Perinatal mental health refers to a woman’s mental health during pregnancy and the postpartum period. The vast majority of research on perinatal mental health examines non-psychotic common perinatal mental disorders (CPMDs), and the majority of studies focus specifically on anxiety and depression.
Research from high-income countries has revealed that 7%-15% of women suffer from antepartum depression, and about 10% of women experience postpartum depression. Available evidence suggests that perinatal mental health issues are more common in low- and middle-income countries (LMICs): According to a 2011 systematic review, the average prevalence of prenatal CPMDs was 16% in LMICs and the average prevalence of postpartum CPMDs was 20%, but these figures were calculated based on limited data from relatively few countries. A more recent systematic review based on data from more countries reported an average prevalence of 25% for prenatal depression among women in LMICs, and an average prevalence of 19% for postpartum depression. Prevalence estimates vary widely and are likely low. Inadequate screening and referral systems often result in women with perinatal mental health issues going undiagnosed and untreated.
A number of social determinants including socioeconomic status, race/ethnicity and a lack of social support influence a woman’s risk of experiencing perinatal mental health issues and the likelihood that she will seek and receive adequate treatment. Fear of stigma can also prevent women from seeking care. However, even if a woman seeks care, she may not have access to the services she needs. Providing high quality perinatal mental health services is particularly difficult in low-resource settings with limited health workforces.
While the prevalence of suicide during pregnancy or postpartum in different contexts is unknown, perinatal mental health issues sometimes lead to self-harm—one of the leading causes of women’s deaths around the globe. Furthermore, perinatal mental health issues can continue after the immediate postpartum period, affecting not only the woman, but also her child. A systematic review of studies in LMICs found associations between perinatal mental health issues and preterm delivery, low birth weight, impaired postnatal infant growth, insecure infant-mother attachments and suboptimal breastfeeding practices.
Additional efforts are needed to identify risk factors and develop culturally appropriate interventions to ensure that all women experiencing perinatal mental health issues are properly screened, diagnosed and treated.