Overview: New evidence on postpartum mental health
Two recent studies from the Karolinska Institutet illuminate how mental health can change around pregnancy and childbirth. While anxiety and other disorders show complex patterns, the research finds that depression and psychosis are more common after giving birth than before, whereas the likelihood of suicide attempts is lower. The work underscores how national screening guidelines may help healthcare systems offer support earlier and more consistently.
Scope and key findings
The Swedish studies analyzed data from national registers covering nearly 1.8 million pregnancies between 2003 and 2019, including all births in Sweden during the period. The researchers observed a general rise in psychiatric diagnoses over time, with distinct shifts around pregnancy: fewer new diagnoses during pregnancy, followed by an uptick after delivery, especially for depression and psychosis.
Depression risk after delivery
For depression, the risk is markedly higher in the postpartum window. Emma Bränn, a researcher at the Institute for Environmental Medicine at Karolinska Institutet, notes that the probability of a depression diagnosis is about 20 percent higher during weeks 5 to 15 after birth compared with the year prior to pregnancy. This finding highlights a specific postpartum period when women may be particularly vulnerable and in need of support.
Postpartum psychosis and timing
The study also shows a substantially elevated risk for psychosis in the early postpartum period, reaching up to seven times higher in the first 20 weeks after delivery. The data emphasize the importance of rapid recognition and treatment for rare but serious cases that can have long-term consequences for mothers and families.
Other diagnoses and the broader picture
Beyond depression and psychosis, the researchers found that anxiety and substance-use–related disorders were less common during pregnancy and after birth. This pattern is likely influenced by biological and lifestyle changes, as well as increased contact with the healthcare system during pregnancy. Nevertheless, the postpartum period remains a critical window for monitoring and support.
Screening and early detection: policy impact
Sweden introduced national guidelines for screening depression during pregnancy in 2010. By comparing women who gave birth before and after these guidelines, researchers could assess whether screening altered when depression tends to be diagnosed after birth. They found that the peak in postpartum depression diagnoses occurred earlier among women who gave birth after screening guidelines were implemented. The authors emphasize that the numbers did not reflect more cases overall; rather, screening can help identify symptoms sooner, allowing timely access to care and reducing the duration of distress.
Suicide risk and paternal differences
In a separate study from the same team, maternal suicide attempts were found to be less common during and after pregnancy compared with fathers. For fathers, the risk dipped in the first ten weeks postpartum but rose again after that period. While suicide attempts remain relatively rare, their potential consequences are severe, underscoring the importance of routine check-ins with both mothers and fathers during and after pregnancy.
What this means for care and families
The findings support the value of systematic mental health screening as part of prenatal and postpartum care. Health services can use these insights to tailor follow-up, ensure early access to treatment for depression and psychosis, and offer targeted support to families during the high-risk postpartum window. As Yihui Yang from Karolinska Institutet puts it, regular checks during and after pregnancy are essential to identify parents who may be struggling and to provide timely help to prevent crises.
Takeaways for patients and providers
Expectant and new parents should view mood changes, anxiety, sleep disturbances, and persistent sadness as important signals to discuss with a clinician. Healthcare teams should maintain proactive screening, facilitate access to mental health services, and coordinate care for both parents where needed. While postpartum depression and psychosis are serious, early detection and support can reduce suffering and improve outcomes for mothers and their families.
References
Maternal psychiatric disorders before, during, and after pregnancy: a national cohort study in Sweden, Molecular Psychiatry; Sex difference in parental risk of suicide attempt during and after pregnancy in Sweden, Nature Human Behaviour.
