Introduction

Mothers face enormous mental health challenges that need to be addressed by counsellors (Forbes et al., 2022; Ko et al., 2012; Lamar et al., 2019; Lamar & Forbes, 2020; McLean & Anderson, 2009). Women have higher rates of depression, anxiety, and stress than men, due to environmental, cultural, and biological factors (Brody et al., 2018; McLean et al., 2011; Medina & Magnuson, 2009). The intersection of motherhood and womanhood creates further challenges for mothers’ development, family roles, gender socialization, careers, and mental health (American Psychological Association, 2017; Forbes et al., 2021; Ko et al., 2012; Lamar et al., 2019; Lamar & Forbes, 2020; McLean & Anderson, 2009; Medina & Magnuson, 2009). The purpose of this research was to increase the understanding of mental health issues faced by mothers from different backgrounds.

State of Maternal Mental Health in the USA

Women experience multiple mental health issues, including depression, anxiety, and stress, at higher rates than men (American Psychological Association, 2017; Ko et al., 2012; McLean & Anderson, 2009). Research on why women experience higher rates of mental health concerns is inconsistent, but it is generally believed to be related to genetic factors, higher prevalence of trauma, gender socialization, hormonal and other biological causes, or environmental factors (Jalnapurkar et al., 2018; Kessler, 2003; McLean & Anderson, 2009). Further exploring these constructs has the potential to contribute to our understanding of mother’s mental health.

The issues faced by women in the USA are also faced by mothers. However, mothers endure additional challenges because they are typically the primary caretakers of children, thus can experience additional mental health issues due to the intersectionality of their roles. Risk factors for mental illness in mothers include past history of depression, anxiety, or bipolar disorder, unintended pregnancy, intimate partner violence, lower income levels, stressful life events, non-traditional work schedules, and lack of emotional and practical support from partners, family, and others (Fisher et al., 2012; Lamar & Forbes, 2020; O'Hara & Wisner, 2014; Story et al., 2018). Mothers experience the added expectations of an intensive mothering culture, which pressures women to be emotionally and physically available for their children at all times; take responsibility for their children’s emotional, cognitive, social, and physical well-being; and to prioritize their children’s needs above their own (Hays, 1996; Lamar et al., 2019). These intense and unrealistic standards placed on mothers can complicate their mental health (Lamar et al., 2019). Mothers who engage in intensive mothering behaviors or attempt to fit within that ideology report more stress, decreased life satisfaction, and depression (Rizzo et al., 2013).

Anxiety and Stress

Anxiety is the most prevalent class of mental health disorders, which include generalized anxiety disorder, panic disorder, and specific phobia, social phobia, and agoraphobia (Johnson et al., 2017; Kessler et al., 2005). The rates of anxiety for women are significantly higher than men, with lifetime prevalence rates for women at 30.5% and 19.2% for men (McLean et al., 2011). Understanding anxiety and stress based on other demographic factors is complex. Mclean et al. (2011) found no differences in the prevalence of anxiety in women, regardless of racial background, while Kessler et al. (2005) found that Black and Latinx women were less likely to have anxiety or depression than White women. Single people, specifically those who were once in a committed relationship, have been found to experience anxiety and depression at higher rates than married couples (Kessler et al., 2005). Prevalence of prenatal anxiety in women ranges from 10 to 25% (Field, 2017; O'Hara & Wisner, 2014). Postpartum anxiety has been reported by as many as 18% of new mothers (Fairbrother et al., 2016; Misri et al., 2015; Paul et al., 2013; Seymour et al., 2015).

Several factors were related to increased anxiety in women, including genetic factors, stress, trauma, and gender socialization (Jalnapurkar et al., 2018). Gender socialization may even encourage the development of anxiety for girls, given that anxious behaviors are more often tolerated in girls and discouraged in boys (McLean & Anderson, 2009). Women who more fully prescribe to traditional gender roles often exhibit higher levels of fear and trait anxiety (McLean & Anderson, 2009). Most people with generalized anxiety disorder do not receive any treatment, yet it increases the chance a mother will experience career barriers, educational challenges, teenage pregnancy, and comorbid mental health disorders, such as depression (Jalnapurkar et al., 2018).

