Mental Health and Sleep Quality of Low-Income Mothers of One-Year-Olds during the COVID-19 Pandemic

Background and Purpose: The COVID-19 pandemic and the subsequent social restrictions created an unprecedented context for families raising young children. Prior research has documented detrimental effects of the pandemic on maternal mental health, but less is known about how the pandemic specifically impacted the mental health of mothers experiencing poverty. In this study, we examined self-reported measures of depression, anxiety, and sleep quality among low-income mothers of one-year-olds during the early phase of the pandemic when social distancing was at its peak in the United States.

Methods: We used survey data from the Age-1 wave of the Baby’s First Years study, collected between July 2019 and June 2020. The Baby’s First Years study is a randomized controlled trial of poverty reduction during early childhood. Launched in 2018, the study recruited 1,000 low-income mothers after they gave birth in hospitals in four metropolitan areas. Mothers were randomized to receive either a large ($333) monthly cash gift or a nominal ($20) monthly cash gift. Approximately one year after the child’s birth, 931 mothers completed the Age-1 survey.

The current study used the control group (n=547) to estimate the associations between the COVID-19 pandemic and maternal depression, anxiety, and sleep quality. We compared mothers who were interviewed before March 14^th, 2020 (n=342) to mothers who were interviewed after March 14^th, 2020 (n=205) to determine whether the pandemic was associated with differences in maternal well-being. We used three types of models to estimate associations: 1) bivariate OLS regression, 2) bivariate OLS regression with inverse-probability treatment weights, and 3) multivariate OLS regression controlling for baseline characteristics.

Results: Mothers who were interviewed during the pandemic reported lower rates of depression, fewer anxiety symptoms, and higher sleep quality compared to similar mothers interviewed before the pandemic (B=-1.06, p<0.01; B=-1.06, p<0.10; B=0.53; p<0.05; respectively). After controlling for differences in baseline characteristics using inverse-probability treatment weights and multivariate OLS regression, the pandemic continued to be associated with lower rates of depression; however, the associations with maternal anxiety and sleep quality were less robust.

Conclusions and Implications: Inconsistent with most research on maternal mental health during the COVID-19 pandemic, we found that low-income mothers of one-year-olds reported better mental health during the early phase of the pandemic. These surprising results may have important implications for understanding the unique circumstances of mothers who are raising young children while experiencing poverty. It is possible that the social context of the pandemic temporarily ameliorated some of the complex life stressors this population disproportionately experiences. Prior research shows that mothers of young children are at an increased risk of experiencing mental health symptoms, and this risk is further elevated under the economic and social inequities associated with poverty. As we look forward to a post-pandemic world, social workers must continue to build solutions within our social safety net and service delivery systems to better support maternal mental health for economically marginalized families.