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Maternal Mental Health

Maternal mental health refers to a mother’s overall emotional, social, and mental well-being, both during and after pregnancy.

The terms “Perinatal Mental Health” and “Maternal Mental Health” both refer to mental health during the time of pregnancy and/or the postpartum period. In the U.S., the postpartum period is defined as the period from birth through one year. Clinicians often use the term perinatal. In Latin, “peri” means around, while “natal” refers to birth. The term perinatalis often confused with prenatal, which means “before” birth (or during pregnancy).

Maternal Mental Health Disorders

Maternal mental health conditions affect 800,000 families each year in the United States.1

Postpartum depression and postpartum anxiety are the 2 most common perinatal mental health or maternal mental health disorders.

The following provides an overview of maternal mental health disorders (also referred to as perinatal mental health disorders), including postpartum depression. This summary includes maternal mental health statistics, symptoms, and support.

Maternal Mental Health (MMH) disorders include a range of disorders and symptoms, including but not limited to depression, anxiety and psychosis. These disorders and symptoms can occur during pregnancy and/or the postpartum period (together often referred to as the perinatal period).

When left untreated these disorders can cause devastating consequences for the mother, her baby, her family and society.

These illnesses can be caused by a combination of biological, psychological and social stressors, such as lack of support, a family history, or a previous experience with these disorders.

Maternal anxiety and maternal depression are the most common complications of childbirth, impacting up to 1 in 5 women, yet they are not universally screened for, nor treated.

The good news is that risk for both depression and anxiety can be reduced and sometimes prevented, and with treatment women can recover.

Overview of Maternal Mental Health Conditions

The Baby Blues

Up to eighty percent (80%) of women will experience the “baby blues” after giving birth, tied to sudden shifts in hormones.2

  • Women who experience the baby blues may feel sad, have mood swings and crying episodes.
  • The Blues are not considered a disorder as the symptoms often resolve within a few days. If symptoms persist, beyond two weeks, it’s likely the mother is suffering from depression.

Pregnancy and Postpartum Depression

(Also referred to as maternal depression, peripartum depression or perinatal depression.) A Major Depressive Disorder with onset during pregnancy or within 4 weeks of birth though in practice it is applied to depression occurring within the first year from birth. Up to twenty percent (20%) of women experience clinical depression during and/or after pregnancy.3

  • Maternal depression is treatable during pregnancy and postpartum.
  • Symptoms can range from mild to severe and, mothers with pre-existing depression prior to or during pregnancy are more likely to experience postpartum depression.
  • Maternal depression is treatable and risk can also be mitigated.
  • Symptoms generally include sadness, trouble concentrating, difficulty finding joy in activities once enjoyed, and difficulty bonding with the baby.

Research shows that the onset of depression occurs before delivery for the majority of women. Depression onset occurred prior to pregnancy among 27% of women, during pregnancy for 33%, and in the postpartum period for the remaining 40%. Therefore, it is important to screen for depression throughout the pregnancy and during the postpartum period.4


Maternal Dysthymia

Dysthymia is defined as a low mood occurring for at least two years, along with at least two other symptoms of depression.

  • Women with pre-existing dysthymia may be at a higher risk for severe symptoms/depression during the perinatal period.

Pregnancy and Postpartum Anxiety

Up to fifteen percent (15%) of women will develop anxiety during pregnancy or after childbirth.

  • Anxiety is treatable during pregnancy and postpartum.
  • Symptoms often include restlessness, racing heartbeat, inability to sleep, extreme worry about the “what if’s” – like what if my baby experiences SIDS, what if my baby falls, what if my baby has autism, etc.; extreme worry about not being a good parent/being able to provide for her family.

Pregnancy and Postpartum OCD

Fairbrother et al., found the prevalence rate for perinatal OCD to be 7.8% during the prenatal period and 16.9% during the postpartum period.

OCD includes obsessions (an unwanted thought or feeling) that a person has an urge to relieve through an action or a “compulsion.” OCD “obsessions” can include intrusive thoughts (see below for more information about intrusive thoughts). About 50% of women with OCD have intrusive/unwanted thoughts about intentionally harming their infant (e.g., throwing the baby).5 

It is important to note that although obsessions often contain alarming content they do not represent a psychotic process, where mothers are at a higher risk of harming themselves or their infants/children.


Birth Related PTSD

The prevalence of postpartum PTSD is 3.1%.6 Most often, this illness is caused by a real or perceived trauma during delivery or the postpartum period.

  • These women are plagued with intrusive memories and flashbacks of the event.


Mental Health Questionnaires

Questionnaires called “screening tools” are used to determine if someone may be suffering from a maternal mental health disorder. You can find these screening tools here.


Other Features and Factors:

Birth Loss and Grief

Expectant mothers who experience miscarriage or stillbirth are also at risk for postpartum mental health disorders including PTSD in addition to grief or complicated grief. In the U.S. 10-15 percent of known pregnancies, end in miscarriage and 1 percent of all pregnancies end in still birth (March of Dimes). According to the CDC Black mothers face double the stillbirth rate as White women in America. Native Americans face the second highest stillbirth rates.


Postpartum Mania

Women may suffer from an extreme inability to sleep, where a mother simply isn’t tired. She generally feels elated, and enthusiastic about completing tasks and motherhood. This is considered a state of hypomania or mania which may or may not be tied to an underlying bipolar disorder.

A state of mania is not in and of itself dangerous but because mania/severe lack of sleep may lead to impulsive and high risk behavior and can be a precursor to psychosis, it’s critically important that the mother receive clinical support from a psychiatric provider experienced in reproductive mental health.


