Perinatal Mental Health
Perinatal Mental Health
The transition to parenthood is a life changing experience with significant physical and psychological adjustments for the entire family. Many parents experience mood changes and feel overwhelmed during pregnancy and/or after the birth of their child. When these symptoms do not resolve on their own, worsen in severity and begin to affect a person’s quality of life, they may be experiencing a perinatal mental health disorder. While the term “Postpartum Depression” has been used in the past, perinatal mental health conditions are actually a spectrum of experiences that can affect individuals during pregnancy and/or postpartum that include postpartum depression as well as a variety of other conditions. Birthing individuals are not to blame or at fault for experiencing a perinatal mental health condition: it is not brought on by anything a person has or has not done. Perinatal mental health disorders occur in people of every culture, age, income level and ethnicity. Treating perinatal mental health conditions may help prevent long-term and adverse effects for parents, children and families.
The spectrum of perinatal mental health conditions includes:
-
Perinatal depression
-
Perinatal anxiety and panic disorders
-
Obsessive compulsive disorder (OCD)
-
Post-traumatic stress disorder (PTSD)
-
Perinatal bipolar disorder and postpartum mania
-
Postpartum psychosis
-
Perinatal substance use
-
Parental suicide
-
Complicated grief after perinatal loss
Note: Pregnancy and parenting are not gender or sex exclusive. Throughout this webpage you will see language that leaves room for many different birth experiences and outcomes. Importantly, the language used in the “Perinatal Mental Health Statistics'' section of this page refers to the participant populations as identified by the researchers who conducted the studies. All people who identify with pregnancy and parenting can be affected by mental health conditions during the perinatal period regardless of gender, sex, or sexual orientation.
On this webpage, we provide basic information about perinatal mental health conditions as well as a compilation of resources from the MHTTC and other reputable sources for the medical and mental health workforce. We also recognize that perinatal mental health conditions are expressed differently across different cultures. Where possible, we have included links and resources to culturally-relevant materials.
Perinatal Mental Health Findings
While exact rates of perinatal mental health conditions are not known, recent studies provide us with some information about their incidence and risk factors:
-
About 70-80% of new parents experience mood swings and feelings of being emotionally and physically overwhelmed after having a baby. These symptoms, sometimes called “baby blues,” usually resolve on their own after 1-2 weeks. On the other hand, perinatal mental health disorders are usually more persistent, of higher intensity, and require treatment.
-
Perinatal mental health symptoms are very common.
-
Depression is considered the most common complication associated with childbirth. It affects at least 1 in 7 women during pregnancy and postpartum (Wisner et al., 2013).
-
Approximately 13–21% of women are affected by anxiety during pregnancy or the postpartum period (Fairbrother et al., 2015).
-
-
Although perinatal mental health symptoms are relatively prevalent, these conditions can be stigmatized, making it difficult for individuals to ask for help. Unfortunately, up to 50% of mothers will never seek treatment (CDC, 2008).
-
Stigma may hinder a person’s recognition of the presence of perinatal mental health distress and help-seeking behavior (O’Mahen & Flynn, 2008).
-
Women report that they feel ashamed that their perinatal mental health concerns and symptoms may be seen as signs of personal failure; they fear their social network will disapprove (Fonseca, Moura-Ramos, & Canavarro, 2018).
-
Stigma was the most important barrier to women’s help-seeking process (Silva (2015) as cited in Fonseca, Moura-Ramos, & Canavarro, 2018).
-
-
Pre-existing mental health conditions are a risk factor. At least 60% of women with perinatal depression have experienced a mental health condition in the past (Wisner et al., 2013).
-
While perinatal mental health conditions can affect individuals of all backgrounds, individuals of low socioeconomic status and of racial-ethnic minority may have a higher likelihood of developing one of these conditions.
-
Individuals of Latinx heritage exhibit a higher prevalence of perinatal mental health disorder(s) and are less likely to be identified or receive adequate and culturally competent mental health care (Lara-Cinisomo, Clark, & Wood, 2018).