Anxiety and stress are often conflated in maternal mental health literature. There is a gap in understanding the stress of mothers from a counselling perspective, with existing research primarily focusing on physical impacts of maternal stress on children. Lamar et al. (2021) found that over half of parents surveyed were experiencing moderate to extreme levels of stress. This sample was taken during COVID, and while there were no gender differences between mothers’ and fathers’ stress, this study is limited in its applicability. For the purpose of this article, we are using Baum’s (1990) definition of stress. There are different types of stress, including acute, chronic, and episodic acute stress. Stress has been defined as “a negative emotional experience accompanied by predictable biochemical, physiological, and behavioral changes” (Baum, 1990, p. 653). Physical responses, such as headaches, chest pain, increased heart rate, stomach and bowel issues, heartburn, shortness of breath, and dizziness often accompany stress (American Psychological Association, n.d.). Chronic stress can often result in heart disease, stroke, insomnia, accelerated aging, and suicide (American Psychological Association, n.d.; Yegorov et al., 2020). Symptoms of stress also include anger, irritation, over-arousal, tension, depression, and anxiety.

Depression

Women experience depression at nearly two times the rate of men (Brody et al., 2018; Kessler, 2003; Ko et al., 2012). The World Health Organization identified depression as the leading cause of disease-related disability for women (Ali et al., 2017). In 2017, 8.7% of women in the USA were documented as having a major depressive episode in the previous 12 months (Center for Behavioral Health Statistics and Quality, 2018). Further, the lifetime prevalence for women with depression is around 21% and women are likely to attempt suicide three times more than men (Ali et al., 2017). Among women, those aged 18–25 had the highest prevalence of a major depressive episode, followed by women aged 26–49 (Substance Abuse and Mental Health Services Administration, SAMHSA, 2021). Racial differences are difficult to find for depression, and no significant differences in depression for White, Latinx, and Black adults were reported in extant research (Brody et al., 2018; Kessler et al., 2005). Brody et al. (2018) did find that non-Hispanic Asian adults had lower levels of depression than those from other racial backgrounds. Family income can also play a role in depression, with those from higher income households experiencing lower levels of depression (Brody et al., 2018). Mothers with low-education level, income, and without employment are also at risk for depression (Ertel et al., 2011).

Depression faced by mothers related to pregnancy, childbirth, and postpartum is complex. Over 11% of women have reported experiencing postpartum depression (Ko et al., 2017), while 14.5% have depression during their pregnancy (Leung & Kaplan, 2009). Depression is undiagnosed in 65.9% of pregnant women and 58.6% in nonpregnant women (Ko et al., 2012). The mental health of mothers in postpartum can also be influenced by their careers and whether they have access to maternity leave. Chatterji and Markowitz (2012) found that mothers with fewer than 12 weeks of maternity leave have increased levels of depressive symptoms. In a more comprehensive study of mothers living with children aged 0 to 18, researchers found that 10% of them had a depressive episode in the previous 12 months (Ertel et al., 2011).

Understanding why mothers have higher rates of depression is difficult. Though it seems biological factors might account for the difference in depression, researchers have found that the hormonal changes women experience, in addition to other physical issues, such as inflammation, do not directly relate to mental health differences in women (Morssinkhoff et al., 2020; Schiller et al., 2021; Slavich & Sacher, 2020). Some evidence suggests that environmental influences, including lower self-esteem, body shaming, gender-based violence, childhood trauma, relational stress, and gender inequality, may have a great impact on the development of depressive symptoms in girls and women (Kuehner, 2017). The stress resulting from having to conform to cultural gender norms and manage challenges such as poverty, intimate partner violence, and gender oppression can cause distress and decreased mental health (Ali et al., 2017).

Understanding the mental health of mothers beyond the postpartum stage is difficult because maternal mental health research has generally been limited to the period before and immediately following childbirth. However, given the mental health challenges faced by mothers throughout their life, it is essential for researchers to study this gap in the literature in order to support maternal mental health across the lifespan. Mothers face sociological challenges related to standards of mothering (Hays, 1996; Lamar & Forbes, 2020), environmental barriers, such as trauma, lower incomes, and relational stress (Kuehner, 2017), and biological issues like hormone changes. Yet, little is known about depression, anxiety, and stress in mothers across the lifespan. Mothers face unique challenges, and for counsellors to more effectively tailor interventions that support them, it is vital to understand the current state of maternal mental health and any key demographic factors that pose a risk to maternal emotional wellbeing. This research provides a more detailed picture of the mental health of mothers in the USA.

