Mental Health Awareness Month: Postpartum Depression in the United States
Every year in the United States since 1949, the month of May has been observed as Mental Health Awareness Month (1). Raising awareness, providing resources, and taking the time to discuss mental health publicly is crucial to destigmatizing mental health conditions and expanding the policy in place to protect the millions of people in the United States who struggle with their mental health.
Mental health conditions can affect any and all people– including parents. As a company that wishes to expand feeding options for families, reduce the guilt around making nutritional decisions for your little ones, and destigmatize the “tabooness” surrounding how we feed our babies, we feel that it is crucial to bring light to a mental health condition that, like many, is not often publicly discussed: postpartum depression, a long-lasting form of depression that many new moms face.
The Stats and Facts
Postpartum depression (PPD) affects between 1 in 10 and 1 in 7 women in the United States with a recent live birth experience. However, it is estimated that nearly 50% of mothers with postpartum depression are undiagnosed by health professionals (2). This equates to almost 600,000 women annually in the U.S., though when the same statistics are applied to women who experienced stillbirths or miscarriages, the number affected rises to 900,000 (2). When looking through a broad lens, diagnosed PPD has increased over the past few decades. The CDC found that the rate of depression diagnosed at delivery was 7 times higher in 2015 than in 2000 (3). However, unexpected events skew these numbers, and the pandemic has once again proven to cause a dramatic shift in lifestyle. During the early COVID days, a study by the University of Michigan School of Nursing found that 1 in 3 new mothers screened positive for PPD, and 1 in 5 had major depressive symptoms (4). The formula shortage only added fuel to the fire. Product recalls, supply chain issues, and inflation have made formula feeding even more difficult than it already is. Even on the best days, parenthood easily strikes feelings of isolation and anxiety, and recent events have reiterated that expanded support for new parents is a necessity.
PPD can often be mistaken for “baby blues,” a term coined to describe new mothers experiencing anxiety, sadness, irritability, trouble sleeping, and mood swings during the first few days or 1-2 weeks postpartum (5). The differentiation between the two stems from the severity and longevity of symptoms. PPD can appear as withdrawing from support systems, difficulty bonding with your baby, panic attacks, harmful thoughts, irritability, anger, losing interest in activities, and more (5). Sleep deprivation, wild fluctuations in hormones, the isolation of being home alone with a new baby, the feelings of guilt when going back to work, and the insatiable nature of the demands of a hungry infant all create the perfect storm for mental health challenges to emerge in early parenthood. Not to mention, parents still have to manage taking care of themselves while navigating all of this. It's easy to forget that none of these obstacles define an individual or who they are as a parent.
PPD can also affect fathers, and adoptive parents. Around 50% of fathers who have partners diagnosed with PPD also go on to experience depression themselves, and some studies show that PPD rates in adoptive parents can be comparable to rates in biological mothers (2).
With parental guilt being a seemingly universal feeling, PPD is an added stressor on any kind of early parenthood. People experiencing PPD, and all parents, deserve all the support and help they can get navigating postpartum life – something that is full of twists and turns and countless challenges!
Though there is no single cause for PPD, there are risk factors like previous history of depression, traumatic birth experiences, unexpected parenting challenges, like struggling to breastfeed, and a wide range of social factors. Lack of familial support, financial support, paid parental leave, and access to resources can all affect the severity of postpartum mental health challenges (6).
The relationship between breastfeeding and postpartum depression has been difficult for researchers to navigate. From one end, women with PPD may have trouble initiating and sustaining breastfeeding, and from the other, women who experience trouble breastfeeding may develop PPD. However, studies have shown that mothers who had intentions of exclusively breastfeeding but had to turn to formula have higher risk of experiencing guilt about their infant feeding choices, and 76% of formula feeding parents feel the need to defend their decision to do so (7). The need to use formula comes from a variety of reasons that can range anywhere from physical challenges, like pain when nursing, to societal challenges, like lack of parental leave. Any factor can be an added weight on maternal mental health, however.
Understanding the extensive number of factors that affect a new parent’s mental health is crucial to learn so that we, as a society, can provide the necessary resources to make parenting as seamless as possible – because the stress of birthing, nurturing, and providing for a new life is challenging enough.
