Perinatal depression (mother)
Depression that starts during pregnancy or after a baby is born. It can range from mild to severe, can make it hard to do daily tasks or care for a baby, and can be treated. NIMH says most episodes begin within the first 4 to 8 weeks after the birth. The short, milder low mood often called the baby blues is a different thing.
- Condition
- In this atlas
Overview
Technical summary
NIMH describes perinatal depression as a mood disorder that occurs during pregnancy and after childbirth, with symptoms from mild to severe. It includes depression in pregnancy (prenatal depression) and in the weeks and months after birth (postpartum depression, recorded as a subtype). The US Preventive Services Task Force says it affects as many as 1 in 7 women (see the claim on this page). NIMH names cognitive behavioral therapy and interpersonal therapy as evidence-based therapies and says treatment usually includes therapy, medication, or both. US regulators have approved two medicines specifically for postpartum depression, brexanolone by infusion and zuranolone by mouth, each recorded in the atlas with its trials. The recipient is the pregnant or postpartum woman. Effects on the baby are not covered by the claims recorded here and would sit in their own contexts.
Recognition
NIMH lists symptoms such as a persistent sad, anxious or empty mood, loss of interest in usual activities, fatigue, trouble sleeping, trouble bonding with the baby, and thoughts of death or of harming oneself or the baby. Women with any of these symptoms are advised by NIMH to see a health care provider.
Assessment
NIMH says a health care provider can determine whether symptoms are due to perinatal depression or something else. Screening questionnaires used in pregnancy and after birth are described on the screening page.
Burden
The US Preventive Services Task Force describes perinatal depression as the occurrence of a depressive disorder during pregnancy or following childbirth. It says perinatal depression affects as many as 1 in 7 women and is one of the most common complications of pregnancy and the postpartum period, and that it is well established that it can result in adverse short- and long-term effects on both the woman and child.
Applies to Maternal- Women in pregnancy or following childbirth. The USPSTF abstract gives the figure of as many as 1 in 7 women without stating a country, year or study for it.
- Not stated in the abstract.
- Not stated for the figure. The statement is a US recommendation.
- Pregnancy and after childbirth
- Gestational age Not reported
- Postnatal age Not reported
- Certainty method
- Not assessed
- Limitations
- This is the importance paragraph of the USPSTF statement's abstract, which gives no source, country, year or definition for the 1 in 7 figure; as many as 1 in 7 is an upper figure, not an average. The atlas read only the abstract. Other organisations publish different prevalence figures; none is used here.
- Last checked
- 2026-10-14
- Next evidence check due
- Not scheduled
Sources and citations (3)
-
- Locator
- Abstract, IMPORTANCE, sentence 1, fragment 1 of 2
- How it applies
- Definition and prevalence, part 1.
- Retrieved
- Source effective date
- Not reported
- Source state
- Current
- Snapshot hash
c7a737a54883711a0300ea526238b7e344c82df6f883be6ed2b8a7f7f8356fa3- Reuse basis
- PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
-
- Locator
- Abstract, IMPORTANCE, sentence 1, fragment 2 of 2
- How it applies
- Prevalence, part 2.
- Retrieved
- Source effective date
- Not reported
- Source state
- Current
- Snapshot hash
c7a737a54883711a0300ea526238b7e344c82df6f883be6ed2b8a7f7f8356fa3- Reuse basis
- PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
-
- Locator
- Abstract, IMPORTANCE, sentence 2
- How it applies
- Adverse short- and long-term effects.
- Retrieved
- Source effective date
- Not reported
- Source state
- Current
- Snapshot hash
c7a737a54883711a0300ea526238b7e344c82df6f883be6ed2b8a7f7f8356fa3- Reuse basis
- PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
Clinical links
Each link reports what one cited claim says about one population. "Evaluated for" means studied, not shown to work. These links do not show that anything is effective or right for you.
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Claim, not a settled fact Recommended for this: Counselling to prevent perinatal depression
Applies to Maternal- Pregnant and postpartum persons who are at increased risk of perinatal depression. The USPSTF says women with a history of depression, current depressive symptoms, or certain socioeconomic risk factors (for example low income, or young or single parenthood) could be considered at increased risk.
- Clinical care in which clinicians can provide or refer to counselling. The abstract names no setting.
