Maternal & Newborn Atlas
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Postpartum psychosis (mother)

A rare, serious illness after childbirth in which a woman may have delusions, hallucinations, mania, paranoia and confusion. NIMH calls it a psychiatric emergency that requires hospital care, and says a woman with these symptoms should seek immediate help by calling 911 or going to the nearest emergency room. Recovery is possible with professional help.

  • Condition
  • In this atlas

Overview

Technical summary

A 2016 review (American Journal of Psychiatry) reports first-lifetime onset in 0.25 to 0.6 per 1,000 births in register studies of psychiatric admissions, with 20% to 50% of women having isolated postpartum psychosis and the rest having episodes outside the perinatal period, usually within the bipolar spectrum (see the claim on this page). The review says the evidence on treatment is sparse, so the atlas records no treatment claim. NIMH and MedlinePlus both describe it as an emergency. It is a different condition from postpartum depression, and both sit under perinatal mental health. The recipient is the postpartum woman.

Recognition

NIMH says women with postpartum psychosis may have delusions, hallucinations, mania, paranoia and confusion. MedlinePlus lists confusion, hallucinations or dangerous behaviours.

Burden

  • Burden Evidence synthesis Certainty not assessed

    A 2016 review in the American Journal of Psychiatry describes psychosis or mania after childbirth as a psychiatric emergency with risk for suicide and infanticide. It reports that first-lifetime onset postpartum psychosis or mania, counted from population-based register studies of psychiatric admissions, occurs in 0.25 to 0.6 per 1,000 births. After an incipient episode, 20% to 50% of women have isolated postpartum psychosis, and the remaining women have episodes outside the perinatal period, usually within the bipolar spectrum. For women with isolated postpartum psychosis, the relapse risk after a subsequent pregnancy is 31% (95% CI 22 to 42). The review says inpatient care is usually required.

    Applies to Maternal
    • Women after childbirth. The incidence figures come from population-based register studies of psychiatric admissions for first-lifetime onset postpartum psychosis or mania. The relapse figure is for women with isolated postpartum psychosis in a subsequent pregnancy.
    • Register studies of psychiatric admissions; inpatient care is usually needed (review abstract).
    • Not stated in the abstract
    • Postpartum, after childbirth
    • Gestational age Not reported
    • Postnatal age Not reported
    Follow-up Relapse risk after a subsequent pregnancy (review abstract).
    Certainty method
    Not assessed
    Limitations
    This is a narrative review and the atlas read only its PubMed abstract. The incidence range comes from register studies of psychiatric admissions, so women who were not admitted are not counted. The review says fewer than 30 publications have focused on treatment; the largest study (N=64) suggested lithium is highly efficacious, and another report (N=34) described successful electroconvulsive therapy. These are small studies, and the abstract gives no controlled comparison, so the atlas makes no treatment claim. The abstract does not name the countries of the register studies.
    Last checked
    2026-10-14
    Next evidence check due
    Not scheduled
    Sources and citations (10)

    1. Supports Postpartum Psychosis: Madness, Mania, and Melancholia in Motherhood

      Publication · The American journal of psychiatry · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2016-12-01 · DOI: 10.1176/appi.ajp.2016.16040454 · PMID: 27609245

      Locator
      Abstract, OBJECTIVE, sentence 1
      How it applies
      Postpartum psychosis described as a psychiatric emergency.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      903460485d582e15f48689d3800d27694c0f6fc4e45d81eeff5f8892ff607938
      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.

    2. Supports Postpartum Psychosis: Madness, Mania, and Melancholia in Motherhood

      Publication · The American journal of psychiatry · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2016-12-01 · DOI: 10.1176/appi.ajp.2016.16040454 · PMID: 27609245

      Locator
      Abstract, RESULTS, sentence 1
      How it applies
      Incidence from register studies.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      903460485d582e15f48689d3800d27694c0f6fc4e45d81eeff5f8892ff607938
      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.

