Postpartum Depression in Maryland

Maryland

Postpartum depression occurs following pregnancy and delivery. It is one of the most common medical complications during the six months following childbirth and is associated with adverse outcomes for both the mother and child. Approximately 1 in 7 mothers experience postpartum depression.

Postpartum depressive symptoms include persistent feelings of sadness, pessimism or anger; frequent crying; difficulty sleeping; disconnection from the baby and worry about hurting the baby. A history of depression, anxiety or mood disorders is the biggest risk factor for postpartum depression. Other risk factors include stressful or traumatic life events during pregnancy, traumatic birth experiences and negative early breastfeeding experiences.

Maternal depression symptoms can affect early infant development and lead to long-term problems for the child, such as impaired cognitive and language development, behavioral issues and poor sleep quality. Mothers with untreated postpartum depression are more likely to engage in risky behavior such as smoking or substance use, experience difficulties in their relationships, discontinue exclusive breastfeeding and use less-healthy infant feeding practices.

The prevalence of postpartum depression is higher among:

• American Indian/Alaska Native, Asian/Pacific Islander and Black women compared with non-Hispanic white and Hispanic women.
• Women younger than age 24 compared with older women.
• Women with lower educational attainment compared with those with higher levels of education. 
• Unmarried women compared with married women.
• Women who smoke during the peripartum (before, during and right after pregnancy) or postpartum period.
• Women who discontinue breastfeeding before eight weeks.
• Women who give birth to infants with low birth weight or infants requiring neonatal intensive care unit (NICU) care.
• Women who experience three or more stressful life events in the year before birth.

The American College of Obstetricians and Gynecologists recommends that providers screen for postpartum depression and anxiety as part of the comprehensive postpartum visit. Screening for postpartum depression is cost-effective. Attending regular postpartum visits with one’s provider can help to identify and treat health concerns such as postpartum depression quickly. The U.S. Preventive Services Task Force recommends providers refer pregnant and postpartum patients they find to be at increased risk of depression to counseling resources. 

Studies have found that postpartum depression may be prevented through supportive and psychological care following childbirth, including home visits, peer support and interpersonal therapy. Examples of evidence-based support programs include Mothers and Babies and the ROSE (Reach Out, Stay Strong, Essentials for mothers of newborns) program.

Treatment for postpartum depression can also include antidepressants. In 2019, the U.S. Food and Drug Administration approved the first pharmaceutical treatment specifically for postpartum depression, an intravenous injection; and in 2023, the first oral medication was approved.

Healthy People 2030 has an objective to increase the proportion of women who are screened for postpartum depression at their postpartum checkups.

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