Your browser is unsupported

We recommend using the latest version of IE11, Edge, Chrome, Firefox or Safari.

Perinatal Depression

Useful tools and resources Heading link

perinatal depression

Perinatal depression is defined as depression during pregnancy up to one year postpartum. It is the most common complication of pregnancy and can affect up to 1 in 5 women according to the CDC. Perinatal depression (PD) is twice as common as Gestational Diabetes (CDC, 2018).

Perinatal depression frequently goes unrecognized. Fewer than 20% of women affected disclose mood symptoms to a healthcare provider (Prevatt, 2018). Depression screening rates are suboptimal and recent changes to recommendations have advocated for increased screening in pregnancy and the postpartum period (ACOG, 2016;  NICE, 2014; USPTF, 2016). Even when women screen positively for depression they often do not receive adequate mental health treatment.

A recent 2016 study found only 8.6% of pregnant women and 6.3% of postpartum women diagnosed with depression received adequate treatment (Cox, 2016).

Perinatal depression

Women with perinatal depression have historically low rates of help-seeking behavior and often also struggle to access care (Bauer, 2017; Gress-Smith, 2012; McGarry  2009). Lack of provider treatment knowledge, fear of medication risks, and the under-recognition of the risks of maternal mental illness to the mother-infant dyad limit adequate treatment.


Perinatal depression is associated with increased risk of poor prenatal care, maternal substance use, suicide, and multiple poor obstetric outcomes including preterm birth and operative deliveries (Grigoriadis, 2013; Şahingöz 2014). Postpartum depression is also associated with parenting difficulties, impaired attachment/bonding, and poorer child functioning at school and home (Avan, 2010; Field, 2011; Lodgson, 2006).

Long term, children with depressed mothers have higher rates of adolescent depression and difficulties in interpersonal relationships (Verbeek,2012).

Proper Recognition

Proper recognition and treatment of perinatal illness reduces maternal and child psychiatric symptoms, improves the quality of mother-child interactions and decreases risk of adverse childhood experiences (Pilowsky, 2008). Treatment may also avert adverse pregnancy outcomes related to antenatal depression (Venkatesh, 2016).

Perinatal Depression in Fathers Heading link

The Maternal Mental Health Leadership Alliance curated a fact sheet to discuss the prevalence, risk factors, impact and  treatment for fathers who may be experiencing perinatal depression.

Doc Assist Can Help!

 screening tools and communicating effectively with patients regarding diagnosis and treatment

 educate about risks of psychotropic medications in pregnancy or lactation

 selecting psychotropic agents with lowest risk profile

 weighing treatment options versus lack of treatment in the perinatal period

 symptoms to monitor in breastfeeding infants exposed to psychotropics

 evidenced based non-pharmacological treatments for perinatal mood disorders

Schedule a Consultation

Recognizing Perinatal Depression Heading link

Perinatal depression presents with:

  • Depressed mood or severe mood swings
  • Excessive crying
  • Difficulty bonding or lack of interest in baby
  • Withdrawing from family and friends
  • Changes in appetite
  • Inability to sleep (insomnia) or sleeping too much
  • Feeling overwhelmed or inability to make decisions
  • Fatigue or loss of energy
  • Decreased interest and pleasure in activities previously enjoyed
  • Intense irritability and anger
  • Feeling like a “bad mother”
  • Hopelessness
  • Feelings of worthlessness, shame, guilt or inadequacy
  • Anxiety especially anxiety related to baby’s health and safety
  • Recurrent thoughts of death or suicide
  • Thoughts to harm baby

Other Perinatal Mental Health Disorders Heading link

Perinatal depression is the most studied and publicized pregnancy-related mental health condition but pregnancy is also associated with onset or worsening of other disorders such as:

  • Anxiety
  • PTSD
  • Postpartum Psychosis
  • Bipolar Disorder
  • OCD symptoms

References Heading link

Centers for Disease Control and Prevention. Division of Reproductive Health. Depression Among Women.  Accessed December 27, 2018.
Prevatt B, Desmarais SL. Facilitators and barriers to disclosure of postpartum mood disorder symptoms to a healthcare provider. Maternal and Child Health Journal, (2018); 22(1):120-129.
American College of Gynecology. ACOG Statement on Depression Screening. January 2016. Accessed January 3, 2019.
National Institute for Health and Care Excellence (NICE). Antenatal and postnatal mental health: clinical management and service guidance. NICE clinical guideline 192. December 2014. Accessed on December 28, 2018.
United States Preventive Task Force. Final Recommendation Statement: Depression in Adults: Screening. January 2016. Accessed December 31, 2018
Cox EQ, Sowa NA, Meltzer-Brody SE, Gaynes BN. The perinatal depression treatment cascade: baby steps toward improving outcomes. The Journal of Clinical Psychiatry. 2016;77(9):1189-1200.
Bauer NS, Ofner S, Pottenger A, Carroll AE and Downs SM (2017). Follow-up of Mothers with Suspected Postpartum Depression from Pediatrics Clinics. Front. Pediatr. 5:212.
Gress-Smith JL, Luecken LJ, Lemery-Chalfant K, Howe R. Postpartum depression prevalence and impact on infant health, weight, and sleep in low-income and ethnic minority women and infants. Matern Child Health J (2012) 16(4):887–93.10.1007/s10995-011-0812-y
McGarry J, Kim H, Sheng X, Egger M, Baksh L. Postpartum depression and help-seeking behavior. J Midwifery Womens Health (2009) 54(1):50–6.10.1016/j.jmwh.2008.07.003
Grigoriadis S, VonderPorten EH, Mamisashvili L, et al. The impact of maternal depression during pregnancy on perinatal outcomes: a systematic review and meta-analysis. J Clin Psychiatry 2013; 74:e321.
Şahingöz M, Yuksel G, Karsidag C, et al. Birth weight and preterm birth in babies of pregnant women with major depression in relation to treatment with antidepressants. J Clin Psychopharmacol 2014; 34:226.
Avan B, Richter LM, Ramchandani PG, Norris SA, Stein A. Maternal postnatal depression and children’s growth and behaviour during the early years of life: exploring the interaction between physical and mental health. Arch Dis Child (2010) 95(9):690–5.10.1136/adc.2009.164848
Field T. Prenatal depression effects on early development: a review. Infant Behav Dev (2011) 34(1):1–14.10.1016/j.infbeh.2010.09.008
Logsdon MC, Wisner K, Billings DM, Shanahan B. Raising the awareness of primary care providers about postpartum depression. Issues Ment Health Nurs. 2006;27(1):59–73. doi: 10.1080/01612840500312860. [PubMed]
Verbeek T, Bockting CL, van Pampus MG, Ormel J, Meijer JL, Hartman CA, et al. Postpartum depression predicts offspring mental health problems in adolescence independently of parental lifetime psychopathology. J Affect Disord (2012) 136(3):948–54.10.1016/j.jad.2011.08.035
Pilowsky DJ, Wickramaratne P, Talati A, Tang M, Hughes CW, Garber J, et al. Children of depressed mothers 1 year after the initiation of maternal treatment: findings from the STAR*D-Child Study. Am J Psychiatry (2008) 165(9):1136–47.10.1176/appi.ajp.2008.07081286
Venkatesh KK, Riley L, Castro VM, et al. Association of Antenatal Depression Symptoms and Antidepressant Treatment With Preterm Birth. Obstet Gynecol 2016; 127:926.