    3. Supports Postpartum Psychosis: Madness, Mania, and Melancholia in Motherhood

      Publication · The American journal of psychiatry · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2016-12-01 · DOI: 10.1176/appi.ajp.2016.16040454 · PMID: 27609245

      Locator
      Abstract, RESULTS, sentence 2
      How it applies
      Share with isolated postpartum psychosis.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      903460485d582e15f48689d3800d27694c0f6fc4e45d81eeff5f8892ff607938
      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.

    4. Supports Postpartum Psychosis: Madness, Mania, and Melancholia in Motherhood

      Publication · The American journal of psychiatry · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2016-12-01 · DOI: 10.1176/appi.ajp.2016.16040454 · PMID: 27609245

      Locator
      Abstract, RESULTS, sentence 3
      How it applies
      Other women have episodes outside the perinatal period.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      903460485d582e15f48689d3800d27694c0f6fc4e45d81eeff5f8892ff607938
      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.

    5. Supports Postpartum Psychosis: Madness, Mania, and Melancholia in Motherhood

      Publication · The American journal of psychiatry · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2016-12-01 · DOI: 10.1176/appi.ajp.2016.16040454 · PMID: 27609245

      Locator
      Abstract, RESULTS, sentence 11
      How it applies
      Relapse risk after a subsequent pregnancy.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      903460485d582e15f48689d3800d27694c0f6fc4e45d81eeff5f8892ff607938
      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.

    6. Supports Postpartum Psychosis: Madness, Mania, and Melancholia in Motherhood

      Publication · The American journal of psychiatry · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2016-12-01 · DOI: 10.1176/appi.ajp.2016.16040454 · PMID: 27609245

      Locator
      Abstract, RESULTS, sentence 10
      How it applies
      Inpatient care.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      903460485d582e15f48689d3800d27694c0f6fc4e45d81eeff5f8892ff607938
      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.

    7. Background Postpartum Psychosis: Madness, Mania, and Melancholia in Motherhood

      Publication · The American journal of psychiatry · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2016-12-01 · DOI: 10.1176/appi.ajp.2016.16040454 · PMID: 27609245

      Locator
      Abstract, RESULTS, sentence 7
      How it applies
      Treatment evidence is sparse.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      903460485d582e15f48689d3800d27694c0f6fc4e45d81eeff5f8892ff607938
      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.

    8. Background Postpartum Psychosis: Madness, Mania, and Melancholia in Motherhood

      Publication · The American journal of psychiatry · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2016-12-01 · DOI: 10.1176/appi.ajp.2016.16040454 · PMID: 27609245

      Locator
      Abstract, RESULTS, sentence 8
      How it applies
      Largest treatment study.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      903460485d582e15f48689d3800d27694c0f6fc4e45d81eeff5f8892ff607938
      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.

    9. Background Postpartum Psychosis: Madness, Mania, and Melancholia in Motherhood

      Publication · The American journal of psychiatry · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2016-12-01 · DOI: 10.1176/appi.ajp.2016.16040454 · PMID: 27609245

      Locator
      Abstract, RESULTS, sentence 9
      How it applies
      Another treatment report.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      903460485d582e15f48689d3800d27694c0f6fc4e45d81eeff5f8892ff607938
      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.

    10. Background Postpartum Psychosis: Madness, Mania, and Melancholia in Motherhood

      Publication · The American journal of psychiatry · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2016-12-01 · DOI: 10.1176/appi.ajp.2016.16040454 · PMID: 27609245

      Locator
      Abstract, RESULTS, sentence 12
      How it applies
      Prevention strategies named in the review.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      903460485d582e15f48689d3800d27694c0f6fc4e45d81eeff5f8892ff607938
      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.

Record details

Record id
maternal:postpartum-psychosis
Content hash
0a15660d0e1356b390ae861579d9a1dba1dbd7d7171fedd1a6ab1ad2f392b6b6