- United States (USPSTF recommendation statement)
- Pregnancy and postpartum
- Gestational age Not reported
- Postnatal age Not reported
In 2019 the US Preventive Services Task Force recommended that clinicians provide or refer pregnant and postpartum persons who are at increased risk of perinatal depression to counselling interventions (B recommendation). It found convincing evidence that counselling such as cognitive behavioral therapy and interpersonal therapy is effective in preventing perinatal depression, bounded the potential harms of counselling as no greater than small, and concluded with moderate certainty that referral of people at increased risk has a moderate net benefit. It found inadequate evidence on the benefits and harms of other, non-counselling interventions.Limitations. Only the PubMed abstract of the JAMA statement was read, not the full statement or its evidence review. The USPSTF letter grade and its certainty wording are the Task Force's own and are not a GRADE rating, so the certainty field is left not assessed. The recommendation is about preventing depression in people at increased risk; it is not a recommendation about treatment, and it is not advice for any individual. The abstract names no programme or number of sessions.
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Claim, not a settled fact Evaluated for this: Counselling to prevent perinatal depression
Applies to Maternal- 205 pregnant women aged 18 years or older, on public assistance and at risk for postpartum depression (mean age 23; 38% Hispanic and 23% Black), randomized to a group intervention based on interpersonal therapy (n=104) or a treatment-as-usual programme (n=101).
- Not stated in the abstract.
- Not stated in the abstract.
- Pregnancy, with the depression rate assessed 6 months postpartum
- Gestational age Not reported
- Postnatal age Not reported
In a randomized controlled trial of 205 pregnant women aged 18 or older who were on public assistance and at risk for postpartum depression, a group intervention based on the principles of interpersonal therapy (n=104) was compared with a treatment-as-usual programme (n=101). At 6 months the overall depression rate was 16% in the intervention group and 31% in the control group, a difference the authors report as statistically significant at p<0.05.Limitations. Only the PubMed abstract was read. The authors note it is unknown whether the findings generalize to a more heterogeneous sample of women, such as women from a range of socio-economic and cultural backgrounds, or marital status, and that the amount of contact differed between the treatment-as-usual and intervention conditions. The abstract names no country or setting and gives no confidence interval. This is one trial of one programme and not a statement about counselling in general.
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Claim, not a settled fact Evaluated for this: Thinking Healthy Programme (CBT by community health workers)
Applies to Maternal- Married women aged 16 to 45 years who were depressed in the last three months of pregnancy, drawn from 40 Union Council clusters across rural Rawalpindi in Pakistan, allocated in equal numbers to intervention or control. The intervention group had 463 mothers and the control group 440.
- Community setting, run within the ordinary duties of community primary health workers (abstract).
- Rural Rawalpindi, Pakistan
- Third trimester of pregnancy at entry; outcomes after birth.
- Gestational age Not reported
- Postnatal age Not reported
In a cluster-randomised trial in rural Rawalpindi, Pakistan, with 20 clusters per group (463 mothers in the intervention arm, 440 in the control arm), trained community-based primary health workers delivered a cognitive behaviour therapy based intervention to mothers with depression in the third trimester, while untrained health workers made the same number of visits in the control arm. At 6 months, 97 (23%) of 418 mothers in the intervention group and 211 (53%) of 400 in the control group had major depression by the trial's criteria (adjusted odds ratio 0.22, 95% CI 0.14 to 0.36, p<0.0001). The difference was sustained at 12 months: 111 of 412 (27%) against 226 of 386 (59%), adjusted odds ratio 0.23 (95% CI 0.15 to 0.36).Limitations. Maternal depression was a secondary outcome. The trial's main outcomes were the infant's weight and height at 6 and at 12 months, and those did not differ significantly (separate claim). The abstract was read in PubMed and the full text in PubMed Central. According to the full text, participants were aware only that the visits came in two types, and the abstract says the interviewers were unaware of group assignment; the health workers could not be masked. The trial was in one rural district of Pakistan, so the result may not carry over to other settings. The full text of the paper has no licence statement the atlas could use, so the public page states its facts in the atlas's own words.
Record details
- Record id
maternal:perinatal-depression- Content hash
7620d44a27912c8462a7526baba7b1be0786f4ff0c0a69921607846339431d77