-
Another study found that less than half as many low-SES African American women received counseling or medication in the six months after giving birth compared to white women of low SES. The African American women also had lower rates of follow-up and continued care (Kozhimannil, 2011).
-
A larger proportion of women of Native American and Alaska native or indigenous identity experience mental health symptoms during the perinatal period relative to the general population. More research is needed to better understand the nature and extent of perinatal distress within this group (Bowen et al., 2014).
-
-
More than 10% of fathers experience depression and anxiety during the perinatal period (O’Brien et al., 2017).
-
Social support can buffer against the onset and severity of perinatal mental health conditions. Notably, these results do not differ by race/ethnicity, suggesting that social support is an important protective factor for individuals affected by depression during the perinatal period regardless of identity (Pao et al., 2019).
MHTTC Products and Resources
Perinatal Mental Health Learning Series: Strategies and Considerations for Behavioral Health and Health Care Providers | MHTTC Network
Session 1: Awareness and Detection of Perinatal Mental Health Concerns
Session 2: Evidence-Based Treatment for Perinatal Mental Health Disorders
This virtual learning series intended for health and behavioral health providers who work with individuals affected by mental health symptoms during the perinatal period. Expert speakers emphasize increasing awareness and screening methods in perinatal mental health and health care, as well as psychotherapeutic treatment.
Black Women and Postpartum Depression | Central East MHTTC
Statistics show that up to 20 percent of women develop a perinatal mental health illness, such as depression or anxiety, either during pregnancy or within a year of giving birth. This fact sheet provides information about postpartum depression (PPD), and explains why women of color are more at risk for developing PPD.
I’ve Screened, Now What? Perinatal Depression Screening and Response; HHS Region 8 | Mountain Plains MHTTC
Screening for depression symptoms without established plans for follow-up interventions can create challenges and anxiety for providers working in a variety of settings. This training reviewed best practices when screening perinatal populations for depression, and when needed, how to implement a team-based response to patients expressing thoughts of suicide. This session also examined unique barriers experienced by perinatal persons when seeking care and discuss the importance of referral pathways for connecting individuals to care.
Perinatal Depression | Mountain Plains MHTTC
It is estimated that 14-23% of women will experience depressive disorders during pregnancy; many of which will be misdiagnosed, undiagnosed and go untreated. This slide deck provides a brief overview of perinatal depression. An accompanying podcast enhances the slide content.
Perinatal Mental Health: Considerations for Health and Mental Health Professionals | MHTTC Network Perinatal Mental Health Coordination Group
The transition to parenthood is a life-changing experience with significant physical and psychological adjustments for the entire family. Many parents experience mood changes and feel overwhelmed during pregnancy and/or after the birth of their child. Many health and mental health care professionals do not receive training on helping new parents identify and manage mental health symptoms. Developed by the MHTTC Network's Perinatal Mental Health Coordination Group, this document is designed to help health and mental health professionals support persons who may be experiencing mental health symptoms and disorders during the prenatal and postpartum periods.
Perinatal Mental Health Disorders (PMHDs): Supporting Latinxs | National Latino and Hispanic MHTTC
Latinxs living in the US experience disparities in access and quality of mental health services. The social determinants of health, immigration status, immigration-related trauma, and the cumulative experience of inequality, combined with the vulnerability during pregnancy and postpartum may result in a higher risk for mental health symptoms. Perinatal Mental Health Disorders (PMHDs) is a term used to include the various disorders that can affect individuals during pregnancy and postpartum. This factsheet provides relevant information on cultural considerations for mental health providers working with Latinx populations experiencing or at risk for PMHDs.
