Reprinted from Council on Contemporary Families Brief Report

A briefing paper prepared by Jeff Hayes, Women’s Bureau, U.S. Department of Labor^[1],  and H. Elizabeth Peters, Urban Institute, for the Council on Contemporary Families symposium The COVID-19 Pandemic and the Future of Gender Equality (PDF).

Many workers will provide care for a newborn or for a family member with a serious illness and will experience the challenges of trying to manage the competing responsibilities of working and caregiving. Indeed, increases in the labor force participation of women, the increasing number of single parent families (and families where the female is the primary breadwinner), and changes in the nature of work (e.g., the 24/7 economy) have contributed to greater work-family conflict. The consequences of managing these dual responsibilities are also unequally experienced across gender, race/ethnicity, age, and socio-economic status. These challenges were exacerbated when the COVID pandemic severely limited the availability of the formal care infrastructure (e.g., childcare and school), and families had to increase their caregiving activities.  Policy makers and employers have attempted to support working caregivers by developing policies such as paid family leave and paid sick leave – including increased access to paid leave during COVID – but access to these supports are not equally distributed.

Some employers provide paid leave as part of an employee benefit package. The proportion of workers who have access to employer-provided paid parental or family leave varies across different surveys. The National Compensation Survey tends to report the lowest numbers (24% of private industry workers with access to paid family leave in 2022) but a greater percentage of workers in other surveys of workers report being able to take paid leave  for family and medical reasons These types of benefits increased early in the pandemic, declined in the second and third years of the pandemic, and have started to increase again in 2023. But, they are still more likely to be available to those who work full-time, have high wages, and are highly educated.

For more than 30 years, most employees have been protected by the Family and Medical Leave Act (FMLA) when taking leave from work to care for themselves, for a new child, or for a seriously ill child, spouse or parent. FMLA provides the right to job-protected, unpaid time off to eligible employees. While FMLA was a major first step in public leave benefits in 1993, FMLA’s protections are not equally available to all workers – only 56% of employees are eligible – and lack of pay puts leave taking out of reach for many. Yet, these protections are crucial for employees and working families. One in five Black (21%) and Hispanic (20%) employees without FMLA protections report that taking family and medical leave resulted in losing their job – higher than reported by those covered under the FMLA (6% and 16%, respectively).

To address disparities in access to FMLA and lack of paid family leave more generally, since 2002 fourteen states, including the District of Columbia,  have adopted public policies that provide paid family and medical leave benefits when workers need time off for covered purposes. These state policies also cover a broader set of workers than the FMLA by including those working in smaller businesses and those with shorter work experience. The primary inequality in these laws relates to geography—only workers living in these states are covered.

One other type of inequality relates to differences in access to paid leave for new parents compared to access to paid leave for family caregiving. Until recently, most of the attention and research on paid leave focused on new parents; yet as the population continues to age, the need for eldercare and for supporting those who provide that care will only continue to increase. There is a similar disparity in access to paid leave for eldercare providers compared to parental leave. One study shows that 53 percent of fulltime workers report that they have access to paid leave for parental leave versus only 42 percent reporting access to paid leave for elder care of other types of family caregiving, and these disparities have been corroborated in other studies as well.  Studies have also found that the take-up rate for family care benefits is also much lower than for parental care, and that some of this difference has been attributed to a lack of awareness about these types of benefits. This discrepancy in availability between parental and family paid leave is also seen across OECD countries: while 37 countries provide paid leave for new mothers only 32 provide paid leave to new fathers. For family care, 35 provide paid leave to parents caring for children with health needs and only 25 provide paid leave for caregivers of a family member who is not a child. Among the OECD countries that do have family caregiving leave, that leave is often less generous than what is available for new parents.

The benefits of paid family and medical leave are supported by research on existing state programs as well as international evidence. Positive outcomes for paid parental leave include two-generational benefits from improved birthweight outcomes, increased breastfeeding, and lower infant mortality. The introduction of paid family leave in California led to more fathers taking leave, and taking longer leaves, both of which can have long-term impacts on father involvement. For those with aging parents or spouses in poor health, living in a state with paid family leave increases labor market attachment as well as an increased likelihood of being a working caregiver and a decline in reports of being depressed or in poor health. Moreover, evidence shows that paid family leave programs can help reduce inequality in access to leave. Indeed, simulation models suggest that a public program does increase paid leave benefits for lower wage workers and lower income families. Data for Washington, the first combined paid family and medical leave program to provide benefits contemporaneously, shows that benefits from the state program are disproportionately reaching women and workers of color needing medical or family leaves.

In 2020, the COVID-19 pandemic made the overall lack of support (and the disparities in that support) for working parents and family caregivers impossible to ignore. Workers needed paid leave when they were sick with COVID, when they were required to quarantine after being exposed to COVID, or when they needed to provide care for sick children or family members, or provide care when schools or child care providers were closed. The US federal government responded to this crisis by passing the Families First Coronavirus Response Act (FFCRA), which required certain employers to provide employees with paid sick leave or expanded family and medical leave for specified reasons related to COVID-19. The FFCRA broadened the allowable reasons for taking paid leave to include not only workers’ own health needs, but also to meet family caregiving needs from both illness and mitigation efforts such as school and child care closures. However, exemptions in the FFCRA meant millions of workers were not covered. The policy was only in place temporarily and expired on December 31, 2020. Data on take up of the FFCRA benefits provided as tax credits to employers is sparse, but GAO has reported that employers’ low awareness or understanding and lack of administrative report for accessing credits may have reduced usage of the credit based on interviews with business representatives and payroll or tax professionals.

In addition to the federal COVID paid leave response, 10 states and 22 cities and counties enacted paid sick leave policies that exceeded FFCRA requirements. Examples of these extensions included allowing paid leave to be used to obtain a vaccination, extending eligibility to gig workers, and covering leave for those who were not actively sick, but who had been exposed to COVID and needed to quarantine.  Many of these responses to the COVID-19 pandemic have since expired, but several states explicitly recognized the possibility of future health public health emergencies, and put in place policies that would provide additional paid leave supports when such public health emergencies were announced.

The COVID-19 pandemic served to highlight the challenges that families face in managing the dual responsibilities of work and caregiving, and served as a warning of how unanticipated events such as a public health emergency could completely undo the plans that families had developed for addressing such challenges. Research has documented the importance of paid leave in reducing the spread of COVID-19 at the start of the pandemic. Emergency policies were able to reach lower-wage service workers, reduce inequality in access to leave, and increase vaccination rates including among socially vulnerable populations. A great deal of suffering and lives might have been saved if such policies had been in place and familiar to workers at the start of the pandemic. Given the ongoing circulation of new variants and the threat of what a next virus might bring, COVID-19 strengthened the case for a national paid leave policy to protect workers and their families in health emergencies. Such a program should be broad, comprehensive, progressive, and responsibly financed. Based on existing state-level policies, a national policy should cover a wide range of family needs, provide leave for care needs across family types, provide adequate benefits to underpin family security, and protect jobs and workers from any retaliation for taking leave. It should also be structured to ensure that workers who need it most — low-income workers, workers of color, and other marginalized groups — can use it. This will require thoughtful design, outreach, and administration.

