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Postpartum depression

Last edited: 4/14/2026

Overview

Postpartum depression (PPD) is a mental health disorder characterized by significant depressive symptoms occurring during the postpartum period, typically within the first year after childbirth, affecting maternal well-being and infant care 1222.

Diagnosis

  • Key Symptoms: Depressed mood, loss of interest, fatigue, changes in appetite or sleep, anxiety, feelings of worthlessness, and thoughts of death or suicide 122.
  • Screening Tools: Edinburgh Postnatal Depression Scale (EPDS) is commonly used for screening 2234.
  • Recommended Tests: No specific laboratory tests; diagnosis primarily clinical 22.
  • Grading: Severity can be graded based on symptomatology and functional impairment 22.

    • Management

  • First-Line Treatments:
    • - Psychotherapy: Cognitive Behavioral Therapy (CBT) 2433. - Pharmacotherapy: Selective Serotonin Reuptake Inhibitors (SSRIs) such as sertraline or escitalopram 2333.
  • Adjunctive Treatments:
    • - Exercise: Regular aerobic exercise during pregnancy may reduce PPD incidence 14. - Telehealth Interventions: Effective for increasing access to care 25. - Support Groups: Online workshops based on CBT have shown benefits 24.

    Special Populations

  • Pregnancy: Regular exercise during pregnancy may lower PPD risk 14.
  • Comorbidities: Vitamin D deficiency and adverse childhood experiences (ACEs) are associated with increased risk 1221.
  • Socioeconomic Factors: Lower income, less education, and certain job types are linked to higher PPD risk 30.

    • Key Recommendations

  • Screen for PPD Using Standardized Tools: Utilize tools like the Edinburgh Postnatal Depression Scale to identify at-risk mothers (Evidence: Strong 2234).
  • Implement Routine Screening Programs: Integrate universal screening for PPD in obstetric and pediatric settings to improve early detection and intervention (Evidence: Strong 2233).
  • Offer Psychosocial Interventions: Provide cognitive behavioral therapy and telehealth interventions as adjuncts to pharmacotherapy (Evidence: Moderate 2425).
  • Consider Exercise as a Preventive Measure: Encourage regular aerobic exercise during pregnancy to potentially reduce PPD incidence (Evidence: Moderate 14).
  • Address Socioeconomic and Psychosocial Factors: Screen for and address socioeconomic stressors and adverse childhood experiences that may increase PPD risk (Evidence: Moderate 1230).

