Early motherhood and mental health in midlife: a study of British and American cohorts

Michael E Wadsworth, MRC National Survey of Health & Development
Lucy Okell
Emily Grundy, London School of Hygiene and Tropical Medicine
John C. Henretta, University of Florida

Early motherhood has been consistently shown to be a risk for social and health disadvantage later on in life. This paper reports analysis of data comparing midlife mental health in early first mothers (first giving birth at or before age 20 years) and mothers who first gave birth at or after age 21 years, in 2 cohort studies, a British national birth cohort study (the MRC National Survey of Health & Development), and the US Health & Retirement Study. Sample members of the British cohort were born in 1946 and those in the US cohort were born in 1931-41. Clinically validated mental health outcome data were collected at age 53 years on 1300 women in the British cohort, and at ages 51-61 years on 4799 women in the US cohort. We used data from the British cohort to ascertain whether the observed long-term adverse mental health risk associated with early motherhood was wholly accounted for by factors associated with selection into early motherhood, and it was not. Analysis of data from both cohorts on life after first motherhood, adjusting for risk factors from before first motherhood, showed that mental health risk was largely the result of the poorer socio-economic status and physical health experienced by early first mothers. We discuss possible pathways from early life to early motherhood, and from early life and early first motherhood to midlife mental health. Many aspects of these findings are cohort specific, and the paper discusses how risk factors described in this analysis may differ in more recently born cohorts in both Britain and the US.