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Who is at risk for postpartum depression?

Postpartum depression is a depressive episode that affects a new mother. In many cases, it develops within 12 weeks of giving birth, but it can occur any time up to a year after the baby is born. This is a serious condition that affects not only the mother, but also her child, her partner and the family as a whole.

“Postpartum depression is a family affair,” says Dr. Cindy-Lee Dennis, senior scientist at the Women’s College Research Institute and Shirley Brown Chair in Women’s Mental Health Research at Women’s College Hospital.

“We know that it impacts child developmental outcomes: behavioural, social, cognitive outcomes,” she says. “We also know that it can negatively impact the relationship with her partner putting the partner at risk of developing depression and placing the child in a stressful home environment.”

Risk factors

Dr. Dennis notes that while it is a common condition experienced by 13 per cent of mothers, there are factors that put some women at greater risk for postpartum depression. The strongest risk factors are both psychosocial and mental health-related:

Mental health factors:

  • previous episodes of depression
  • depression during pregnancy
  • anxiety during pregnancy
  • significant “baby blues” after giving birth

Psychosocial factors:

  • lack of support, including social isolation
  • poor relationship with partner
  • high number of life stressors
  • exposure to intimate partner violence

About 10 per cent of fathers will also experience postpartum depression. Risk factors for the father developing depression include having previous mental health issues, and the mother experiencing postpartum depression.

“Often what you see is the mother develops the depression first, then later the father can also develop depression,” says Dr. Dennis.

Prevention

Recent evidence suggests that preventive treatment may help avert postpartum depression. A review completed by Dr. Dennis of 28 randomized controlled trials looking at preventive options showed that psychosocial and psychological interventions can decrease the risk of postpartum depression by about 22 per cent. Psychosocial and psychological interventions include things like support from a healthcare professional in the home, such as home visits from a public health nurse or midwife early in the postpartum period.

Dr. Dennis conducted a large randomized controlled trial in Ontario that looked at the preventive effects of peer support, which means support from another mother.

“We showed that telephone-based support early in the postpartum period from another mother who previously experienced postpartum depression and had recovered was beneficial. We know that this type of support can decrease the risk of developing postpartum depression by approximately 50 per cent,” Dr. Dennis says.

“We also know that interpersonal psychotherapy might be beneficial in preventing postpartum depression. Sessions focus on examining the mother’s interpersonal relationships, linking them to changes in mood, identifying a major problem area (grief, interpersonal role disputes, role transitions or interpersonal deficits). It clearly addresses the social context that women live in.”

Treatment

For women who do develop postpartum depression, treatment depends on symptom severity and is similar to treatment for other types of depression. Those with mild symptoms may benefit by joining a mothers’ group or by receiving non-directive counselling from a public health nurse. Moderate to severe postpartum depression may be treated with psychotherapy, such as interpersonal psychotherapy or cognitive behavioural therapy, and in some cases with antidepressant medication. Severely depressed new mothers often require antidepressant medication as a first step to treatment.

This information is provided by Women’s College Hospital and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: Feb. 4, 2014

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