About the Authors

Jeff Hayes is a Survey Statistician with the U.S. Department of Labor Women’s Bureau. He can be reached at jeffrey.a.hayes@gmail.com.

H. Elizabeth Peters is an Institute Fellow at the Urban Institute in Washington DC and a Professor Emerita in the Department of Policy Analysis and Management at Cornell University. She can be reached at epeters@urban.org.

Across the United States, thousands of mothers of newborns are fighting a common enemy: postpartum depression. In 2022, the Centers for Disease Control found that 23% of pregnancy-related deaths stemmed from worsened mental health conditions, making them the leading cause of pregnancy-related deaths. Postpartum depression is so much more than a phenomenon known as the “baby blues.” The American Psychiatric Association classifies the “baby blues” as lasting one to two weeks with symptoms of restlessness, irritability, anxiety, and crying for no reason. While the “baby blues” typically resolve itself, postpartum depression takes professional intervention to improve the mother’s mental health. This information is especially prevalent given the rise in postpartum depression diagnoses and how postpartum depression affects some demographics of mothers more than others.

In a recently published study, a research team led by Khadka explored trends regarding postpartum depression, or PPD, over the past ten years, emphasizing trends between demographics of race, ethnicity, and body mass index. Analyzing 442,308 pregnancies occurring from 2010 through 2021 with still- and live births occurring at least 20 weeks into gestation, the researchers give critical results into staggering trends in diagnoses and patients with postpartum depression. Here is what the researchers found.

Startling General Trends

Of the 442,308 individuals included in the study, 61,556, or 13.9%, were diagnosed with postpartum depression, prescribed antidepressants within a year of childbirth, or both. Rates of postpartum depression increased nearly 10% (from 9.4 to 19.0%) over the ten years of the study. 

Several distinctions appeared when comparing the individuals diagnosed with postpartum depression and those without diagnoses. When compared to those without postpartum depression, those diagnosed were likely to be older mothers, ranging in age from 30 to 40. Diagnosed individuals had a higher likelihood of being non-Hispanic White and non-Hispanic Black. This group was found more likely to have not given birth for the first time and showed higher rates of obesity. Individuals with postpartum depression were also found to be more likely to smoke or consume alcohol at some point during their pregnancy. The distinctions of age, consumption of alcohol or smoking, and body mass are particularly interesting, as they could all contribute to additional physical stress on the pregnant body. 

Disproportionately Affected Races & Ethnicities

While rates of postpartum depression increased for all ethnicities and races from 2010 to 2021, some groups had a greater likelihood of being diagnosed than others. Relative to their population size, individuals of Asian and Pacific Islander descent saw the highest increase in postpartum depression in the ten years, with diagnoses increasing 10.2%. Non-Hispanic Black and Hispanic individuals saw the second and third most increases relative to their populations in the study, with diagnoses increasing by 12.8% and 9.9% among the respective groups. Those belonging to multiple ethnic and race groups (including Native Americans and Alaska Natives) saw an increase of 7.8% and non-Hispanic White individuals saw an increase of 8.3% relative to their populations. The largest overall increases were seen in Asian and Pacific Islander participants and non-Hispanic Black participants, with the former seeing a 280% increase and the latter seeing a 140% increase. 

Body Mass Index: Playing a Factor

The body mass index (BMI) of an individual also plays a factor in the likelihood of a postpartum depression diagnosis. Individuals across all five BMI classifications (underweight, normal weight, overweight, class I obesity, and class II/III obesity) saw an increase in diagnoses of postpartum depression. Similarly to the data on races and ethnicities, specific BMI groups saw an increase in diagnoses of postpartum depression. Individuals classified as being “obese” (class I BMI) or “morbidly obese” (class II/III BMI) saw particularly high rates of postpartum depression. Throughout the study, class I individuals increased from 11.0% to 21.2% in rates of diagnosis, and class II/III individuals increased from 14.9% to 24.4%, meaning that those with the highest body mass index experienced the greatest rates of postpartum depression diagnoses. When viewing the interaction between delivery year, race and ethnicity, and body mass index, the increasing trends across different BMI classes are similar across the race and ethnicity groups. 

What Action Must Be Taken

Across the ten years of this study, individuals across all ethnic and racial groups, in addition to all categories of body mass index, saw significant increases in diagnoses of postpartum depression. This rise in diagnoses of postpartum depression could, at least partially, be attributed to improved practices in psychological screenings and proper diagnoses. However, the burden that postpartum depression places on mothers highlights the ever-increasing need for better forms of mental health treatment to ensure improved outcomes in the mental health of mothers. This ever-increasing need is also extended to equitable treatment needs across different demographics of individuals. Postpartum depression’s impact on the well-being of both mother and child could be mitigated if efforts are steered toward addressing the mental health needs of certain groups with considerable risk, like women with greater body mass index. Alleviating health disparities based on race and ethnicity should also be of top priority if healthcare professionals want to see a decrease in postpartum depression diagnoses. This study stresses how closer monitoring and continued research on postpartum depression is necessary, providing great insight into how to shape public health initiatives regarding the well-being of mothers and children.

Sawyer Wampler is a senior at the Honors College of Missouri State University. They are double majoring in Political Science and Communication Studies while also serving as a research assistant for Dr. Alicia M. Walker in the Department of Sociology, Anthropology, and Gerontology. You can follow them and their academic/professional pursuits on Twitter/X at @wampler_sawyer

Reprinted from the Council on Contemporary Families Brief Reports

A briefing paper prepared by Daniel L. Carson, University of Utah, and Melissa A. Milkie, University of Toronto, for the Council on Contemporary Families symposium The COVID-19 Pandemic and the Future of Gender Equality (PDF).

The COVID-19 pandemic was a stressful time for American adults. Indeed, rates of clinical depression and anxiety were 300% higher in the early days of the pandemic than they were the previous year. Not only was there substantial concern and worry about the virus itself, but social measures to stem the virus spread (i.e., lockdowns; school closures) created work-family stressors for many adults, parents especially. Like other impacts of the pandemic, work-family stress was not distributed evenly as US mothers’ mental health appeared most negatively affected. Given pre-existing gender disparities in psychological well-being, the COVID-19 pandemic exacerbated gender inequalities in mental health. This brief focuses on gender differences in psychological distress and its links to work-family stressors during the COVID-19 pandemic. We highlight how the pandemic may have magnified existing differences in well-being between mothers and fathers and conclude with a discussion of interventions that are needed to reduce these inequalities.

COVID and Mental Health

In addition to its obvious costs to life and physical health, the COVID-19 pandemic took a big toll on psychological well-being. In the United States, estimates from the US Census Household Pulse Survey indicate that one-third of the adult population suffered from clinical levels of depression and anxiety during the early days of the pandemic. In contrast, estimates indicate that only 10% of US adults reported clinical levels of anxiety and depression in 2019. Worse yet, the number of depressed and anxious adults increased as the pandemic persisted, rising to more than 2 in 5 by the end of 2020. Today, psychological distress remains elevated compared to pre-pandemic levels. Estimates indicate that as of June 2023, nearly one-third of US adults still suffered from clinical levels of anxiety and/or depression.