    • References

    1 Saccone G, Buonomo G, Ammendola A, Bardi L, Motta M, Gragnano E et al.. Exercise in Pregnancy and Risk of Postpartum Depression: A Randomised Controlled Trial. BJOG : an international journal of obstetrics and gynaecology 2026. link 2 Chen L, Pan W, Chen Z, Yan S, Xu Y. Real-world safety profile of zuranolone for postpartum depression: A FAERS analysis. Journal of affective disorders 2026. link 3 Guo Y, Chen W. Meta-analysis of the association between gut microbiota and postpartum depression. Journal of psychosomatic obstetrics and gynaecology 2025. link 4 Hicks LE, Graf MD, Yeo S. Prenatal exercise and its effects on postpartum mental health: systematic review and meta-analysis. Archives of women's mental health 2025. link 5 Mozaffari R, Bahrami N, Bahramkhani M, Griffiths MD, Alimoradi Z. A randomized controlled trial investigating the impact of coping strategies training for fathers during pregnancy on postnatal depression among couples. Journal of psychosomatic obstetrics and gynaecology 2025. link 6 Chen X, Yao L, Pi X. Exploration of intervention strategies for alleviating maternal separation anxiety from the perspective of obstetrics and neonatology collaboration. Medicine 2025. link 7 Jin L, Yang K, Wu X, Zhang J. Safety assessment of brexanolone in the FAERS database: real adverse event analysis and discussion of side effects. Expert opinion on drug safety 2025. link 8 Ahmadinezhad GS, Karimi FZ, Abdollahi M, NaviPour E. Association between postpartum depression and breastfeeding self-efficacy in mothers: a systematic review and meta-analysis. BMC pregnancy and childbirth 2024. link 9 Jiaming W, Xin G, Jiajia D, Junjie P, Xue H, Yunchuan L et al.. Psychological experience of patients with postpartum depression: A qualitative meta-synthesis. PloS one 2024. link 10 Wei X, Wang W, Law YW, Zhang H. The Impacts of Intimate Partner Violence on Postpartum Depression: An Updated Meta-Analysis. Trauma, violence & abuse 2024. link 11 Wang J, Carru C, Sedda S, Fiori PL, Li Z, Chen Z. Comparative impact of exercise-based interventions for postpartum depression: A Bayesian network meta-analysis. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 2024. link 12 Fu C, Li C, Wan X, Yang Y, Zhang S, Hu J. The Relationship Between Adverse Childhood Experiences and Postpartum Depression: A Systematic Review and Meta-Analysis. Trauma, violence & abuse 2024. link 13 Clifford BN, Eggum ND, Rogers A, Porter CL, Gale M, Sheppard JA et al.. Mothers' and fathers' depressive symptoms across four years postpartum: An examination of between- and bidirectional within-person relations. Journal of affective disorders 2024. link 14 Osornio AC, Lane SP, Urizar GG, Gonzalez A, Halim MLD. Developmental trajectories of internalizing distress among ethnic minoritized mothers following childbirth: Associations with early child psychological adjustment. Development and psychopathology 2024. link 15 Klatzkow H, Gitomer S, St John-Larkin C, Scholes MA, Cooper E. Prevalence of Postpartum Depression in Mothers Presenting to a Pediatric Otolaryngology Clinic. The Laryngoscope 2024. link 16 Xiao G, Hu J, Wang H, Li Q, Peng S, Qin C et al.. Experience of postpartum depression among Chinese women: A meta-synthesis of qualitative research. Midwifery 2023. link 17 Aoki A, Mochida K, Balogun OO, Tomo CK, Tchicondingosse L, Sapalalo P et al.. Association between the continuum of care and postpartum depression among Angolan mothers. Journal of affective disorders 2023. link 18 Wainwright S, Caskey R, Rodriguez A, Holicky A, Wagner-Schuman M, Glassgow AE. Screening fathers for postpartum depression in a maternal-child health clinic: a program evaluation in a midwest urban academic medical center. BMC pregnancy and childbirth 2023. link 19 Blair LM, Wheeler E, Hutti MH. Social and Behavioral Problems in School-Aged Children After Maternal Postpartum Depression: A Secondary Analysis of Future of Families and Child Wellbeing Study. Maternal and child health journal 2023. link 20 Noshiro K, Umazume T, Inubashiri M, Tamura M, Hosaka M, Watari H. Association between Edinburgh Postnatal Depression Scale and Serum Levels of Ketone Bodies and Vitamin D, Thyroid Function, and Iron Metabolism. Nutrients 2023. link 21 Wang Y, Zhong W, Zhao A, Szeto IM, Lan H, Zhang J et al.. Perinatal depression and serum vitamin D status: A cross-sectional study in urban China. Journal of affective disorders 2023. link 22 Liu X, Wang S, Wang G. Prevalence and Risk Factors of Postpartum Depression in Women: A Systematic Review and Meta-analysis. Journal of clinical nursing 2022. link 23 LeFevre NM, Buck K, Strickland DP. An FP's guide to identifying-and treating-postpartum depression. The Journal of family practice 2022. link 24 Rosenberg K. One-Day Workshop Beneficial for Postpartum Depression. The American journal of nursing 2022. link 25 Zhao L, Chen J, Lan L, Deng N, Liao Y, Yue L et al.. Effectiveness of Telehealth Interventions for Women With Postpartum Depression: Systematic Review and Meta-analysis. JMIR mHealth and uHealth 2021. link 26 Mullins CH. Postpartum Blues. Patient education and