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Pregnancy and childbirth usually bring feelings of joy and satisfaction. Sometimes these experiences activate post-traumatic stress, having lasting consequences for both mother and child.

Postpartum depression, the appearance of feelings of sadness and fatigue after giving birth to a baby, are not at all unusual. In fact, as many as 85% of all women may experience some degree of a diagnosable mood disorder within the first year of giving birth.

Most of the time, these new baby blues don't last very long and don't cause debilitating depression. In up to 15% of new mothers, however, postpartum depression can be both disabling and persistent, and 1 or 2 mothers in 1000 experience postpartum psychosis, a severe derangement of psychological functioning triggered by giving birth.

Why Is Postpartum Depression So Common?

The reason why nearly all new mothers experience some degree of postpartum depression is biological. A new mother's estrogen, progesterone, and cortisol levels all fall drastically during the first 48 hours after giving birth. Their energizing effects come to an abrupt halt. 

Amounts of these hormones, however, don't determine whether the postpartum mood changes are mild or severe. And giving depressed mothers of newborns estrogen replacement therapy actually can make depression worse.

Social support networks, and having a job to go back to, not surprisingly are linked to having fewer problems with postpartum depression.

The difficulty of the pregnancy, having to deal with complications of pregnancy, does not seem to have any direct bearing on the severity of postpartum depression, although finding out a child has been born with birth defects or health challenges, understandably, almost always does. 

The most significant factors in the severity of postpartum depression are about more than just the experience of pregnancy and childbirth. Researchers have found that:

  • Partner violence is more common in women who suffer postpartum depression, and healthcare providers need to be sensitive to the new mother's needs for physical protection when depression is diagnosed.
  • Women who have experienced a recent death in the family, who have financial difficulties, or who cannot find needed employment are more likely to have to deal with postpartum depression. And, significantly,
  • Women who have had to deal with postpartum depression after the birth of one child have a 90% chance of having to deal with another round of postpartum depression after the birth of another child.

Postpartum Depression Is Common, But Not "Natural"

Too often doctors dismiss depression in mothers of newborns as only natural. Most women suffer some degree of depression after giving birth, so it must be OK. But the fact is that many women continue to experience postpartum depression for months or even years after the birth of the child, affecting not just their quality of life but also the quality of life of the child and the entire family.

See Also: Baby Blues and Postpartum Depression (PPD): Causes and Treatment

Symptoms of depression after giving birth may remit spontaneously, but they sometimes persist indefinitely without medical intervention.

When depression, tearfulness, irritability, and anxiety peak four or five days after the birth of the child and go away within 2 weeks, most doctors will not attempt any kind of intervention, but when feelings of fatigue, sadness, anger, anxiety, and/or depression persist for 2 weeks or more, medical intervention is a must.

Continue reading after recommendations

  • Shalev, A.Y., Freedman, S., Peri, T., Brandes, D., Sahar, T., Orr, S., Pitman, R. (1998). Prospective study of posttraumatic stress disorder and depression following trauma. Am J Psychiatry, 155. pp. 630-637.
  • Soderquist, J., Wijma, B., Thorbert, G., Wijma, K. (2009). Risk factors in pregnancy for post-traumatic stress and depression after childbirth. BJOG: An International Journal of Obstetrics and Gynaecology, 16(5). pp. 672-680.
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