Work and Family Roles and Psychological Distress During the COVID-19 Pandemic:

One of the primary reasons psychological distress increased during the COVID pandemic is that it created a great deal of stress in people’s work and family roles. Social distancing measures designed to stem the transmission of COVID (e.g., closures of schools, childcare centers, non-essential services, and changes in work conditions) had numerous impacts. First, many people experienced a reduction in social integration, social support, and loss of potentially valued identities – all of which are central to mental health. Indeed, loneliness and job loss were two of the strongest predictors of mental health during the pandemic. Job loss also threatened mental health through financial hardship.

Second, roles and their responsibilities became increasingly overwhelming, particularly for mothers, due to the loss of childcare, school, and informal parenting supports. Both men and women increased their time in housework and childcare during the pandemic, though women continued doing the majority share of these tasks. Time in both physical and mental domestic labor during the pandemic was positively associated with increases in psychological distress, but primarily for women. Yet, at least for a time, fathers increased their relative share of domestic labor, particularly when they were able to work from home; this increase in equality was associated with perceptions of better relationship quality among mothers. Occupational changes occurred too, with some jobs becoming potentially better due to remote work and less commuting time, and other jobs largely populated by women such as essential service, teaching, and health care work, becoming increasingly difficult due to potential virus transmission, staff shortages, and other problems.

Third, at least in the early days of the pandemic, conflicts between work and family obligations for US parents appear to have worsened, on average. Among those who remained employed during the pandemic, increases in distress were limited largely to parents and tied to work-family conflict and adjustments to paid work schedules. Parents who were essential workers had to worry about facilitating virtual school or arranging care, while remote-working parents faced with the blurring of boundaries between home and work, had to juggle paid work while simultaneously monitoring and educating children. In the US at least, psychological distress was tied especially to interference of domestic responsibilities with paid work and the associated guilt of not meeting obligations for one’s job. Nevertheless, when push came to shove, many parents, but mothers especially, cut back on paid work during the pandemic – likely to alleviate work-family conflict. Alas, altering paid work schedules was also associated with higher levels of distress.

Exacerbated Gender Disparities in Stress and Mental Health?

Gender disparities in mental health in the US grew during the COVID-19 pandemic, due to steeper declines in women’s mental health than men’s. This is likely due, in part, to the fact that women reported more feelings of social isolation, more job loss, more work-family conflicts, and are more susceptible to the negative effects of domestic labor on mental health than men. Though gender inequalities in mental health increased in the US, this was not the case everywhere. Indeed, cross-national examinations of psychological well-being reveal possible reasons why inequalities increased in the US and not in other places and also suggest interventions to protect mental health and reduce mental health disparities moving forward.

Studies from the US, UK, Canada, and Australia reveal that gender disparities in mental health grew in the US and UK but not in Canada and Australia. Moreover, the pandemic appeared to affect mental health to a lesser extent in Canada and Australia than in the US and UK. One reason for these differences is better government and worker supports in Canada and Australia. Though public policies to deal with job loss (e.g., unemployment insurance) were universally generous cross-nationally and appear central to limiting family financial loss, access to supportive leave and care policies varied. Compared to Canada and Australia, parents in the US and UK had no guaranteed access to paid parental/childcare leave, leaving parents in these countries potentially more financially, emotionally, and psychologically distressed. Domestic responsibilities increased broadly in all four countries, yet in the US and UK especially, parents had fewer resources to help them handle the increase in care and educational responsibilities.

Another reason for increased mental health disparities in the US appears to be individual and cultural beliefs about gender, work, and family. Ideal worker culture is particularly intense in the US compared to many other countries. As such, the existence of family-to-work conflict and family-to-work guilt and its ties to US parents’ distress during the pandemic is unsurprising. Additionally, though both men and women increased their performance of domestic labor during the pandemic, this increase was associated largely with increased distress among mothers only – which may be owed to persistent external and internal pressures toward intensive mothering. Indeed, in the US, beliefs in intensive mothering coupled with a lack of comprehensive public policy to limit the transmission of COVID, placed mothers at the forefront of protecting family health. Worries over COVID were especially associated with maternal stress in the US.

Discussion: What about gender inequalities in mental health beyond pandemic times?

Though the WHO declared an end to COVID-19 as a global health emergency in May 2023, levels of stress and distress in US society are as high today as they were in 2020 when the pandemic started. Questions remain, therefore, as to the long-term impact of the pandemic on mental health and gender disparities in psychological well-being. While the jury is still out as to the full impacts of the pandemic for men versus women, and the longevity of some of the changes and their sequelae, research provides a potential roadmap for how to protect mental health moving forward, especially for parents, and reduce gender disparities.

Given the centrality of work to mental health, job losses during the pandemic likely had significant, long-term impacts. Mothers in less resourced positions may have been the worst off. Women’s labor force participation rates returned to pre-pandemic levels in 2023, though the most disadvantaged mothers lagged behind as of 2022. Efforts to return mothers to the paid labor force, and avoid penalizing them for interruptions to paid work during the pandemic, are essential to promoting gender equality moving forward.

Though rates of labor force participation have returned to normal, one change that is proving to last is remote work, as a much larger portion of workdays are currently done remotely compared to pre-pandemic times. Yet, whether the new climate of remote work reduces or exacerbates gender disparities in mental health may depend on how it is used and by whom. Prior to the pandemic, a substantial proportion of parents reported elevated levels of distress linked to time deficits with their children. During the pandemic, parents were able to spend more time with children in part due to remote work, suggesting that remote work may have somewhat protected mental health, at least for mothers. Potentially, valued time with children could continue in some form post-pandemic for those with increased access to autonomy, remote work, or other expanded control over paid work commitments, leading to improvements in well-being.

At the same time, working mothers managed homeschooling much more so than fathers and were overloaded due to stretched roles of supervision and care while children were locked down. Women experience more work-family conflicts due to high expectations at home and job characteristics (i.e., less autonomy) that don’t provide them enough or the right kinds of freedom or resources. Though being home has benefits by potentially providing more parental fulfillment and easing of managing home demands, remote work by mothers coupled with primary responsibility for domestic labor, without partners also stepping up, would likely exacerbate gender mental health disparities. In contrast, remote work by fathers could reduce gender disparities broadly, including in mental health. Not only does domestic labor have little impact on men’s mental health (vs. the negative effect for women), but men who work remotely also do more domestic labor. This was true both before and during the pandemic.

In all, the pandemic allowed us to see more closely the problems with work roles, family roles and connection between them that undermine mental health in the US. Both structures and cultures need to change in order to better people’s, especially women’s, lives. Structurally both government and workplace policies matter; the exacerbated gaps between U.S. mothers’ and fathers’ mental health that emerged due to overwhelming demands in roles and work-family conflict could be mitigated by policies such as paid parental/childcare leave, increased autonomy, remote work, low-cost quality child care, a 4-day workweek and so on. Additionally, direct child credits, as well as guaranteed paid time off and vacations could go a long way to reducing work-family conflicts and stressors through provision of financial supports. Yet, despite the pandemic creating a great reflection about our values around time, relationships, and work, the culture of ideal workers and intensive parenting that contributes to higher work-family conflict and pushes mothers out of paid work may be harder to change. Regardless, more awareness and social change toward “work-family justice” is possible. Nonetheless, the conversation surrounding work-family justice and gender equality must also include a discussion of parental well-being. Parents’ mental health is important not only in its own right, but also through those they care for – our future generations. The tolls of the pandemic on mental health and gender disparities in mental health cannot be ignored.

