Postpartum depression affects around one in seven women, and while the “the baby blues,” which improve quickly, are relatively common, postpartum depression is longer lasting and tends to be quite debilitating. Postpartum depression can interfere with bonding between mother and baby, cause marital distress, and have a negative effect on parenting practices and the baby’s development. Given the consequences of postpartum depression, it’s important to understand the risk and protective factors for this mental health condition. One risk factor that is important to consider is the contribution of stressful events during pregnancy. 

The Link Between Pregnancy Stress and Postpartum Depression 

Research has revealed that there is a link between having a stressful pregnancy and experiencing symptoms of postpartum depression. One recent study with over 10,000 women found that stressful life experiences, including relationship conflict, difficulty paying bills, and separation/divorce increased the risk of postpartum depression. Stress had a cumulative effect, meaning that women who experienced a greater number of stressful life events were more likely to develop postpartum depression symptoms.

In another study with other 5,000 participants, researchers found that women who experienced one or more stressors during pregnancy were 68% more likely to experience symptoms of postpartum depression. Women who experienced stress related to their relationship with their partners were 90% more likely to show symptoms of postpartum depression. 

Taken together, the results of recent research suggest that stress is a contributing factor to postpartum depression. Women who experience stressors during pregnancy should be encouraged to seek support to help them manage stressful life events, and those who experience a particularly stressful pregnancy should be provided with psychoeducation on postpartum depression and encouraged to seek professional treatment. 

Other Risk Factors for Postpartum Depression 

Stress has been identified as a contributing factor to postpartum depression, but that doesn’t mean it is the only risk factor for this mental health condition. Other risk factors include:

• Having a history of depression or anxiety
• History of being a victim of sexual abuse
• Disappointment regarding the baby’s gender
• Negative attitude toward the baby
• Giving birth prematurely 
• Giving birth to a low birth weight baby
• Having a risky pregnancy (frequent hospitalizations while pregnant, giving birth via emergency cesarean section) 
• Lack of social support
• Being a victim of domestic violence during pregnancy (which is also a form of stress)
• Smoking during pregnancy 
• Unhealthy lifestyle habits, such as poor diet, lack of sleep, and lack of exercise
• Sudden changes in hormone levels after giving birth
• Adjusting to the demands of new motherhood, which include lack of sleep, loss of free time, and changes in routine 

Postpartum Depression Treatment

Not everyone who has risk factors for postpartum depression will develop this condition, but given the fact that it can be debilitating and interfere with parenting, if you or someone you love has had a stressful pregnancy, it’s important to be aware of postpartum depression symptoms and to seek treatment if you develop symptoms. 

In addition to typical depression symptoms, like sadness, fatigue, and difficulty making decisions, women with postpartum depression may also have thoughts of harming the baby or have trouble bonding with the baby. Some women may feel as if their baby belongs to someone else. 

If you have symptoms, treatment can help you to recover. Common treatment modalities for postpartum depression include: 

• Therapy: For women with mild to moderate postpartum depression, therapy is the recommended course of treatment. Therapy is the preferred option, especially for women who want to breastfeed and are concerned about potential side effects of medications. Therapy can help women to learn coping strategies and correct negative thinking patterns that are leading to depression symptoms.

• Medication: Antidepressant medications are also used in the treatment of postpartum depression, often in combination with therapy. Adding an antidepressant drug is recommended for women with moderate to severe depression, and SSRIs are the first line of pharmacological treatment. Women who are breastfeeding should discuss the risks and benefits of medication with their doctor. 

• Alternative treatments: In some cases, women may not respond to therapy and/or medication, and additional treatment may be warranted. One treatment option is transcranial magnetic stimulation (TMS), which can be beneficial because it is safe for breastfeeding mothers. This modality uses electromagnetic waves to stimulate areas of the brain associated with mood. It is non-invasive and beneficial for treatment-resistant depression. 

• Social services and other resources: In addition to seeking professional mental health treatment, women who struggle with postpartum depression, or who are at high risk of developing postpartum depression, benefit from accessing social services and resources within the community, both during and after pregnancy. For instance, new or expecting mothers may benefit from attending support groups or accessing financial or medical resources. You might consider asking to speak with a social worker at the hospital where you’re giving birth about options for financial assistance and other social services. Additionally, given the fact that relationship problems can increase stress and contribute to postpartum depression, it can be helpful to seek couples counseling during the prenatal period. 

If you experienced a stressful pregnancy, or you have other risk factors that have contributed to postpartum depression symptoms, there is no shame in reaching out for help. Postpartum depression is a common yet treatable mental health disorder, and showing signs of this condition does not mean you have failed as a mother. Hormonal changes that occur after pregnancy, coupled with the life changes associated with having a baby, make new and expecting mothers particularly susceptible to depression. 

Reaching out for treatment is the first step in overcoming postpartum depression. If you have not found relief with therapy and/or medication, you may be a candidate for TMS. For those in the Southern California area, Pulse TMS offers services in the heart of West Los Angeles, with an office that is conveniently accessible from Santa Monica, Beverly Hills, and Culver City. Contact us today to determine if you’re a candidate and to begin the admissions process.