with treatment and support, and children can benefit from strong relationships with partners, grandparents, teachers, and other caregivers.

At the population level, however, maternal depression and anxiety have been associated with increased risks in areas such as early language development, emotional regulation, behavior, and, later, internalizing symptoms. The pathways are complex. A caregiver experiencing severe depression or anxiety may have less energy, emotional availability, or practical support, which can affect everyday interactions with a baby or young child.

That is why supporting the caregiver is also an investment in the child’s developmental environment. The caregiver’s health matters in its own right, but effective support can have benefits across the family.

More recently, you’ve turned your attention to the partners of birthing caregivers. Why?

Our earlier study showed us that PMADs do not occur in isolation. Birthing caregivers frequently described their partners as their primary source of emotional support, but many also told us that their partners were struggling and had received very little information or attention from healthcare providers. In that study, 98 percent of birthing caregivers reported that their partners had not been screened for perinatal mental health concerns.

Communication within the couple also emerged as a major concern. Only 22 percent of birthing caregivers in our study said they felt able to speak honestly with their partners about their mental health. That means many parents may be relying most heavily on the person they feel least able to fully open up to during one of the most vulnerable periods of their lives.

At the same time, the partner may also be experiencing depression, anxiety, exhaustion, or feelings of exclusion, while being treated by the healthcare system primarily as a helper. When both caregivers are struggling, they may each have less capacity to support the other.

We’re now asking non-birthing caregivers directly about their own experiences—fathers, LGBTQ+ parents, adoptive parents, and other caregivers who are often missing from this research. So far we’ve heard from about 400 caregivers and hope to reach 1,000, with a particular focus on groups that have historically been left out of the conversation. We’re also conducting around 30 in-depth interviews to understand what the transition to parenthood felt like emotionally and psychologically, what support people got, and what support they were missing.

The goal is not to shift attention away from birthing parents. It is to recognize that supporting partners and strengthening communication can make the entire caregiving system more resilient.

What changes do you want to see to support new parents?

First, screening should be ongoing and connected to care. It should occur at several points during pregnancy and the postpartum period, and a positive screen should lead to timely assessment, treatment options, and follow-up. We also need appropriate ways to identify and support mental health concerns among non-birthing caregivers. That starts with screening that feels human, not like a checklist with “right” answers. A positive screen also needs to lead somewhere. It can’t just end with a referral list of providers who aren’t taking new patients. That means investing in training: there’s currently a shortage of providers with real expertise in perinatal mental health.

Second, the United States needs comprehensive paid family leave. Recovery from birth, bonding with a new child, attending medical appointments, and supporting a partner in distress all require time. Leave policies should reflect the diversity of modern families and recognize the caregiving roles played by partners, adoptive parents, grandparents, and other relatives.

Third, mental health support should be integrated into the places where families already receive care. Obstetric and pediatric settings are especially important because pediatric providers may continue seeing the family regularly after the birthing parent’s routine postpartum care has ended.

Finally, providers need training not only in administering a questionnaire but also in having conversations that feel safe and nonjudgmental. Screening without trust, follow-up, and a realistic path to treatment is not enough.

What about outside of healthcare? Could there be support for parents to access in other community settings?

One of the central questions guiding our future work is how to create more approachable pathways into care. Through research-practice partnerships in New York City, we are working with community organizations and early-childhood partners to explore how trusted community supports can play that role. One area we are studying is whether preschool teachers and early-childhood staff can be better equipped to notice caregiver distress and connect families with services, without asking educators to become therapists.

Our aim is to work alongside community partners to develop and test practical models that can be offered in familiar settings, such as preschools, Head Start programs, family centers, and community-based organizations. Ultimately, we want families to have more than one door through which they can reach care.

Jade McClain
(646) 469-8496