Overview: Why postpartum mental health matters
Two new studies from Karolinska Institutet illuminate how mental ill-health evolves around pregnancy and childbirth. They find that depression and psychosis are more likely after giving birth than before, while the risk of suicide attempts slightly declines. The findings also suggest that national screening guidelines may help identify problems earlier, enabling timely support for families.
The Swedish cohort: depression and psychosis after birth
The researchers analyzed data from Swedish registers covering nearly 1.8 million pregnancies between 2003 and 2019. The cohort included all women who delivered a child in Sweden during that period. The pattern over time showed a gradual rise in psychiatric diagnoses, with notable differences before, during, and after pregnancy.
Key results include that the risk of depression is about 20% higher in the 5 to 15 weeks after birth compared with the year before pregnancy. For psychosis, the increase is even more striking—up to sevenfold in the first 20 weeks postpartum. In contrast, during pregnancy the rate of new psychiatric diagnoses tends to be lower, highlighting a transition period where mood changes are more likely to emerge after birth.
Dr. Emma Bränn of Karolinska Institutet notes that these shifts reflect a complex mix of biological and psychosocial changes occurring around delivery.
Screening and early detection: what changed in 2010
National guidelines for screening depression during pregnancy were implemented in 2010, aiming to detect mental health issues earlier. By comparing women who delivered before and after the guidelines, researchers observed that the peak in postpartum depression occurred earlier among those who gave birth after screening was introduced. This pattern supports the idea that screening does not necessarily increase the number of diagnoses but helps identify women sooner, so they can access care earlier and potentially avoid prolonged suffering.
The study also found that anxiety and substance use disorders were less common during pregnancy and after birth, likely due to a combination of biological changes, lifestyle adaptations, and the increased contact with health services during pregnancy and the postpartum period.
Suicide risk: what the data show
A second study from the same team compared suicide attempts among parents around pregnancy. The data indicate that mothers are less likely to attempt suicide during and after pregnancy than at other times. For fathers, the risk dips in the first ten weeks postpartum but then rises again. Although postpartum suicide attempts remain rare, the consequences can be devastating, underscoring the importance of regular parental health checks and accessible mental health support for families.
Clinical implications and what this means for care
The combined findings point to several practical implications for health systems and clinicians:
- Maintain routine mental health screening for both mothers and fathers during pregnancy and after birth, with a focus on postpartum depression and the risk of psychosis.
- Provide timely access to confirmation, counseling, and treatment options immediately after screening identifies concern.
- Educate families about warning signs of mood disorders and suicidal risk, ensuring pathways to help are clear and accessible.
- Recognize that a lower incidence of certain conditions during pregnancy does not guarantee protection after birth; continuous monitoring remains essential.
These insights emphasize a shift toward proactive, ongoing mental health support in maternity care. By embedding screening into routine care and ensuring robust follow-up, health services can reduce the burden of postpartum mood disorders and improve outcomes for both parents and children.
Bottom line
As Sweden demonstrates, structured screening and sustained care around pregnancy and the postpartum period can facilitate earlier detection of postpartum depression and psychosis. While suicide attempts are rare, the data reinforce the need for accessible, continuous mental health support for new families, reinforcing the value of national guidelines in guiding practice.