About the Authors

Daniel L. Carlson is Associate Professor of Family and Consumer Studies at the University of Utah and Treasurer of the Council on Contemporary Families. He can be reached at daniel.carlson@fcs.utah.edu. You can follow him on Twitter at @DanielCarlson_1.

Melissa A. Milkie is Professor of Sociology and Chair of the graduate department at the University of Toronto. She’s also Professor Emerita at the University of Maryland, and she served recently as President of the Work and Family Researchers Network. Professor Milkie can be reached at melissa.milkie@utoronto.ca and you can follow her on Twitter at @melissamilkie.

Nicholas H. Wolfinger is Professor of Family and Consumer Studies and Adjunct Professor of Sociology at the University of Utah. His previous books include Understanding the Divorce Cycle: The Children of Divorce in Their Own Marriages (Cambridge University Press, 2005), Fragile Families and the Marriage Agenda (edited, with Lori Kowaleski-Jones; Springer, 2005), Do Babies Matter? Gender and Family in the Ivory Tower (with Mary Ann Mason and Marc Goulden; Rutgers University Press, 2013), and Soul Mates: Religion, Sex, Children, and Marriage among African Americans and Latinos (with W. Bradford Wilcox; Oxford University Press, 2016). Wolfinger is also the author of about 40 articles or chapters, as well as short pieces in The Atlantic, Huffington Post, and other outlets. His edited collection Professors Speak Out: The Truth About Campus Investigations will be published by Academica Press later this year. Matthew McKeever is Professor of Sociology and Department Chair at Haverford College. His research focuses on the structure of social inequality within a variety of institutional, cultural, and regional contexts, from the U.S. and Europe to South Africa and Asia. This work examines different theories regarding the distribution of education, occupation, and income, and how processes that determine the distribution of these resources vary regionally.   Before coming to Haverford he was at Mount Holyoke College, teaching in the Department of Sociology and Anthropology.  He has also taught at Rice University, University of Houston, University of Kentucky, and Yale University. He received his Ph.D. from UCLA, and his B.A. from Haverford. Here, they talk to us about their new book, Thanks for Nothing: The Economics of Single Motherhood since 1980.

AMW: How has the profile of single mothers changed from the 1980s to today, and what impact does that have on poverty rates?

NHW & MM: In 1980, families headed by single mothers were five times as likely to be poor as two-parent families. Forty-five years later, single mothers were still almost five times as likely to have incomes below the poverty line. How can that be, given the gains in education and employment women have made over the past few decades?

Our book shows that the answer to this question stems from changes in the kinds of women likely to become single mothers. In 1980, most single moms were divorced women; by 2025, the majority are women who had children out of wedlock. On the basis of over 130 charts, we establish that there are profound differences between the two kinds of single mothers. On paper, divorced mothers look a lot like married mothers. The primary difference lies in the absence of a spousal income.

Never-married mothers are a totally different story. To be sure, they have less education and other forms of human capital than do divorced mothers, but their disadvantage is much more pervasive. Even when they do get college degrees, the pecuniary returns are much smaller than they are for divorced mothers (let alone married mothers). We also show that this disadvantage is multigenerational. Never-married mothers are themselves more likely to come from single-parent families. Indeed, they’re less likely to grow up in households with library cards or newspaper subscriptions.

So that’s the science behind the book: a deep dive into the ecology of poverty over the past few decades.

AMW: Why did you frame your research around Daniel Patrick Moynihan and Sara McLanahan’s work, and what did their ideas contribute to your findings?

NHW & MM: Our research connects directly to the work of Daniel Patrick Moynihan and Sara McLanahan, two figures whose ideas have shaped how scholars think about family structure and poverty. In 1965, Moynihan’s report about race, poverty, and single motherhood sparked widespread controversy. Many came to see the report as blaming the victim, and academics studying the family spent the next decade running away from the idea that family structure was something that merited scholarly inquiry (these academics also ignored Moynihan’s structural explanation for poverty, his call for massive investment in disadvantaged communities, and later his proposal for a universal basic income). This was the state of affairs Sara McLanahan encountered as a postdoc (and a single mother) at Madison in 1980. She set out to prove Moynihan wrong, thus launching a very accomplished career as one of our foremost scholars of family structure and poverty (it seemed almost anticlimactic when Sara and Christopher Jencks published an article in 2015 titled “Was Moynihan Right?”)

When we first started thinking about single mothers and poverty way back in the 1990s, Sara McLanahan’s work was the single greatest scholarly influence. As we finished up the book decades later, we realized that we’d come full circle, right back to where Sara McLanahan had started: Daniel Moynihan and his 1965 report.

AMW: How do your findings address conservative claims about welfare disincentivizing work and provide evidence that social programs improve economic outcomes?

NHW & MM: We’d start by pointing out that the majority of people in single-parent families are children, and thus fall victim to benefit cuts predicated on how their parents are supposed to behave.  Our data analysis shows that government transfers comprise an ever shrinking pool of economic benefits for these families—average benefits have fallen, and while they remain an important source of funds for the poorest families, they go to fewer and fewer single mothers. And notice the broader trend: cash welfare gradually disappeared over the same years that the rate of nonmarital births skyrocketed.

Our book challenges the conservative assertion that public aid undermines work by highlighting evidence from programs like the Earned Income Tax Credit (EITC) and the 2021 Child Tax Credit (CTC). These initiatives have demonstrated that direct cash transfers reduce poverty without discouraging labor force participation. For instance, the expanded CTC during the pandemic lifted millions of children out of poverty, and studies revealed no significant decline in maternal employment. About 90% of the CTC funds were spent on necessities like food and housing, showcasing its effectiveness in ameliorating the consequences of poverty​.

We thus contend that welfare is not a disincentive to work (or, for that matter, to get married), emphasizing that providing financial support does not deter work but instead helps families maintain stability. These arguments align with the observations of the late Daniel Patrick Moynihan. The federal government is good at redistributing income but little else when it comes to families. In particular, it is singularly ineffective when it comes to changing cultural attitudes, such as those surrounding marriage.

This leads us to argue that those concerned about American families and children should support bipartisan proposals like the Romney-Bennet bill in 2019, which would have funded universal cash transfers, regardless of recipient income. A government initiative like this could sustainably alleviate economic hardship. These programs counter poverty without the stigma or fecklessness of marriage-promotion policies, focusing on empowering single mothers and thereby improving the lives of their children. These are objectives best accomplished through economic stability rather than cultural engineering.