In the United States, only 24% of private sector employees have access to paid family leave, and when narrowing the scope to the lowest 10% of earners, that number drops to 6% who have access (8). Studies have found that there is an increased risk for PPD when mothers receive less than 6 months of maternity leave, and significantly higher scores for maternal depression have been found in correlation with women who received less than 12 weeks (about 3 months) of paid leave (9). Though new laws have been put in place to protect parents, like the recent PUMP Act, which requires employers to provide pumping spaces for employees up to a year after a child’s birth, there is still much to be done to ensure that work-stress doesn’t bleed into home-stress for new parents (10).
PPD is at large a mental health issue, one that is not publicly discussed enough and one that is understudied and underfunded (11). This is, unfortunately, a common trend in women’s health research. Women represent at least 60% of people diagnosed with mental health conditions, which are underfunded in proportion to the burden exerted on the US population, like many other health conditions that predominately affect women (12). This is no surprise, as women were not required to be included in clinical research studies until 1989, and that kind of historical exclusion takes time to catch up to.
Though this news may sound disheartening – the women’s health space shows endless promise. Just last year, two US members of Congress introduced a bill calling for a doubling of investment in women’s health research, and the innovation in the FemTech space has never been more powerful!
Postpartum depression is one of the many adversities of parenthood, women's health, and mental health, and should not go unnoticed or unsupported. As we end Mental Health Awareness Month, let’s all carry with us the knowledge and understanding that nobody is alone in their struggles, and publicly discussing uncomfortable issues – especially in the guilt-ridden world of parenting – is crucial to changing public perception, policy, and the strength of a community.
View the list below for (some of many!) PPD and mental health resources in the United States:
Mental Health Awareness Month. NAMI. (n.d.). https://www.nami.org/Get-Involved/Awareness-Events/Mental-Health-Awareness-Month
Medically Reviewed and Fact-Checked by: Kimberly Langdon M.D., by:, M. R. and F.-C., & Editor, M. (2023, February 16). Postpartum depression statistics: Recent research and data about PPD. PostpartumDepression.org. https://www.postpartumdepression.org/resources/statistics/
Centers for Disease Control and Prevention. (2023, May 1). Depression during and after pregnancy. Centers for Disease Control and Prevention. https://www.cdc.gov/reproductivehealth/features/maternal-depression/index.html#:~:text=Recent%20CDC%20research%20shows%20that,and%20every%20woman%20deserves%20support
A third of new moms during early COVID had postpartum depression. University of Michigan News. (2022, May 23). https://news.umich.edu/a-third-of-new-moms-during-early-covid-had-postpartum-depression/
Mayo Foundation for Medical Education and Research. (2022, November 24). Postpartum depression. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/postpartum-depression/symptoms-causes/syc-20376617
Ghaedrahmati, M., Kazemi, A., Kheirabadi, G., Ebrahimi, A., & Bahrami, M. (2017, August 9). Postpartum depression risk factors: A narrative review. Journal of education and health promotion. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5561681/
Centers for Disease Control and Prevention. (2023a, April 4). Postpartum depression. Centers for Disease Control and Prevention. https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/maternal-or-infant-illnesses/postpartum-depression.html
Director, S. N. A., Nadeau, S., Director, A., Shepherd Director, M., Shepherd, M., Director, Director, E. L. A., Lofgren, E., Kogan, B., McConville, D., Jordan, A., & Conner, A. (2023, January 5). The state of paid family and medical leave in the U.S. in 2023. Center for American Progress. https://www.americanprogress.org/article/the-state-of-paid-family-and-medical-leave-in-the-u-s-in-2023/
Paid maternity leave improves health, mental health ... - psychiatric news. (n.d.). https://psychnews.psychiatryonline.org/doi/full/10.1176/appi.pn.2020.4b9
FLSA protections to pump at work. DOL. (n.d.). https://www.dol.gov/agencies/whd/pump-at-work
Payne, J. L., & Maguire, J. (2019, January). Pathophysiological mechanisms implicated in postpartum depression. Frontiers in neuroendocrinology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370514/#R1
Smith, K. (2023, May 3). Women’s health research lacks funding – these charts show how. Nature news. https://www.nature.com/immersive/d41586-023-01475-2/index.html