Training and Technical Assistance Needs: Findings from a National Survey of Professionals Who Serve Individuals Experiencing Mental Health Symptoms During the Perinatal Period | MHTTC Network Perinatal Mental Health Coordination Group
The MHTTC Network's Perinatal Mental Health Coordination Group developed and distributed an electronic needs assessment to gauge training and technical assistance needs related to PMH. The needs assessment was distributed via email and social media to health, mental health, and addiction treatment providers; community health centers; and perinatal health contact lists. This document is a summary report of responses. These results will aid in the Network's collaboration with health and mental health professionals and stakeholders throughout the country and inform the development of products, training materials, and technical assistance
Understanding American Indian Perinatal Care and Cultural Considerations | National American Indian and Alaska Native MHTTC
Other Resources
National Maternal Mental Health Hotline: Call or text 1-833-9-HELP4MOMS (1-833-943-5746; English or Spanish)
Postpartum Support International Helpline: Call 1-800-944-4773 (#1 en Español or #2 in English)
References
Bowen, A., Duncan, V., Peacock, S., Bowen, R., Schwartz, L., Campbell, D., & Muhajarine, N. (2014). Mood and anxiety problems in perinatal indigenous women in Australia, New Zealand, Canada, and the United States: A critical review of the literature. Transcultural Psychiatry, 51(1), 93-111. doi:10.1177/1363461513501712
Centers for Disease Control (CDC). (2008). Prevalence of self-reported postpartum depressive symptoms—17 states, 2004–2005. Morbidity and Mortality Weekly Report, 57(14), 361–366.
Fairbrother, N., Young, A. H., Janssen, P., Antony, M. M., & Tucker, E. (2015). Depression and anxiety during the perinatal period. BMC psychiatry, 15, 206. doi:10.1186/s12888-015-0526-6
Fonseca, A., Moura-Ramos, M., & Canavarro, M. (2018). Attachment and mental health-seeking in the perinatal period: The role of stigma. Community Mental Health Journal, 54(1), 92-101. doi:10.1007/s10597-017-0138-3.
Kozhimannil, K. B., Trinacty, C. M., Busch, A. B., Huskamp, H. A., & Adams, A. S. (2011). Racial and ethnic disparities in postpartum depression care among low-income women. Psychiatric Services, 62(6), 619-625. doi:10.1176/appi.ps.62.6.619
Lara-Cinisomo, S., Clark, C. T., & Wood, J. (2018). Increasing diagnosis and treatment of perinatal depression in Latinas and African American women: Addressing stigma is not enough. Women’s Health Issues, 28(3), 201-204. doi:10.1016/j.whi.2018.01.003
Miller, L. & LaRusso, E. (2011). Preventing postpartum depression. Psychiatric Clinics of North America, 34, 53-65. doi:10.1016/j.psc.2010.11.010
O'Brien, A. P., McNeil, K. A., Fletcher, R., Conrad, A., Wilson, A. J., Jones, D., & Chan, S. W. (2017). New Fathers' Perinatal Depression and Anxiety-Treatment Options: An Integrative Review. American Journal of Men's Health, 11(4), 863–876. doi:10.1177/1557988316669047
O’Mahen, H., & Flynn, H. (2008). Preferences and perceived barriers to treatment for depression during the perinatal period. Journal of Women’s Health, 17(8), 1301-1309. doi:10.1089/jwh.2007.0631
Pao, C., Giuntivano, J., Santos, H., & Meltzer-Brody, S. (2019). Postpartum depression and social support in a racially and ethnically diverse population of women. Archives of Women’s Mental Health, 22, 105-114. doi:10.1007/s00737-018-0882-6
Wisner, K. L., Sit, D. K. Y., McShea, M. C., Rizzo, D. M., Zoretich, R. A., Hughes, C. L., …, & Hanusa, B. H. (2013). Onset Timing, Thoughts of Self-harm, and Diagnoses in Postpartum Women With Screen-Positive Depression Findings. JAMA Psychiatry, 70(5), 490–498. doi:10.1001/jamapsychiatry.2013.87
SAMHSA’s Disaster Distress Helpline is standing by 24/7 to support you during the pandemic & beyond. Toll-free, multilingual, & confidential support services are available to all residents in the U.S. & its territories. Call 1-800-985-5990 or text TalkWithUs to 66746 to connect with a trained counselor.