Alicia M. Walker is Associate Professor of Sociology at Missouri State University and the author of two previous books on infidelity, and a forthcoming book, Bound by BDSM: What Practitioners can teach Everyone about Building a Happier Life (Bloomsbury Fall 2025) coauthored with Arielle Kuperberg. She is the current Editor in Chief of the Council of Contemporary Families blog, serves as Senior Fellow with CCF, and serves as Co-Chair of CCF alongside Arielle Kuperberg. Learn more about her on her website. Follow her on Twitter or Bluesky at @AliciaMWalker1, Facebook, and Instagram @aliciamwalkerphd

American attitudes toward marriage and divorce are changing. In a recent survey, 40% of Americans said they were pessimistic about the future of marriage and the family, and only one-quarter said that having children or being married was very important to having a fulfilling life. Indeed, only about 10% of Americans think that getting married or having children are extremely important as a milestone for adulthood. Americans have held tolerant views of divorce for a while, and a recent Gallup poll shows that 81% of Americans think that divorce is morally acceptable.

Given these shifts in attitudes, we recently conducted a study of attitudes towards marriage and divorce when children are involved. We use data from the American Marriage Survey, conducted across the United States in late summer 2021. The survey includes 2,789 American adults. We created an attitudinal measure to see whether people hold one of the following views:

• Pro-institutionalization attitudes: those who agree that couples who have children should get married and should try to stay married for the sake of their children.
• Marriage deinstitutionalization attitudes: those who do not agree that couples who have children should get married but agree that people should try to stay married for the sake of their children.
• Divorce deinstitutionalization attitudes: those who agree that couples should get married but do not agree that people should stay married for the sake of their children.
• Transformational deinstitutionalization attitudes: those who do not think people should get married or stay married for children.

What do Americans think about marriage and divorce?

A majority of Americans (55%) disagree that people should get married and stay married if children are involved. A little more than one-fifth of Americans (22%) think that couples with children should get married but also think that people don’t need to stay married for their children. Only 16% of Americans are what we might call “traditional” in that they think people should get and stay married for the sake of their children. All in all, people are generally okay with the idea that marriage is not really necessary even when children are involved.

Who is more likely to think people with children don’t need to get married or stay married?

• Women – cis women are 2.7 times as likely as men to think that people with children don’t need to get married or stay married (a similar pattern exists for trans and nonbinary individuals, but it was not significant).
• LGB adults – gay and lesbian adults are 2.4 times as likely and bisexual and pansexual adults are 3.7 times as likely as heterosexual adults to think that people with children don’t need to get married or stay married.
• People who are not married – those who are cohabiting are 1.7 times as likely and those who are divorced or separated are 1.5 times as likely as married individuals to think that people with children don’t need to get married or stay married.

What are the implications of these findings?

We provide evidence of transformative change in Americans’ views as not only do a majority of people support divorce, but this coexists with attitudes that are supportive of not marrying even when children are involved. Attitudes are often linked with behaviors. While there has been a lot of attention to the prevalence of divorce over the last few decades, the concern over declines in marriage may rise as fewer people get married. According to the American Community Survey, 25% of 40-year-old Americans have never married. The US has historically attached many benefits to marriage related to tax, social security, insurance, and public assistance. With clear evidence that people do not feel the need for marriage even when children are involved, there should be more attention paid to policies that provide benefits regardless of marital status. Families come in all shapes and sizes, and there is greater need for policies addressing health care, housing, and multi-parent custody. Finally, there should be consideration of access to legal status and connections that may tie people together outside of the traditional confines of marriage.

Gayle Kaufman is the Maddrey Professor of Sociology and Gender & Sexuality Studies at Davidson College. They study gender, sexuality, and family attitudes, marriage, fatherhood, work and family, and LGBTQ+ families. You can follow them on Bluesky at @gaylekaufman.bsky.social.

D’Lane Compton is a Full Professor of Sociology at the University of New Orleans. Their research focuses on sexual, gender, and family inequalities through social psychology and demographic analysis. You can follow them on Bluesky at @drcompton.bsky.social.

Lucas is a SSHRC Postdoctoral Fellow at University of Toronto Mississauga and was formerly the Justice, Equity, and Transformation Postdoctoral Fellow at University of Calgary. He is the editor of Shame-Sex Attraction: Survivors’ Stories of Conversion Therapy (JKP Books), and he is the author of At Home with the Holocaust: Postmemory, Domestic Space, and Second-Generation Holocaust Narratives (Rutgers University Press), which received the Jordan Schnitzer First Book Publication Award. His public-facing writing has appeared in The Advocate, Queerty, LGBTQ Nation, and Religion Dispatches, among other venues. He is currently working on an edited collection about queer experiences at Christian colleges, universities, and seminaries. You can follow him on Twitter, Instagram, Bluesky, LinkedIn, Facebook, & Threads

AMW Your book highlights the persistence of conversion practices, even in places where they are legally banned. Can you elaborate on how these practices continue to exist underground and the challenges this presents for victims and advocates?
LW: Like all crime, conversion therapy will continue to happen in places where it is banned; just because something is outlawed does not mean it will no longer happen. It oftentimes just means that such illegal activity will go underground. The most common contexts in which conversion practices take place, including in places where it is banned, are Christian churches and ministries. These organizations do not label their efforts to change queer individuals’ sexualities and genders “conversion therapy.” Rather, they use euphemisms—like “pastoral counseling,” “biblical counseling,” and “sexual addiction counseling”—to obfuscate their dirty and damaging work.

These efforts to conceal their conversion practices pose several challenges for victims and advocates alike. Victims are made more vulnerable because those practicing conversion therapy in religious spaces are able to get away with their efforts to change queers; conversion practitioners hide behind religion, arguing that they are helping queers pursue spiritual wholeness, when in reality they are practicing textbook conversion therapy that wreaks psychological, emotional, and spiritual havoc on their victims. For advocates, this euphemistic language, in tandem with religious organizations hiding behind their sincerely held (homophobic and transphobic) beliefs, makes it more difficult to find conversion-therapy programs. Regardless, we advocates will not stop doing our best to expose organizations that practice conversion therapy and to support survivors.

AMW: Shame is a recurring theme in the narratives of conversion therapy survivors. How do you see shame being used as a tool within these practices, and what impact does it have on survivors’ identities and recovery journeys?

LW: Often, shame is what first draws individuals into conversion therapy, and it is also typically one of the main consequences of such practices. Unless they were forced into conversion therapy by their parents, religious communities, or otherwise—and even then, many have long been made to feel ashamed of their queerness—most who undergo conversion therapy are motivated to change themselves by the shame they have been made to feel throughout their lives. Indeed, why would they submit themselves to conversion practices, if it were not for feeling like who they are is dirty, defective, and/or damaged? This shame is then compounded during and/or after conversion therapy. Individuals frequently realize that, despite their efforts to change their sexualities and/or genders, they will never change, which causes them to feel like failures (especially in God’s eyes) and thus amplifies the shame they had felt for years about being queer. As both a significant motivator for and a common outcome of conversion therapy, shame is a necessary ingredient in such death-dealing practices.

AMW: Your book explores the connection between conversion practices and broader cultural and religious systems. What do you think needs to change within these systems to meaningfully address and dismantle the conditions that allow conversion therapy to persist?

LW: Much needs to change. If we think about conservative Christianity specifically, we need to recognize that such a religious system is wildly allergic to difference, especially when it comes to gender and sexuality. Insofar as conservative Christianity is predicated on a binary understanding of the world—black vs. white, of God vs. of the enemy, etc.—there is no room for diversity in numerous senses; everything is considered either right or wrong, and if it does not align with conservative Christian dogma, it is labeled evil or even demonic. This does not allow for productive dialogue.