Postpartum Psychosis

Postpartum psychosis is a rare/disorder symptom and occurs in approximately 1 to 2 out of every 1,000 deliveries, or approximately 0.1-0.2% of births. 

The onset is usually sudden, most often within the first 2 weeks postpartum.

The most significant risk factors for postpartum psychosis are a personal or family history of bipolar disorder, or a previous psychotic episode.

Postpartum Psychosis is considered a medical emergency due to the potential for a mom to harm herself or her baby.


Intrusive Thoughts

70-100% of women (and their partners) have “intrusive” thoughts surrounding childbirth/the postpartum period. These thoughts may include thoughts of infant harm (e.g., dropping the baby or a woman herself harming her baby). These thoughts are unwanted (ego-dystonic) and recognized by the woman as inappropriate and concerning, (which is why these thoughts alone are not cause for alarm).

It is important to note that although obsessions often contain alarming content they do not represent a psychotic process, where mothers are at a higher risk of harming themselves or their infants/children. Intrusive thoughts are not considered a “disorder.” When symptoms become persistent and are disabling, they are generally thought to be tied to OCD.


Facts About Maternal Mental Health and Substance Use Disorder

In reference to maternal mortality (maternal death), the CDC defines “Maternal Mental Health Conditions” to include both mental health and substance use disorders. Maternal Mental Health conditions are the leading cause of maternal mortality pregnancy-related). Suicide and overdose are responsible for nearly 23% of maternal deaths.


National Maternal Mental Health Hotline:

Health Resources & Services Administration

  • Free, 24/7, confidential support, resources and referrals to any pregnant and postpartum mothers facing mental health challenges and their loved ones.
  • The National Maternal Mental Health Hotline’s counselors provide real-time emotional support, encouragement, information, and referrals. Pregnant and postpartum women can get the help and resources they need, when they need it.
  • Call or text, 1-833-9-HELP4MOMS (1-833-943-5746) to connect with counselors at the National Maternal Mental Health Hotline. Learn more at www.MCHB.HRSA.gov/national-maternal-mental-health-hotline

Support for Those Not in Crisis:

Postpartum Support International

NOTE: Postpartum Support International is not a crisis hotline and does not handle emergencies.


Support for those Who Are Suicidal or in Severe Distress:

The National 988 Suicide & Crisis Lifeline

The 988 Suicide & Crisis Lifeline (formerly known as the National Suicide Prevention Lifeline) provides free and confidential emotional support to people in suicidal crisis or emotional distress 24/7, across the United States. The Lifeline is comprised of a national network of over 200 local crisis centers, combining custom local care and resources with national standards and best practices.

If you need immediate help, please call or text 988 to talk with a trained counselor. A chat feature is available on the website: 988lifeline.org

People call to talk about lots of things: substance abuse, economic worries, relationships, sexual identity, getting over abuse, depression, mental and physical illness, and loneliness, to name a few.

  • The line is available to anyone in suicidal crisis or emotional distress.
  • Callers are routed to their nearest crisis center to receive immediate counseling and local mental health referrals.
  • The lifeline supports people who call for themselves or someone they care about.

Línea de Prevención del Suicidio y Crisis
1-888-628-9454

Lifeline Options For Deaf + Hard of Hearing
For TTY Users: Use your preferred relay service or dial 711 then 988.

  1. Werner, E., Miller, M., Osborne, L. M., Kuzava, S., & Monk, C. (2015). Preventing postpartum depression: Review and recommendations. Archives of Women’s Mental Health, 18(1), 41–60. https://doi.org/10.1007/s00737-014-0475-y ↩︎
  2. Wisner, K. L., Sit, D. K. Y., McShea, M. C., Rizzo, D. M., Zoretich, R. A., Hughes, C. L., Eng, H. F., Luther, J. F., Wisniewski, S. R., Costantino, M. L., Confer, A. L., Moses-Kolko, E. L., Famy, C. S., & Hanusa, B. H. (2013). Onset timing, thoughts of self-harm, and diagnoses in postpartum women with screen-positive depression findings. JAMA Psychiatry (Chicago, Ill.), 70(5), 490. https://doi.org/10.1001/jamapsychiatry.2013.87 ↩︎
  3. Chaudron, L. H., Szilagyi, P. G., Tang, W., Anson, E., Talbot, N. L., Wadkins, H. I., Tu, X., & Wisner, K. L. (2010). Accuracy of depression screening tools for identifying postpartum depression among urban mothers. Pediatrics, 125(3), e609–e617. https://doi.org/10.1542/peds.2008-3261 ↩︎
  4. Luca, D. L., Garlow, N., Staatz, C., Margiotta, C., & Zivin, K. (2019, April). Societal Costs of Untreated Perinatal Mood and Anxiety Disorders in the United States. Mathematica. https://www.mathematica.org/publications/societal-costs-of-untreated-perinatal-mood-and-anxiety-disorders-in-the-united-states ↩︎
  5. Fairbrother, N., Challacombe, F. L., Collardeau, F., & Truong, T. T. (2022). Perinatal and postpartum obsessive-compulsive disorder. In E. A. Storch, J. S. Abramowitz, & D. McKay (Eds.), Complexities in obsessive-compulsive and related disorders: Advances in conceptualization and treatment (pp. 249–269). Oxford University Press. https://doi.org/10.1093/med-psych/9780190052775.003.0014 ↩︎
  6. American Psychological Association. (2018). Generation Z stressed about issues in the news but least likely to vote. Stress in America. Stress In America. https://www.apa.org/news/press/releases/2018/10/generation-z-stressed
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