“Wow, this is really hard,” is the resounding theme we hear from new parents in our social circles, many of whom delayed childbearing until their thirties, when they were well-established in their chosen careers. Even those of us who studied parenting and child development for years felt barely any more prepared, finding ourselves taken aback by the sleep-deprived stress of caring for a tiny human who depends on you wholly and continuously to survive.

Nearly half of parents of minors report their stress is completely overwhelming on most days—a rate double that of adults without children. Parents report that stress “makes it hard for them to focus,” and when they are stressed, they “can’t bring themselves to do anything.”

This trend has persisted for more than 10 years during a time of increased school violence, social media pressure, and the rising cost of living challenging family finances. Reports of high stress among parents have spiked since the COVID-19 pandemic. On top of this, parents are spending more time on parenting and more time working than they were 40 years ago, a trend reflecting growing norms around time-intensive parenting practices. They’re also even more stressed about financial pressure and their children’s needs and safety, and they’re experiencing increasing social isolation (PDF).

Yet, public acknowledgement of the stress of parenting has been largely absent—at least until recently. In an unprecedented step several months ago, the US surgeon general issued a public health advisory (PDF) calling attention to the problem.

A new brief we released today with the National Home Visiting Resource Center shows how early childhood home visiting programs—in which a designated support person provides services to new and expecting parents in their homes—can design services to address parents’ mental health, including high levels of stress.

Some families experience disproportionate exposure to stress

The parents at the greatest risk of experiencing damaging levels of stress have often experienced ongoing or extreme hardship over time, including exposure to early life trauma and adversity, community and interpersonal violence, poverty (PDF), and racism and discrimination (PDF). They are vulnerable to the negative effects of chronic stress on their mental and physical health and may also face greater barriers to accessing mental health resources.

The situation has grown so dire that maternal mental health conditions are now identified as the leading cause of pregnancy-related death (PDF) among pregnant and postpartum individuals. Remarkably, more than 6 million birthing-age women (PDF) in the United States live in counties with high risk for maternal mental health problems and inadequate maternal mental health resources, creating mental health “dark zones” (PDF) for women. As many as 60 percent of women report experiencing one or more stressful events (PDF), including traumatic and emotional stressors, in the year before they give birth.

Women of color, younger women, and women experiencing chronic stressors, obstetric complications, or first-time or unplanned pregnancies may have higher levels of pregnancy-related stress, which may be driven in part by the social determinants of health (PDF) in their communities, including access to health care. When parents face high levels of stress, they may experience growing mental health challenges, poor sleep, substance use, exhaustion, and reduced self-efficacy in the parenting role.

Parental stress affects children too. Parents focused on coping with stress may have more difficulty engaging positively with their children, responding in a consistent and attuned manner, and building new skills to support their parenting (PDF). As a result, their children are more likely to struggle with behavioral health and development challenges.

Early childhood home visiting can alleviate parent’s stress

Our new brief shows how evidence-based home visiting practices are being designed and targeted to support parents managing high stress, depression, and anxiety. Home visiting programs also implement the following practices to reduce parents’ stress:

• Screening parents to identify mental health concerns and other comprehensive family needs. Federally funded maternal, infant, and early childhood home visiting programs (PDF) are required to screen parents to identify and address experiences that may be linked with stress, including untreated depression, domestic violence, and child developmental needs. Many programs additionally screen for needed services such as child care and early education, primary care, and basic material needs, such as diaper insecurity.
• Supporting healthy pregnancies and nurturing parent-child relationships from the start. Prenatal home visiting programs use evidence-based practices to help parents prepare for a baby (PDF) and reduce the stress that comes with labor, delivery, and the postpartum experience. After the baby is born, postpartum home visitors work with parents to develop self-efficacy and parenting skills (PDF), which can reduce parents’ stress over time and buffer children from the effects of stress. Home visitors also combat the social isolation parents may experience by meeting them where they are most comfortable, typically in their homes.
• Prioritizing parents who are the most vulnerable to experiencing high stress and adversity. All parents can benefit from the support of home visiting, and some home visiting programs are universally available in certain communities. However, many programs target parents known to face difficulties, such as first-time parents with low incomes, adolescent parents, and parents involved with child welfare services. Some home visiting models have adapted services to meet the needs of families who may face additional challenges that could place their mental health at risk, such as refugee and immigrant families, families experiencing homelessness, and families experiencing challenges with substance use.
• Implementing strategies to support parents with mental health conditions. Although home visiting programs typically include comprehensive referrals for needed services and can support parents with reducing stress, some home visiting models are specially designed to include mental health providers within their home visiting teams. These programs incorporate psychotherapy into their approach and can support parents’ processing of current stress and past trauma. Other programs partner with mental health providers to enhance access to services for families who need them most.

Even under the best conditions, the transition to parenting and early parenting years can be stressful and demanding. Home visiting provides tailored support for parents across all of these stages—helping combat feelings of isolation, providing emotional support, and connecting parents with the resources they need to thrive.