As such, we need to view this conservative religious system for what it is: emphatically dangerous. We are already seeing the consequences of white Christian nationalism in the United States after Trump regained power, and we will continue to see how destructive this way of thinking and being is. With conversion practices being only a part of this system that seeks the erasure of anyone or any group that looks different from conservative Christians, we must be vigilant and work against the colonizing efforts of the Christian Right to homogenize society in its own image. If we don’t—and I don’t think this is in any way hyperbolic—life as we know it will be radically different soon.

Alicia M. Walker is Associate Professor of Sociology at Missouri State University and the author of two previous books on infidelity, and a forthcoming book, Bound by BDSM: What Practitioners can teach Everyone about Building a Happier Life (Bloomsbury Fall 2025) coauthored with Arielle Kuperberg. She is the current Editor in Chief of the Council of Contemporary Families blog, serves as Senior Fellow with CCF, and serves as Co-Chair of CCF alongside Arielle Kuperberg. Learn more about her on her website. Follow her on Twitter or Bluesky at @AliciaMWalker1, Facebook, and Instagram @aliciamwalkerphd

Reprinted with permission from Newsweek

President Donald Trump has begun his rampage on reproductive rights, and it’s as bad as we expected. Not content with the usual script for every GOP administration coming into power since 1984, of halting US aid to groups providing or even discussing abortion, Trump’s move is true to his brand of mean-spirited, punitive retribution against the most vulnerable. His version of the directive stops the flow of funds not just to organizations providing family planning assistance, but to those offering a wide range of health services—with dire consequences for people across the world seeking not only contraception and abortion, but HIV treatment, child nutrition, and treatment for malaria and tuberculosis.

A 2019 analysis has shown that GOP-led funding cuts have actually had the effect of increasing abortions by 40 percent. That’s a clear sign, if we needed one, that the policy is not about protecting unborn lives but about punishing women. And though the Trump directive has occasioned rightful ire from reproductive rights advocates and others on the liberal end of the political spectrum, on one level the distinction between Trump’s move and increasingly prevalent liberal arguments for increased birth rates is one of degree, not kind.

On this level, the Trump eructation of hateful decrees designed to reduce women to their reproductive capacity is merely the logical extension of the belief, widely accepted all along the political spectrum, that making babies is a social good in itself. This pronatalist worldview is so prevalent on the right and the left and the center; in countries the world over; in religions and families and songs and stories; in the redemption arcs of sitcom heroines; and in the doctor’s offices that deny young women elective sterilization but never question a decision to carry a pregnancy to term, that it has a profound effect on narrowing the spectrum of reproductive choices that people feel are available to them.

In Iran, once a leader in family planning, recent legislation has restricted access to abortion and contraception, required programming in state-run media that promotes childbearing and denounces single, childfree, and small-family choices, and required removal of educational content deemed to discourage childbearing at Iranian universities. Russia has signed into law a ban on “childfree propaganda,” which bans any person or organization from promoting the childfree lifestyle or encouraging people, either in person or online, not to have children. Leaders of two South Indian states have called for women to have more children, in a transparent bid to increase funding allocation for their states.

These efforts are all just desperate attempts by world leaders to bolster their own economic and political power by controlling women’s reproduction. They compound pronatalist pressures felt in the home, as in low-income countries where many women must use contraception without the knowledge of their husbands to avoid divorce or domestic violence.

It is in these countries where women endure the most oppressive pronatalist and patriarchal environments that Trump’s gag rule will hit hardest. Previous iterations of the rule saw disrupted contraception and abortion from Kenya to Nepal, with emboldened conservative Christian organizations launching highly visible anti-abortion campaigns and targeting women and health care workers with intimidation and harassment.

The truth is that the liberal tendency to view Trump’s pronatalist overreach as some unprecedented aberration is unfounded. Trump’s extension of the global gag rule, horrifying as it is, is along a continuum of policies and cultural norms that have defined and limited women’s lives at every level, for millennia. Even progressive policies implemented with the goal of increasing birth rates feed into the time-honored but outdated cultural institution of pronatalism, as they view women not as human beings with the absolute right to make their own reproductive choices, but as tools to achieve economic growth or political power.

To be sure, a safety net that ensures quality of life for all citizens—particularly children and the most vulnerable—should be a baseline provision of the social contract. But we should be skeptical of any government that adopts these measures with pronatalist intentions and not simply because they are the right thing to do. As the experience of Finland demonstrates, even the most generous such policies are unlikely to raise birth rates. In countries all over the world, once women experience the freedom and financial benefits of having fewer children, they are not turning back.

This is why fighting the egregious assaults on reproductive rights by Trump 2.0 is not enough. These assaults are enabled by a cultural landscape that normalizes the notion that women’s purpose is to breed children and assumes that high birth rates would emerge as women’s “natural” choice if only conditions were supportive. When we are told, for example, that American women state in surveys that they have fewer children than their ideal number, we should consider the centuries of pronatalist conditioning that have shaped that “ideal.”

And we should be fighting not only the global gag rule, but the global institutions and cultural norms that pressure women to have children for any reason and interfere with their right to choose any number of children or none at all. At a time when multiple cascading ecological crises, escalating global military conflict, and worsening levels of wealth inequality and poverty threaten our species and others across the globe, we should be embracing global women’s turn toward smaller family and childfree choices, and doing everything possible to ensure that these choices are celebrated and protected.

Kirsten Stade is a conservation biologist and communications manager of the NGO Population Balance. She has worked for more than two decades for nonprofits fighting extractive industries on public lands, safeguarding the integrity of regulatory science, and challenging growth-biased media narratives and political institutions. You can learn more about her here https://www.populationbalance.org/

Abigail Ocobock is a sociologist of families, sexualities, and gender. She has been researching and writing about marriage for over a decade. Her work has appeared in journals like The American Journal of Sociology and The Journal of Marriage and Family as well as in publications such as The Atlantic, Bustle, Slate, and The Daily Beast. Her 2024 book, Marriage Material: How an Enduring Institution is Changing Same-Sex Relationships, published by The University of Chicago Press, draws on interview data with over 100 LGBQ+ individuals, who were among the first to gain access to legal same-sex marriage. She examines how marriage is changing same-sex relationships, and how same-sex couples are changing marriage. You can find out more about Abigail at her website. And you can follow her on Bluesky @abiocobock.bsky.social

 AMW: How do LGBTQ+ people challenge heteronormative assumptions about marriage?

AO: That depends. What types of marriage behaviors are you imagining? Which kinds of LGBTQ+ people are you thinking of? Do you want to know how they try to, or only how they succeed?

LGBTQ+ people regularly resist marital practices that center on assumptions of gender inequality and sexual ownership. Widely shared beliefs emanating from the LGBTQ+ community concerning gender equality and sexual freedom provide them with alternative scripts for behavior.

