The arrival of a baby is often celebrated as a joyous occasion. But for some new parents, this time can be overshadowed by feelings of sadness, anxiety, and exhaustion.
Perinatal depression encompasses both prenatal depression (during pregnancy) and postpartum depression (after childbirth). While it is a common condition affecting up to 20% of pregnant and postpartum people, the health consequences can be significant – for both mother and baby.
Perinatal depression includes persistent feelings of sadness, hopelessness, and worthlessness, perinatal depression can significantly impair a mother’s ability to function and bond with her baby. While it’s normal for new mothers to experience mood fluctuations and occasional moments of doubt or worry, perinatal depression involves persistent symptoms that interfere with daily life and can escalate into a serious mental health crisis if left untreated.
Perinatal depression takes a profound toll on maternal health, affecting not only emotional well-being but also physical health and overall quality of life.
All pregnancies with singletons between 2001 and 2017 in the Swedish medical birth register were screened, 86551 women were identified with a first ever diagnosis of perinatal depression compared with 865510 controls. The risk of death was increased in the perinatal depression women that were not confounders. It is associated with pregnancy complications including pre-eclampsia and gestational diabetes. It is also associated with reduced physical activity resulting in higher weight retention after pregnancy. Suicidal ideation and attempts were more common in this group. Leading to long term mental ill health recurrent depression, premenstrual disorders and bipolar affective disorders. Increased risk of cardiovascular disease and autoimmune disease.
The study above shows that the mother’s health can be affected by increased risk of suicide, pre-eclampsia, gestational diabetes, long-term mental ill-health and chronic physical ill-health. The physiological stress response associated with depression can disrupt the hormonal balance and compromise the immune system, potentially impacting foetal development and maternal health outcomes.
Women experiencing perinatal depression may neglect their own self-care and engage in unhealthy coping mechanisms, such as substance abuse, overeating, or avoiding medical appointments. Disrupted sleep patterns, poor nutrition, and lack of exercise can exacerbate depressive symptoms and contribute to a cycle of deteriorating physical and mental health.
The child’s health can also be affected with premature birth, low birth weight and developmental delay. Perinatal depression can have profound implications for infant health and development, shaping the child’s emotional, cognitive, and behavioural outcomes in the long term.
Infants born to mothers with untreated depression may experience disruptions in attachment and emotional regulation, affecting their ability to form secure attachments, regulate emotions, and develop healthy social relationships later in life. Children exposed to maternal depression during the perinatal period may be at higher risk of cognitive deficits, behavioural problems, and emotional disorders, including anxiety, attention-deficit/hyperactivity disorder (ADHD), and conduct disorders.
Feelings of detachment, guilt, and inadequacy may hinder maternal-infant bonding, leading to difficulties in breastfeeding, sleep disturbances, and strained parent-child relationships.
Perinatal depression can strain family relationships and undermine the cohesiveness of the family unit, leading to increased stress, conflict, and instability in the child’s environment. These relational disruptions can have lasting effects on the child’s emotional well-being and social development.
The stigma surrounding mental illness, particularly during pregnancy and early motherhood, can exacerbate feelings of shame, embarrassment, and social isolation for women experiencing perinatal depression. Fear of judgment or perceived failure as a mother may prevent women from seeking help or confiding in friends and family, further perpetuating the cycle of silence and suffering.
The most important things are that perinatal depression is common, there are specialist teams in England to treat this condition with all its complexities, and with specialist clinicians it is easy to treat.
Unfortunately, new mothers are often isolated and when they do not feel as they are expected to feel they do not know how to seek help.
Despite its prevalence and profound impact, perinatal depression remains vastly underdiagnosed and undertreated, with many women suffering in silence due to stigma, shame, or lack of awareness. However, it’s essential to recognise that perinatal depression is a treatable condition, and timely intervention can make a significant difference in both maternal and infant outcomes.
Healthcare providers play a crucial role in identifying and addressing perinatal depression through routine screening and assessment during pregnancy and the postpartum period. Validated screening tools, such as the Edinburgh Postnatal Depression Scale (EPDS), can help healthcare professionals detect symptoms of depression and initiate appropriate interventions.
Women experiencing perinatal depression require comprehensive, multidisciplinary care that addresses their physical, emotional, and social needs. This may include counselling, psychotherapy, medication management, support groups, and peer support services tailored to the unique challenges of pregnancy and early motherhood.
The support of partners, family members, and close friends is instrumental in helping women cope with perinatal depression and navigate the challenges of parenthood. Encouraging open communication, empathy, and practical assistance can alleviate feelings of isolation and promote maternal well-being.
Access to community resources, mental health services, and peer support networks is essential for women seeking help for perinatal depression. Advocacy efforts aimed at raising awareness, reducing stigma, and improving access to perinatal mental health care can empower women to seek support and overcome barriers to treatment.
Promoting maternal mental health requires a holistic approach that addresses the social determinants of health, including poverty, discrimination, housing instability, and access to healthcare. Investing in policies and programs that support maternal well-being, such as paid family leave, affordable childcare, and mental health parity, can create a supportive environment for women and families during the perinatal period.
Perinatal depression is a significant public health concern with far-reaching implications for maternal and infant health. The realities of perinatal depression and its profound impact on maternal and infant well-being need to be addressed with greater awareness, compassion, and support for women and families. Through collaborative efforts among healthcare providers, policymakers, advocates, and communities, we can ensure that every mother receives the care, support, and treatment she needs to thrive during pregnancy and early motherhood, laying the foundation for a healthier, more resilient future for generations to come.