Methods

Three research questions were developed to evaluate maternal mental health: (1) how are mothers across the USA rating their mental health status, (2) what is the relationship between stress, depression, and anxiety for mothers, and (3) are differences seen in mental health scores based on demographic characteristics?

Participant Recruitment and Sample Description

Data for the exploratory analysis were collected from mothers across the USA (N = 525) from a crowdsourced sample via a Qualtrics sampling pool (Qualtrics Online Sample, 2019). Power analysis using G*Power software (Erdfelder et al., 1996) was conducted to examine a priori sample sizes needed for analysis of variance (n = 266), correlational analysis (n = 137), and confirmatory factor analysis (n = 400); therefore, the researchers targeted a minimum sample of 500 mothers. The data from this study was gathered from a larger study examining mental health, parenting attitudes, social support, and gender role adherence. The sample was stratified to only include mothers. The survey also included 16 demographic questions and 7 health history questions. Race/ethnicity categories were matched to the US census percentages as well as a fairly even representation of education levels and US regions. For racial analysis, responses lower than 5% were not included as the category was not represented in a manner to generalize results. Quality checks in place to verify participants included time checks to ensure participants read all items, removing overly consistent responses (e.g. 3’s on all items in the survey) and utilizing a Qualtrics panel where they ensured participants are human responses and not artificial intelligence responses (Mullen et al., 2021). Based on survey design, item simplicity, and participant familiarity with the Qualtrics platform, it took participants 10–15 min to complete.

Detailed information about the sample can be seen in Table 1. Participants were represented from all four major regions of the USA, with categories defined by the US census (retrieved from https://www.census.gov/programs-surveys/economic-census/guidance-geographies/levels.html). Of note, participants were asked to tell us whether they experienced lower, middle, or upper class status during their childhood. These were not further defined because we were mostly interested in their general understanding of this experience and assumed most children would not know their parent’s income.

Table 1 Sample characteristics
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We also asked participants to report if they had a history of experiencing depression or anxiety. Again, we did not further define this because we did not want to influence later responses to the mental health measure. We simply wanted to know if they perceived having anxiety or depression and whether they had been diagnosed with either disorder. There was a significant association between self-reporting depression and self-reporting anxiety, χ2 (1) = 164.60, p <.001, φ = 0.56. There was also a significant association between being formally diagnosed with depression and formally diagnosed with anxiety, χ2 (1) = 42.88, p < .001, φ = 0.40.

Measures

Consent to participate in the survey was requested in the first question of the survey. The survey continued with demographic items about the mother and family, and the scale items were asked afterward. The Depression Anxiety Stress Scales (DASS) has a 42- and a 21-item version. This study used the DASS-21, which included 7 items measuring stress, 7 items measuring depression, and 7 items measuring anxiety (Antony et al., 1998). To categorize mental health, the DASS has a strict scoring guide placing participants into normal, mild, moderate, severe, and extremely severe mental health categories (Antony et al., 1998). The DASS-21 had a high reliability for our study with a Cronbach’s alpha of 0.95, which is consistent with previous studies, including Henry and Crawford (2005) reporting a 0.93 for the total scale. Confirmatory factor analysis demonstrated evidence of internal structure, with all items loading on the corresponding factors of stress, anxiety, and depression. In essence, the DASS-21 can be interpreted as three unidimensional metrics; therefore, taking the mean of the raw scores for each factor was appropriate.

Analysis

Data analysis began with descriptive statistics on each item, along with evaluations of item and scale reliability. Mean scores were then used to investigate differences and relationships between constructs within the measure. Differences were examined by demographic items using independent sample t-tests or analysis of variance, while relationships between constructs were examined using Pearson’s correlations (Leech et al., 2012).

Results

The mothers in this sample reported varied concerns for mental health. Items began with “over the last week,” with participants responding “did not occur,” “some of the time,” “a considerable amount of time,” or “most of the time.” Scoring based on the DASS-21 scale recommendations (Lovibond & Lovibond, 1995) showed that, on average, mothers in the sample reported mild stress scores (TS = 16.41, SD = 10.05, n = 525), mild depression scores (TS = 11.00, SD = 11.03, n = 525), and moderate anxiety scores (TS = 10.46, SD = 10.96, n = 525). Noting the high standard deviation of the average scores, analysis then considered the number of participants in each mental health category (Table 2). Roughly half of the sample reported scores in the normal range for stress (47%), depression (54%), and anxiety (51%) with roughly a quarter of the sample reporting severe or extremely severe scores for stress (20%), depression (21%), and anxiety (27%).