Engagement proposals stand out as an example. Older LGBTQ+ people who had sustained long-term relationships prior to legal access to marriage usually rejected the need for a proposal, seeing them as a heteronormative practice unnecessary for their relationships. Younger LGBTQ+ people in newer same-sex relationships tended to be much more heteronormative. They insisted on proposals for signaling commitment and as the epitome of romance. Yet they also often insisted on equality in proposal practices. They argued that in heterosexual relationships a man proposing symbolizes his ownership and control of the woman. They made conscious efforts to ensure both partners were mutually proposed to instead. But escaping heteronormativity is not always so easy, and same-sex couples unconsciously bought into heteronormative ideas even while consciously rejecting others. Heterosexual men’s proposals also symbolize his readiness to commit based on gendered ideas about men’s weaker commitment. Some LGBTQ+ people subscribed to a gender-neutral version of this idea, arguing that the person who most needed to demonstrate commitment should be propose first.

Another area in which LGBTQ+ people challenged heteronormativity was marital nonmonogamy. Many sustained non-monogamous marriages. Moreover, many “currently monogamous” individuals displayed a remarkable openness to nonmonogamy as a future relationship form. They believed that spouses should attend to changing sexual desires and needs, and prioritize relational commitment over fidelity. More accurately defined as sexually fluid than monogamous, they were consciously questioning the marital monogamy norm. However, the security they felt to explore nonmonogamy emanated in part from a heteronormative belief that marriage represents a unique form of relational commitment, that outside sex could therefore less easily undermine. In these ways, and others, we observe a messy mix of both heteronormative and LGBTQ+ cultural beliefs and practices in same-sex marriage.

AMW: How does marriage change the dynamics of same-sex relationships?

AO: To be clear, marriage already influenced the dynamics of same-sex relationships before it became legal to marry. Many same-sex couples drew on marital meanings and rituals in their relationships, for example by exchanging rings and having commitment ceremonies, even though they never expected the institution to legally include them.

But after same-sex marriage became legal we observe a much more transformative impact. Half the LGBTQ+ people who participated in my study had formed relationships prior to the availability of legal marriage, half only afterward. The stark contrast between their relationships makes the impact of marital access clear. Younger LGBTQ+ individuals who had come of age with access to legal marriage enacted their relationships very differently than older LGBTQ+ individuals who had sustained relationships without it. For the younger cohort, marriage was taken-for- granted, widely conceived as the norm, and required for relationship investment and success. New dates were vetted as potential marriage material. Reassurances about marriage were needed to feel secure. And marriage was a regular source of tension and conflict in their relationships. This was not usually true for the older cohort, who were better able to conceptualize love and commitment outside of a marital model.

Access to marriage has brought many gains for same-sex couples, including providing a clearer model for long-term relationship planning, the enjoyment of participating in widely recognized cultural practices for relationships, and a way to gain social validation and legitimacy. These freedoms serve to make same-sex relationships more easily legible between partners and to others. But same-sex relationships have also lost something important—the freedom from marriage. Having access to legal marriage has limited what LGBTQ+ people are able to imagine. It shapes how they evaluate potential partners and then narrowly defines commitment and security, creating qualitatively new forms of work, anxiety, and conflict.

AMW: Why does marriage persist even though family life has changed so much?

AO: Americans might be waiting longer to marry, cohabiting first, and having children outside of marriage, but most young Americans still want and expect to marry. Looking at marriage from an institutional perspective, my research shows that marriage persists because it remains a powerful institution with the ability to shape our choices. It operates through three broad institutional mechanisms – regulative, normative, and cultural-cognitive – which work independently and in tandem.

The regulative part of marriage operates through formal rules and laws, such as the policies of state and federal governments, which provide married couples access to rights denied to the nonmarried. So long as marriage maintains a monopoly over important rights and protections the institution will persist. I saw this power among LGBTQ+ people who did not want to marry and who critiqued marriage as an institution, but who nonetheless ultimately decided to marry, or expected to do so in the future, for no other reason than to gain access to some benefit, such as health insurance.

The normative part of marriage helps it persist through informal norms, expectations, and values. People continue to marry because they feel a sense of duty or social pressure to do so, or because they have internalized expectations that marrying is the right thing to do. Many younger LGBTQ+ people believed marrying before having children was the “right thing to do,” despite having only vague understandings of why. Some LGBTQ+ people who did not want to marry also found themselves succumbing to social pressure to marry their more enthusiastic partners, because their own political rejection of marriage was made to feel “selfish” or “immature” in comparison to their partner’s more socially approved of desire for marriage

Lastly, the cultural-cognitive part of the institution ensures marriage persists by establishing shared ideas about what has meaning and shaping what people are able to imagine for themselves. Individuals often marry simply because they cannot conceive of alternatives as meaningful ways to live. Despite the recency of access to legal marriage, many younger LGBTQ+ people took for granted that marriage represents a unique form of relational commitment like. As such, they simply could not imagine long-term relationships without it. So long as our culture promotes this idea, marriage will persist – even if the regulative and normative based mechanisms driving marriage weaken.

Alicia M. Walker is Associate Professor of Sociology at Missouri State University and the author of two previous books on infidelity, and a forthcoming book, Bound by BDSM: What Practitioners can teach Everyone about Building a Happier Life (Bloomsbury Fall 2025) coauthored with Arielle Kuperberg. She is the current Editor in Chief of the Council of Contemporary Families blog, serves as Senior Fellow with CCF, and serves as Co-Chair of CCF alongside Arielle Kuperberg. Learn more about her on her website. Follow her on Twitter or Bluesky at @AliciaMWalker1, Facebook, and Instagram @aliciamwalkerphd

The COVID-19 pandemic brought unprecedented challenges, causing widespread financial strain, heightened mental health struggles, and deepening existing inequalities across communities. While this wave of challenges was felt nationwide, for some, these challenges were magnified. Two such groups particularly impacted by the COVID-19 pandemic include those exposed to incarceration—either directly or through a partner—and those who experienced a pregnancy during the COVID-19 pandemic. Indeed, incarceration is a stressful experience, not just for those behind bars but for their loved ones as well. Going through the uncertainty of the COVID-19 pandemic was a hardship for millions of Americans, but handling this stress while dealing with the impacts of having a husband or partner incarcerated and during pregnancy can amplify stress levels and stressful experiences.

Incarceration is not just an isolated event. It reverberates through families, especially during periods of instability like a pandemic. Even before COVID-19, incarceration exposure has been tied to economic and emotional hardships. During the pandemic, these existing issues were compounded, leading to even more struggles for those trying to navigate pregnancy and prepare for a newborn. When a partner or loved one is incarcerated, families are often in need of critical sources of support. The pandemic made accessing community resources and social networks that could have provided some relief even harder. Under these conditions, these valuable resources are even more critical when coupled with preparing for a birth or caring for a newborn. Even so, whether women exposed to incarceration during pregnancy endured heightened stressors had not been subject to research.

Our Study

Our study explored how exposure to incarceration affected women’s experiences during the initial months of the COVID-19 pandemic. Using data from the 2020 Pregnancy Risk Assessment Monitoring System (PRAMS), we analyzed responses from recent mothers in 17 states that participated in a special COVID-19 supplement. The survey included questions about various stressors brought on by the pandemic, such as job loss, difficulty paying rent, food insecurity, and mental health struggles.

