By Molly Mottram Associate Director, Ohio Suicide Prevention Foundation
The initial year following the birth of a child poses a vulnerable period for a new mother. Physical, emotional, and hormonal shifts, coupled with new responsibilities, can significantly impact a mother's well-being and family dynamics. These changes may cause a mother to be more susceptible to conditions like depression, anxiety, and in rare cases, psychosis—collectively known as Perinatal Mood and Anxiety Disorders (PMAD). Such disorders often lead to feelings of isolation and loneliness in mothers. Lack of adequate support places mothers facing postpartum mental health issues at a heightened risk of suicide, a major contributor to maternal-related deaths.
A recent study has shown that women who experience depression during pregnancy or within a year after giving birth are 6 times more likely to die early, mostly by suicide [i]. In another [ii] study by the American Journal of Obstetrics and Gynecology, nearly 9 percent of females who died by suicide in the past 10 years were pregnant or recently postpartum.
Perinatal mood and anxiety disorders are used interchangeably with postpartum depression. It serves as an umbrella term commonly referred to varying mental health conditions that can occur during the postpartum period including:
Postpartum Depression (PPD)
Postpartum Anxiety (PPA)
Postpartum Psychosis (PPP)
Bipolar Mood Disorders
Postpartum Obsessive-Compulsive Disorder (PPOCD)
Postpartum Post-Traumatic Stress Disorder (PPTSD)
PMAD symptoms can affect individuals across various cultures, ages, income levels, and races, occurring at any point during pregnancy or within the initial year post-childbirth. Between 15% and 21% of pregnant or postpartum women encounter PMADs, with one in seven experiencing postpartum depression and 13%-21% grappling with postpartum anxiety [iii].
African American and Hispanic women have the highest prevalence of postpartum depression, primarily attributed to the lack of social support and access to care and a history of trauma or prior depression. [iv]
There are several risk factors that can cause maternal mental health conditions including biological, social, environmental, or psychological such as:
Change in hormone levels after childbirth
Previous experience with depression or anxiety
Family history of depression or mental illness
Low or no social support
Gestational Diabetes
Pregnancy and birth complications[v]
PMADs have varying mental health conditions meaning symptoms can range from feeling sad or isolated to thoughts of self-harm and suicide and are different for each woman. Symptoms can include:
Feeling sad, depressed, or anxious
Feeling irritable or angry to those around you
Difficulty bonding or caring for the baby
Having intrusive or upsetting thoughts
Experiencing sudden mood changes
Thoughts of hurting the baby or feeling like you don’t want your baby[vi]
Leaving PMADS undiagnosed or untreated can have devastating impacts on new mothers, infants, and families. Many new moms experience feeling ashamed or guilty about their emotions or struggles with mental health that prevent them from seeking help. It is important to implement postpartum mental health screenings across the continuum of care and encourage more compassionate and supportive environments for new parents.
Supporting women facing postpartum depression and suicidal thoughts is a compassionate and preventive measure that benefits not only the individuals directly affected, but also their families including the child’s well-being and the broader community. It plays a pivotal role in fostering a culture of empathy, understanding, and collective well-being and reduces stigma.
Where to find help:
If you or someone you know is struggling with perinatal depression or anxiety or having thoughts of suicide, call or text the Suicide and Crisis Lifeline at 988 for free access to a trained crisis counselor who can provide you with support and connect you with additional help and resources. If you’re deaf or hard of hearing, use your preferred relay service or dial 711 then 988.
Additional resources include the National Maternal Mental Health Hotline at 833-TLC-MAMA (833-852-6262) for 24/7 free access to professional counselors. If you’re deaf or hard of hearing, use your preferred relay service or dial 711 then 833-852-6262. Call or text “Help” to the Postpartum Support International helpline at 800-944-4773 for PPD information, resources, and support groups for women, partners, and supporters.
[ii]https://journals.lww.com/greenjournal/Citation/2022/10000/Pregnancy_Associated_Homicide_and_Suicide__An.6.aspx