Table 2 DASS-21 category counts
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A chi-square test of association was used to examine the association between self-reported depression and the DASS-21 depression ratings. A significant association was found between self-reported (SR) depression and the depression rating on the DASS-21, χ2 (4) = 39.00, p <.001, φ = 0.27. Specifically, more participants self-reported having depression while also having a score in the normal range on the DASS-21 depression scale, indicating no evidence of depression (see Table 3). Conversely, fewer participants self-reported no depression, yet had scores in the moderate or extreme category of depression on the DASS-21. Similar associations were found between self-reporting anxiety and the DASS-21 anxiety categories, χ2 (4) = 34.08, p <.001, φ = 0.26. Specifically, fewer participants reported having anxiety but scored in the normal range for anxiety on the DASS-21, while more participants reported having no anxiety but scored in the moderate and extremely severe categories for anxiety.

Table 3 Crosstab of DASS-21 category and self-reported
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Relationship Between Stress, Depression, and Anxiety

Pearson’s correlations between mean scores of each factor were conducted. Correlations above 0.70 are considered strong, while correlations between 0.40 and 0.69 are considered moderate (Cohen, 1988). Correlations above 0.80 may indicate that the two variables are measuring the same latent construct (DeVellis, 2003). The relationships between all three factors can be considered moderate to strong. Stress was positively correlated with depression (r = 0.65, p <0.001) and anxiety, (r = 0.65, p <0.001). Anxiety and depression were also strongly related, r = 0.76, p <0.001. Though stress, depression, and anxiety were related, each describes distinct constructs of mental health.

Differences by Demographic Characteristics

No significant differences were found for stress, depression, or anxiety across the following demographic items: race, ethnicity, education level, family income, relationship status, years in the relationship, number of children, region of the USA, or job status. Significant differences were seen by age categories for stress (F (5,519) = 5.91, p < .001, η2 = .05 (95% CI [0.02, 0.09])), depression (F (5,519) = 3.09, p = .009, η2 = .03 (95% CI [0.002, 0.05])), and anxiety (F (5,519) = 3.11, p = .009, η2 = .03 (95% CI [0.002, 0.05])), with older mothers (over 45 years old) scoring lower than younger mothers (Table 4).

Table 4 Mothers’ age
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Significant differences were also seen across social class upbringing levels for depression (F (2, 522) = 4.14, p = .02, η2 = 0.02 (95% CI [< .001, 0.04)), and anxiety (F (2,522) = 5.52, p = .004, η2 =.02 (95% CI [0.002, 0.05])), but not for stress. In both cases, mothers who self-identified with a lower-class upbringing reported higher depression and anxiety scores than mothers with a middle-class upbringing (Table 5).

Table 5 Social class upbringing
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Discussion

This research was designed to understand the mental health of US mothers, specifically rates of depression, anxiety, and stress, how those constructs are correlated, and what demographic factors might put mothers at higher risk for depression, anxiety, and stress. Despite being related to each other, depression, anxiety, and stress are distinctly different constructs. Given that stress and its symptoms are included in the diagnostic criteria for both depression and anxiety-related disorders (American Psychiatric Association, 2013), our results demonstrating a connection between those constructs makes sense. Our results show a strong correlation between anxiety and depression, which is consistent with previous research on the comorbidity of these diagnoses (Goodman, 2007). Zender and Olshansky (2009) found that about half of the people diagnosed with depression are correspondingly diagnosed with an anxiety disorder (2009). Given that 8.7% of women in the USA were diagnosed with depression in 2017, it estimated that over 4% of them also had an anxiety disorder (Center for Behavioral Health Statistics and Quality, 2018).

Our results indicated that there were no significant differences found for stress, depression, or anxiety across the demographic items of race, ethnicity, education level, family income, relationship status, relationship length, number of children, region of the USA, or job status. This was a surprising finding, as we expected to see some differences in mental health scores based on demographic factors. Specifically, Ertel et al. (2011) found that mothers with lower levels of education, lower income, or without employment were more likely to experience depression, so we assumed our participants would be similar. Other research has found that people separated from a partner had higher rates of anxiety and depression (Kessler et al., 2005), while our findings demonstrated that there was no difference for relationship status. Finally, we expected to see mothers of color report different levels of depression, anxiety, and stress than their white counterparts. Black, Latina, and Asian mothers have reported lower levels of anxiety and depression in some studies (Brody et al., 2018; Kessler et al., 2005), while other research has reported no difference in racial groups for anxiety (Mclean et al., 2011). These results indicate that more research is needed to understand the complex experience of mothers.

