postpartum depressive illness

Last edited 03/2021 and last reviewed 03/2021

Moderately severe depressive illness can occur during the puerperium. The peak incidence appears to be at 3 months but with significant numbers of cases still appearing by 6 months and after.

A systematic review calculated the incidence and prevalence of depression in the postnatal period (i.e. antenatal and postnatal))(1)

  • pooled prevalence was 11.9% of women during the perinatal period (95% CI 11.4-12.5)
  • pooled prevalence for postnatal depression of 9.5% (95% CI 8.9 to 10.1) in high-income settings and 18.7% (95% CI 17.8 to 19.7) in low- and middle-income settings

The usual features are similar to non-psychotic depression appearing in women at any other time of life.

  • postnatal depression is depression that occurs after a woman has given birth
  • an important and common disorder that can have short- and long-term adverse impacts on the mother, her child, and the family as a whole
  • associated with (2):
    • impaired maternal-infant attachment,
    • internalising and externalising problems in children of mothers who have postnatal depression
      • especially where the depression is severe and persistent and there are familial co-morbidities
  • characteristic features include:
    • persistent low mood and loss of pleasure or interests,
    • associated symptoms such as
      • changes in appetite and energy levels
      • sleep disturbance
      • low self-confidence

Possible risk factors include:

  • previous psychiatric history
    • evidence suggests that of women who experience postnatal depression (4)
      • around a third also had depression in pregnancy
      • and a third had pre-pregnancy depression
  • poor marital relationship
  • lack of social support
  • stressful life events
  • severe postnatal blues

It is important to distinguish postnatal depression from less severe, short-lived conditions, such as the "baby blues" (2)

  • "baby blues" occurs in approximately 50% of women and resolve spontaneously within a few days


  1. Woody CA et al. A systematic review and meta-regression of the prevalence and incidence of perinatal depression. Journal of Affective Disorders
  2. Howard LM et al. Non-psychotic mental disorders in the perinatal period. Lancet 2014;384(9956):1775-88.
  3. Stein A et al. Effects of perinatal mental disorders on the fetus and child. Lancet 2014;384(9956):1800-19
  4. Wisner KL et al. Onset timing, thoughts of self-harm, and diagnoses in postpartum women with screen-positive depression findings. JAMA Psychiatry 2013;70(5):490-8.