Parents of Twins More Likely to Have Anxiety or Depression


Mother and father's hands cradling twin babies' feet on a pale backgroundThe Journal of Psychiatric Practice has published new research on mental health in parents of multiples (twins, triplets, etc.). Parents of multiples reported higher rates of depression and anxiety than other parents. Despite a high rate of mental health concerns, few parents of multiples sought treatment.

The use of fertility treatments has greatly increased the prevalence of multiple births in the United States. Since 1980, the rate of twin births has increased by 76%. The rate of triplet births has increased by 700% during this period. About 20% of families in the study used fertility treatments to conceive their children.

Mental Health Symptoms Among Parents of Multiples

The study included 241 parents of multiples, most of whom (197) were mothers. Researchers recruited parents through a twin listserv, an in-person twin gathering, and a BabyCenter twin forum. Participants completed written questionnaires about their experiences following childbirth. The questionnaires included scientifically validated measures of depression and anxiety.

Most people reported mild mental health symptoms of anxiety or depression. One in four parents showed clinically significant symptoms of generalized anxiety. Fourteen percent reported symptoms of major depression. Mothers were more likely to have anxiety or depression than their partners.

Parents were more likely to report mental health concerns if they:

  • Had younger babies
  • Were unmarried
  • Had lower incomes
  • Had babies born prematurely

Many parents of singletons report less sleep after childbirth. Yet parents can have a particularly hard time managing the schedules of multiple babies. Many parents reported a drop in sleep quality during the first three months after birth. Poor sleep quality was linked to worse depression and anxiety symptoms.

Barriers to Care for Parents of Multiples

Nearly half (48%) of parents said they would have been interested in receiving mental health care either during pregnancy or in the year following birth. Yet less than 10% received mental health treatment during the postpartum year. The study says the most common barrier to seeking care was a lack of time.

Another barrier was a lack of information. Most participants (63%) said no health care provider discussed mental health with them during pregnancy. Previous research suggests many obstetricians feel uncomfortable talking to people about mental health.

This discomfort could prevent parents from getting diagnoses and treatment referrals. Many parents in the study were unprepared for the challenges associated with multiples. The study authors urge providers to do more to address the mental health needs of parents expecting multiples.

Parents experiencing depression or anxiety may find therapy a worthwhile investment of time. Therapy can be a safe place to talk about one’s feelings without judgement.


  1. For parents of multiples, elevated rates of mental health symptoms but low rates of treatment. (2018, May 4). EurekAlert. Retrieved from
  2. Wenze, S. J. & Battle, C. L. (2018). Perinatal mental health treatment needs, preferences, and barriers in parents of multiples. Journal of Psychiatric Practice, 24(3), 158-168. Retrieved from,.4.aspx?PRID=JPP_PR_050418

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