The impact of motherhood on the course of women’s psychological wellbeing

Background: Having children or being childless is associated with differences in women's psychological wellbeing during the reproductive age period. Methods: An individually matched case-control cohort study, measuring psychological wellbeing with the 5-item Mental Health Inventory (MHI-5) was conducted. Repeated measures analysis of variance and chi-square tests were used to measure the across time changes of MHI-5 scores. ANCOVA and Cochran's Q examined the differences between MHI-5 scores of women with children (cases) and of childless women (controls) at three timepoints. Timepoints were determined by the cases’ pre-pregnancy (T1), post-birth (T2), longer-term (T3) moments. Results: Motherhood status has a significant medium effect on psychological wellbeing [F(1.112) 20.99, p<.001, d.47). Psychological wellbeing of cases declines significantly from T2 to T3 (p<.001) and from T1 to T3 (p<.001), while psychological wellbeing of controls remains the same. Cases have significantly more often MHI-5 scores below the cut-off value at T2 compared to T3 (p.05) and at T1 compared to T3 (p<.001). Controls have significantly more often MHI-5 scores below the cut-off value at T1 compared to T2 (p<.001) and at T1 compared to T3 (p<.001). Limitations: We depended on an existing data set with few predetermined variables. There was insufficient information about the full context of women’s lives such as (in)voluntary childlessness, life-events affecting happiness, or age of children, affecting a comprehensive representation of possible confounders or mediating factors. Conclusion: Psychological wellbeing of mothers declines over time, while childless women’s wellbeing remains stable. Overall, both groups show evidence of good mental health.