Study Suggests Postpartum Depression May Begin Before Birth

A mother holds her infant

Between 10% and 20% of women experience postpartum depression, which can cause intense sadness, feelings of worthlessness, crying, and appetite and sleep changes, and lead to difficulty bonding with the baby. Postpartum depression has long been attributed to changes—hormonal, physiological, and environmental—related to having recently had a baby. New research published in Lancet Psychiatry, however, suggests otherwise. According to the study, signs of postpartum depression often begin well before childbirth.

Who’s at Risk for Postpartum Depression?

The study looked at symptoms of depression in 8,200 women seen at 19 different clinics in 7 countries. Researchers found that in women who had the most severe symptoms of depression, such as thoughts of suicide and frequent crying, symptoms often began during pregnancy, not after. Among moderately depressed women, symptoms more commonly emerged after delivery.

For both groups of women, pregnancy health factors appeared to play a role in the development of depression. Women with moderate depression were more likely to experience pregnancy-related complications such as pre-eclampsia and gestational diabetes. Women who had severe depression frequently reported complications during birth.

Improving Postpartum Depression Treatments

The study’s authors hope that their research might improve outcomes for women at risk of postpartum depression. Overall, two-thirds of women who suffered from severe depression first experienced symptoms during pregnancy, and 60% of women with moderate depression reported a pregnancy-related health problem. Popular wisdom dictates that pregnancy-related depression is—at least in part—a product of hormonal changes after pregnancy, but this research could undermine that claim.

One possible direction for future research, the study’s authors explain, is immune system issues. Since 60% of moderately depressed women reported a health problem, it’s possible that immune deficiencies could contribute to both pregnancy complications and depression. Moreover, with so many depressed women reporting traumatic childbirths, improving care during labor and delivery might help improve maternal mental health.


Belluck, P. (2015, February 02). Maternal depression often starts before giving birth, study says. Retrieved from

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  • Estelle


    February 9th, 2015 at 10:25 AM

    So maybe it IS related to hormones and stuff, but that for some women the problems begin during pregnancy and they experience these feelings even before the baby is born.

  • tony


    February 9th, 2015 at 4:06 PM

    You have to wonder at times if these women either hide this very well while they are pregnant or if so many people just say this is because you are pregnant that you are feeling this way and they sort of blow off this potentially serious ailment that the women are feeling. I remember my wife being pregnant and she was always pretty emotional, maybe even more so while pregnant, and while I can’t say that she was depressed, it can get anyone down sometimes when you don’t feel too good for 9 months. Anyway I guess this is just more affirmation that we need to take the feelings of other people seriously and not try to blow them off, because this could lead to something even bigger later on that should have been treated previously.

  • KELI


    February 10th, 2015 at 10:52 AM

    how about the support system that the women had throughout the pregnancy? you think that this could play a role?

  • April


    February 14th, 2015 at 2:42 PM

    So add this to the list of various other things that the woman’s ob-gyn needs to be on the lookout for.

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