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.
- Perinatal Mental Health Series
The Lancet | November 2014
- Interventions for common perinatal mental disorders in women in low- and middle-income countries: A systematic review and meta-analysis
Bulletin of the World Health Organization | April 2013
- Migration and perinatal mental health in women from low- and middle-income countries: A systematic review and meta-analysis
BJOG | June 2016
- Perinatal psychiatric disorders: An overview
American Journal of Obstetrics & Gynecology | June 2014
- Epidemiology of maternal depression, risk factors, and child outcomes in low-income and middle-income countries
The Lancet | October 2016
- Grand challenges: Integrating maternal mental health into maternal and child health programmes
PLOS Medicine | May 2013
- Maternal depression and mental health in early childhood: An examination of underlying mechanisms in low-income and middle-income countries
The Lancet | October 2016
- Interventions to treat mental disorders during pregnancy: A systematic review and multiple treatment meta-analysis
PLOS One | March 2017
- Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: A systematic review
Bulletin of the World Health Organization | November 2011
- Women’s experiences of seeking and receiving psychological and psychosocial interventions for postpartum depression: A systematic review and thematic synthesis of the qualitative literature
Journal of Midwifery & Women’s Health | December 2017
- Thinking healthy: A manual for psychological management of perinatal depression
World Health Organization | 2015
- Screening for perinatal depression: Committee opinion
The American College of Obstetricians and Gynecologists | May 2015
- Basic counselling skills: A guide for health workers in maternal care
Perinatal Mental Health Project | 2013
- ACOG practice bulletin no. 92: Use of psychiatric medications during pregnancy and lactation
Obstetrics and Gynecology | April 2008
- Service development guidelines for facilities providing maternal mental health care
Perinatal Mental Health Project | 2010
The Role of the MHTF
The fifth MHTF-PLOS Collection features several open access papers about maternal mental health.
In June 2015, the MHTF Quarterly highlighted issues and resources related to maternal mental health.
In 2012, the MHTF partnered with the Public Library of Science (PLOS) to publish a collection of perspectives and original research on maternal health in the context of women’s health.
Meetings & Events
In April 2015, as a part of the Advancing Dialogue on Maternal Health Series, the MHTF hosted a panel discussion at the Woodrow Wilson Center to discuss ways of integrating mental health into maternal health programs.
Blog Series: Mental Health: The Missing Piece in Maternal Health