Child Care and Mothers' Mental Health: Is High-Quality Care Associated with Fewer Depressive Symptoms?

By Gordon, Rachel A.; Usdansky, Margaret L. et al. | Family Relations, October 2011 | Go to article overview
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Child Care and Mothers' Mental Health: Is High-Quality Care Associated with Fewer Depressive Symptoms?

Gordon, Rachel A., Usdansky, Margaret L., Wang, Xue, Gluzman, Anna, Family Relations

Finding high-quality child care may pose financial and logistical challenges and create ongoing emotional strains for some mothers. We use the Study of Early Child Care and Youth Development to ask (a) are childcare settings that mothers select on the basis of their own perceptions of quality rated more highly by independent observers (and more often recommended by mothers to friends) than settings that mothers selected for other reasons? (b) Do mothers report fewer depressive symptoms when they use high-quality care, as they perceive it, as assessed by independent observers and as indicated by their likelihood of recommending it? We find that mothers' reports coincide with independent observers' ratings in some respects but diverge in others, and only mothers' reports significantly relate to fewer average depressive symptoms after adjusting for confounds. Future research and policy should consider how mothers evaluate care quality and how these evaluations affect their mental health.

Key Words: child care, child-care quality, maternal depressive symptoms.

Although studies of child care are abundant, most associate characteristics of child care with child outcomes (Vandell, 2004). The limited research that examines parental outcomes focuses on the supply or cost of child care and its effects on maternal employment (e.g., Blau & Tekin, 2007; Danziger, Ananat, & Browning, 2004; Han & Waldfogel, 2001; Hofferth, 1996). Very little research has examined the potential associations between child care and a broader range of parental outcomes, particularly mothers' mental health. This is surprising given the near daily interactions children and parents have with caregivers and numerous popular accounts of parents' fears of entrusting child care providers with their young children and their concerns about finding affordable, stable child-care arrangements that meet their needs (e.g.,, 2010; Beckstrom, 2003; Grimes, 2010; Naughton, 1999; Nelson, 2010).

We aim to fill this void in the literature by examining how child-care quality associates with maternal depressive symptoms. Because prior literature suggests parents' definitions of quality may differ in some regards from developmentalists' definitions, we first estimate whether mothers who report choosing for quality versus for other reasons (such as cost, hours, and location) use settings that are rated higher by trained independent observers and whether these mothers are more likely to recommend their setting to friends. We also examine whether each of these quality ratings associate with maternal depressive symptoms, anticipating stronger associations with own than independent ratings. Although our study is descriptive and cannot attribute causality, it lays important groundwork for future research and practice considering parental perceptions of child care and their consequences for mental health.


Developmental models of what is best for child development dominate scholarly writing about high-quality child care, even though these may differ from some parents' childrearing preferences and norms (Emlen, 2010; Fuller, 2010; Harrist, Thompson, & Norris, 2007; Holloway & Fuller, 1999; Uttal, 1996). For example, Fuller's (2010) case studies identified state prekindergarten programs that followed a liberal-humanist model, offering children great latitude to direct their learning, whereas some parents and teachers preferred more structure and found children's self-directed behavior at times disrespectful or unruly. A broader literature on parents' preferences suggests that they are not always aligned with developmentalists' conceptions. For example, parents often express a desire for a homelike setting, with a provider that they can trust, especially for their infants and toddlers (Early & Burchinal, 2001 ; Johansen, Leibowitz, & Waite, 1996).

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Child Care and Mothers' Mental Health: Is High-Quality Care Associated with Fewer Depressive Symptoms?


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