Our sample indicated that younger mothers were more likely to have anxiety than older mothers. This is consistent with current findings that indicate that anxiety disorders are most prevalent in middle age and then decrease as women age (Jalnapurkar et al., 2018). A similar pattern was seen in the results for depression and stress, in that younger mothers (18–24) were more likely to report having depression and stress than older mothers (45–55). This is similar with recent research findings that young adult women (ages 18–25) experience higher rates of depression than older women (SAMHSA, 2021). While a significant difference is noted between age groups, the effect size is small, meaning it may not be as noticeable to counsellors. Still, previous research has demonstrated that age is related to mental health for mothers (Jalnapurkar et al., 2018; SAMHSA, 2021) and counsellors should consider assessing young mothers for mental health concerns. A possible explanation for these results is that younger mothers are more likely to have younger children, who are often more demanding of their mother’s time and attention than older children. According to Williford et al. (2007), maternal stress decreases as children age from infants to kindergarteners. They also suggest that decreasing stress pattern continues past early childhood. Other research has demonstrated that mothers of young children experience significant fatigue, which impacts their well-being (Dunning & Giallo, 2012; Giallo et al., 2013). Future research examining mental health and both the age of the mother and age of the child would be useful to further understand the mothering experience.

Our data suggested that mothers who grew up in families with lower incomes had higher depression and anxiety. Again, while the effect size is low, it is consistent with previous findings (Belle & Doucet, 2003; Brody et al., 2018). Women experience higher rates of poverty than men, with women of color living in poverty at higher rates than white women (Belle & Doucet, 2003; U.S. Census Bureau, 2018). Poverty has been shown to have a clear correlation with depression, especially for mothers with young children (Belle & Doucet, 2003). Heflin et al. (2005) found that approximately 20% of the women receiving welfare benefits met the criteria for major depression. Women in poverty often do not have access to mental health services (Belle & Doucet, 2003), which, given their higher risk for depression, should be a point of concern and advocacy for the mental health field.

An interesting result of our study, not found in previous research, is the finding about the levels of stress, anxiety, and depression that mothers experience. We found one previous study, using the DASS-21, that reported the levels of depression, anxiety, and stress in a normal, nonclinical sample of college students (Beiter et al., 2015). When comparing levels of stress, anxiety, and depression (normal, mild, moderate, severe, and extremely severe), our sample was similar to the Beiter et al. (2015) findings in the mild to severe ranges for all three constructs. A primary difference was found in the normal and extremely severe levels of stress, anxiety, and depression. Our sample, compared to the Beiter et al. (2015) sample, had fewer participants reporting normal levels of stress (47% vs. 62%), anxiety (51% vs. 60%), and depression (54% vs. 67%). Additionally, the participants in our study reported more than double the levels of extremely severe stress (7% vs. 3%), anxiety (23% vs. 8%), and depression (10% vs. 5%) than the Beiter et al. (2015) study. Our findings indicate that mothers are experiencing more disturbing levels of depression, anxiety, and stress, and more research is needed to understand this difference.

Another finding of note was the number of mothers who self-reported having depression or anxiety and how their self-report compared to their results on the DASS-21. The results showed that 10.29% (n = 54) of mothers in this sample self-reported that they did not have depression, yet their score on the DASS-21 placed them in the moderate to extremely severe level of depression. Conversely, 126 (24%) mothers said that they were depressed but scored in a normal range on the DASS-21. For anxiety, 9.52% (n = 50) of our sample self-reported that they did not have anxiety, but then scored in the moderate to extremely severe levels of anxiety. However, 142 (27.05%) mothers said they had anxiety but scored in the normal range on the DASS-21. It is concerning that so many mothers are at moderate to extremely severe levels of depression and anxiety, yet do not recognize that in themselves. A possible explanation for the finding that many mothers self-report as having depression and anxiety, yet score in a normal range, is that mothers, especially those with young children, often experience exhaustion, poor nutrition, and overwhelming pressure from juggling children, work, and household responsibilities (Dunning & Giallo, 2012; Giallo et al., 2013). Mothers have reported fatigue as a physically unrelenting experience, similar to jetlag (Giallo et al., 2013). They experience negative cognitive and emotional impacts of fatigue, including trouble concentrating, increased guilt and lowered parenting self-efficacy, parenting satisfaction, and general well-being (Dunning & Giallo, 2012; Giallo et al., 2013). These experiences are similar to symptoms seen in depressed and anxious people. It is important to note that, while these mothers may not have diagnosable depression or anxiety, they are still coping with stressors that could be addressed in counselling. More advocacy is needed to educate mothers about mental health and to provide better screening tools to helping professionals who work with mothers.