To understand the impact of incarceration, we assessed differences in COVID-19-related stressors between women who had experienced incarceration themselves or through a partner in the year before giving birth and women who had not reported such experiences. The findings showed that women exposed to incarceration reported significantly more COVID-19-related stressors than their peers. On average, they experienced about five different stressors, compared to fewer than three among those without incarceration exposure. They were over twice as likely to face difficulties such as homelessness, increased anxiety, and depression, physical, sexual, or emotional aggression from a husband/partner, as well as problems paying bills and meeting basic necessities like food. For example, nearly 39% of incarceration-exposed women worried that food would run out, while only 14% of non-exposed women shared this concern. These results highlight the unique vulnerabilities that incarceration-exposed families faced during a time of widespread uncertainty and upheaval.

Implications

Our study emphasizes the need for more targeted support for families impacted by incarceration, especially during times of widespread crisis like a pandemic. Programs that focus on helping with housing stability, mental health support, and economic relief can make a big difference. For example, connecting families with community organizations offering public assistance or expanded access to home visiting programs could help ease the burden during tough times.

It is also important for healthcare providers to recognize the unique challenges faced by these families. Screening for incarceration exposure and other social determinants of health during prenatal visits could open the door to resources that can mitigate some of the hardships these families face. By focusing on holistic care that includes social and public assistance support, we can better aid mothers and their families through such challenging times.

While the height of the COVID-19 pandemic has passed, challenges—especially for families who faced compounded difficulties due to incarceration—show few signs of slowing down. As the babies born during 2020 grow into toddlers, their families continue to grapple with the long-term effects caused by the stressors endured by the pandemic and the ongoing collateral consequences tied to incarceration for families and children. Our research highlights a crucial need for policies and programs that support these vulnerable families, especially during their most critical moments.

Alexander Testa is an Assistant Professor in the Department of Management, Policy, and Community Health at the University of Texas Health Science Center at Houston. His research examines the consequences of criminal justice contact and violence exposure on health over the life course. Follow him on Twitter @testaalex

Chantal Fahmy is an Associate Professor in the Department of Criminology and Criminal Justice at The University of Texas at San Antonio. Her research focuses on reentry and reintegration from prison, health criminology, social support and social health, and the intersection of public health and incarceration. Her recent work has been published in Social Science & Medicine, American Journal of Preventive Medicine, Journal of Traumatic Stress, and Journal of Mental Health. Follow her on Twitter @ChantalFahmy

Benjamin Jacobs is a resident physician in Obstetrics and Gynecology at Duke University. His research interests center around adverse childhood experiences (ACEs) and its impact on the prenatal, perinatal, and postpartum periods. Follow him on Twitter @ben_m_jacobs1

Dylan B. Jackson is an Associate Professor in the Department of Population, Family and Reproductive Health at the Johns Hopkins Bloomberg School of Public Health. He is a developmental and health criminologist who uses a life-course lens to study the intersection of crime, criminal legal system contact, and health among children, adolescents, and families. His research aims to inform policies and interventions that 1) promote health as a developmental crime-prevention tool, and 2) reduce health inequities for children, adolescents, and families impacted by crime and the criminal legal system. Follow him on Twitter @Dr_DylanJackson

When was the last time you heard someone say they wanted sex that was just “good”? Ever heard anyone wax nostalgic about an “average” sexual experience they had? Probably not.

Whether scrolling through social media, thumbing through glossy magazine pages, or even in late-night chats with friends, the talk is always about making sex great. But what actually separates great sex from the merely good?

In a companion piece published earlier, we explored how chemistry, connection, and orgasms topped the list for “great sex” components. With Valentine’s Day around the corner, we thought you might enjoy learning about three more surprising but essential ingredients for great sex: sexual skills, sexual responsiveness, and sexual mindfulness.

1. Sexual Skills: More Than Just Techniques

Sure, knowing your way around your partner’s body is important. But sexual skills go beyond just technique. They include reading body language, understanding non-verbal cues, and adapting to your partner’s unique needs and desires. As one participant explained, “It’s about knowing when to lead, when to follow, and when to simply listen.” For them, great sex wasn’t just about physical acts; it was about creating an experience of mutual understanding and connection.

Yet, as with any skill, there’s a catch. When sexual prowess becomes a competition or a source of personal validation, the focus shifts from connection to ego. One man shared, “I caused a lot of first orgasms, and I’m prouder of that than anything else I’ve done.” For some, sexual prowess can become a source of personal validation, shifting the focus from mutual connection to individual ego. Great sex demands shared joy, not a race to the orgasm finish line.

2. Sexual Responsiveness: Listening Without Words

You definitely don’t want to feel like you’re invisible during a sexual encounter. Participants described bad sex as encounters where their partner was oblivious to their needs, treating them more like an accessory than an equal participant. As one woman put it, “I could have been a blow-up doll, and it wouldn’t have mattered.”

Responsiveness changes the game. It’s about tuning into your partner’s signals, both verbal and non-verbal, and showing genuine care for their pleasure—or even their lack of desire. In healthy relationships, responsiveness fosters trust and a sense of safety, allowing couples to navigate everything from mismatched libidos to periods of low sexual interest. As one woman said, “Sex with my lover is GREAT sex no matter what is added or what is remiss. He always has ‘ME’ in mind when he is thinking of his next move. No matter if it’s what can I do with this ice cube or what happens if I touch her there. There’s always tomorrow, and it’s always good, or we stop, readjust, and try something else new or something that is tried and true.”

3. Sexual Mindfulness: Being Fully Present

Imagine this: You’re completely in the moment, free from insecurities about your body or worries about how you’re “performing.” You’re not thinking about tomorrow’s to-do list or whether you left the stove on. You’re just… there. That’s sexual mindfulness, and according to our participants, it’s a hallmark of great sex. One woman shared, “When I let go of my insecurities and focused entirely on the sensations, it was like discovering a new level of intimacy.” Many participants explained how being fully present can transform a sexual encounter into a profoundly connected experience.

But mindfulness can be elusive, especially for those grappling with body image issues. One woman confessed, “The lights were on, and I just feel less insecure with them off.” For many women, societal pressures about appearance create barriers to fully enjoying the experience. However, as body confidence grows, so does the ability to relax and embrace the moment.

What Does This Mean for You?

These findings challenge us to think beyond the basics of “good sex” advice like trying new positions or spicing things up. Instead, they invite us to focus on the deeper, often overlooked aspects of connection:

• Are you actively honing your sexual skills by learning about your partner’s desires?
• Do you practice responsiveness, making sure your partner feels heard and valued in the bedroom?
• And finally, can you let go of distractions and insecurities to be fully present?

Alicia M. Walker is Associate Professor of Sociology at Missouri State University and the author of two previous books on infidelity, and a forthcoming book, Bound by BDSM: What Practitioners can teach Everyone about Building a Happier Life (Bloomsbury Fall 2025) coauthored with Arielle Kuperberg. She is the current Editor in Chief of the Council of Contemporary Families blog, serves as Senior Fellow with CCF, and serves as Co-Chair of CCF alongside Arielle Kuperberg. Learn more about her on her website. Follow her on Twitter or Bluesky at @AliciaMWalker1, Facebook, and Instagram @aliciamwalkerphd