Implications for Practice

There has been limited research regarding the mental health of mothers in the counselling literature. This study attempted to fill that gap and provide practitioners with a clearer picture of the issues mothers face. Mothers, overall, show alarming levels of stress, anxiety, and depression. Counsellors should assess mothers for depression, anxiety, and stress early and often (Lamar & Forbes, 2020). Client’s level of gender role adherence and parenting beliefs may be important to assess to understand how unattainable mothering standards might be impacting her mental health. Counsellors may also want to educate their clients about mood disorder symptoms because so many of our participants did not accurately self-identify their mental health status.

This study provided evidence that there is such a clear connection between income level and the mental health of mothers. Counsellors should consider whether their practice is accessible to women who may lack the resources to seek services. Additionally, professional leaders can continue to advocate communities and lawmakers for mental health services for low-income clients.

Counsellors may not be aware of bias that exists in their practice that can be prohibitive for mothers (Gilbert & Kearney, 2006; Haddock & Bowling, 2001; Jackson & Slater, 2017). Counsellors should work to reduce gender bias from their practice by examining their personal beliefs, attending to their use of language, and assessing their interventions for unintentional gender bias (Lamar & Forbes, 2020). Perpetuating gender bias and stereotypical gender norms can place further blame on mothers and can potentially convey a message that their emotional distress derives from within, rather than from the extreme expectations and pressures mothers face. Examples of potential bias include the use traditional counselling approaches that may put misplaced responsibility on the client. Cognitive-behavioral therapy puts emphasis on faulty thinking patterns and behaviors, which can implicitly place blame on mothers. Counsellors should help mothers consider the impact of the socio-political context in which she lives and the gender norms placed on her in order to make sense of the symptoms she is experiencing. Asking a mother if she can ask her partner for help, take time for self-care, or work fewer hours to reduce her stress reinforces the cultural values that a mother should stay home and manage the roles assigned to her with ease.

Limitations of the Study

This study is limited most greatly by lack of information about mothers who do not identify as female, single, or a mother of color. Most of our participants were partnered (71%) and white (76%). Greater generalizability could be achieved with a more diverse sample especially for findings related to race and ethnicity. Making more effort to recruit single mothers and BIPOC mothers is essential to better capture the landscape of maternal mental health. Our results are also not generalizable to mothers in the LGBTQ+ community because we did not have enough respondents who identified as mothers partnered with a woman and 100% of our sample identified as female. This is due in part to the limitations of crowdsourcing data as these samples, while still valid, are limited in their diversity tending to be mostly Western, educated, industrial, rich, and democratic in nature (Mullen et al., 2021). There are additional quality checks available on some crowdsourcing platforms that could be included for future considerations, like adding in attention check items, and more demographically targeted panels (Mullen et al., 2021).

Future research is necessary to continue understanding the mental health of mothers across the lifespan. Specifically, it will be helpful to understand how the mental health of mothers impacts their parenting approaches, long-term development, and relationship health. Additionally, we would recommend that researchers examine how social support affects mental health and, specifically, how single mothers are impacted by social support.

Conclusion

Stress, anxiety, and depression are prevalent in US mothers. All mothers are in need of support; however, younger mothers and mothers with low incomes need additional mental health services to support the challenges they face. Additionally, mothers need to be screened for severe depression, anxiety, and stress, so counsellors have an accurate understanding of the status of their mental health. This study reported that mothers are more likely to report extremely severe levels of stress, anxiety, and depression. Future research should continue to examine mothers across the lifespan with special focus on more diverse populations. Counsellors should work to make their practices more accessible to mothers and attend to bias in the counselling session. Perhaps with more sophisticated assessment and treatment for mothers’ mental health, mothers can feel more supported in their mothering experience and be better equipped to deal with typical expectations they face.