counseling 2021. link 27 Zejnullahu VA, Ukella-Lleshi D, Zejnullahu VA, Miftari E, Govori V. Prevalence of postpartum depression at the clinic for obstetrics and gynecology in Kosovo teaching hospital: Demographic, obstetric and psychosocial risk factors. European journal of obstetrics, gynecology, and reproductive biology 2021. link 28 Yokoyama M, Tanaka K, Sugiyama T, Arakawa M, Miyake Y. Cesarean section is associated with increased risk of postpartum depressive symptoms in Japan: the Kyushu Okinawa Maternal and Child Health Study. Journal of affective disorders 2021. link 29 Deninotti J, Denis A, Berdoulat É. Emergency C-section, maternal satisfaction and emotion regulation strategies: effects on PTSD and postpartum depression symptoms. Journal of reproductive and infant psychology 2020. link 30 Miyake Y, Tanaka K, Arakawa M. Associations of job type, income, and education with postpartum depressive symptoms: The Kyushu Okinawa Maternal and Child Health Study. Psychiatry research 2020. link 31 Szpunar MJ. Association of antepartum vitamin D deficiency with postpartum depression: a clinical perspective. Public health nutrition 2020. link 32 Puryear LJ, Nong YH, Correa NP, Cox K, Greeley CS. Outcomes of Implementing Routine Screening and Referrals for Perinatal Mood Disorders in an Integrated Multi-site Pediatric and Obstetric Setting. Maternal and child health journal 2019. link 33 Zanardo V, Giliberti L, Giliberti E, Volpe F, Straface G, Greco P. The role of elective and emergency cesarean delivery in maternal postpartum anhedonia, anxiety, and depression. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 2018. link 34 Goldin Evans M, Phillippi S, Gee RE. Examining the Screening Practices of Physicians for Postpartum Depression: Implications for Improving Health Outcomes. Women's health issues : official publication of the Jacobs Institute of Women's Health 2015. link 35 Behimehr S, Curtis DA, Curtis RL, Hart CL. Perceived healthcare providers' responsibility with postpartum depression: whose problem is it, anyway?. The Journal of reproductive medicine 2014. link 36 Schaar GL, Hall M. A nurse-led initiative to improve obstetricians' screening for postpartum depression. Nursing for women's health 2013. link 37 Leddy MA, Farrow VA, Joseph GF, Schulkin J. Obstetrician/gynecologists and postpartum mental health: differences between CME course takers and nontakers. The Journal of continuing education in the health professions 2012. link 38 Leddy M, Haaga D, Gray J, Schulkin J. Postpartum mental health screening and diagnosis by obstetrician-gynecologists. Journal of psychosomatic obstetrics and gynaecology 2011. link 39 Thomas N, Sleath BL, Jackson E, West S, Gaynes B. Survey of characteristics and treatment preferences for physicians treating postpartum depression in the general medical setting. Community mental health journal 2008. link 40 Dent E. Mental health. Born under a bad sign. The Health service journal 2007. link 41 Mancini F, Carlson C, Albers L. Use of the Postpartum Depression Screening Scale in a collaborative obstetric practice. Journal of midwifery & women's health 2007. link 42 Blackmore ER, Carroll J, Reid A, Biringer A, Glazier RH, Midmer D et al.. The use of the Antenatal Psychosocial Health Assessment (ALPHA) tool in the detection of psychosocial risk factors for postpartum depression: a randomized controlled trial. Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC 2006. link32268-X) 43 Logsdon MC, Wisner K, Billings DM, Shanahan B. Raising the awareness of primary care providers about postpartum depression. Issues in mental health nursing 2006. link 44 Campagne DM. Comment on "the effectiveness of various postpartum depression treatments and the impact of antidepressant drugs on nursing infants". MedGenMed : Medscape general medicine 2004. link 45 Owoeye OA, Aina OF, Morakinyo O. Postpartum depression in a maternity hospital in Nigeria. East African medical journal 2004. link 46 Lepper HS, DiMatteo MR, Tinsley BJ. Postpartum depression: how much do obstetric nurses and obstetricians know?. Birth (Berkeley, Calif.) 1994. link 47 Daw JL. Postpartum depression. Southern medical journal 1988. link 48 Petrick JM. Postpartum depression. Identification of high-risk mothers. JOGN nursing; journal of obstetric, gynecologic, and neonatal nursing 1984. link

    Original source

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      Exercise in Pregnancy and Risk of Postpartum Depression: A Randomised Controlled Trial. — Saccone G, Buonomo G, Ammendola A, Bardi L, Motta M, Gragnano E et al. BJOG : an international journal of obstetrics and gynaecology (2026)
    2. [2]
      Real-world safety profile of zuranolone for postpartum depression: A FAERS analysis. — Chen L, Pan W, Chen Z, Yan S, Xu Y Journal of affective disorders (2026)
    3. [3]
      Meta-analysis of the association between gut microbiota and postpartum depression. — Guo Y, Chen W Journal of psychosomatic obstetrics and gynaecology (2025)
    4. [4]
      Prenatal exercise and its effects on postpartum mental health: systematic review and meta-analysis. — Hicks LE, Graf MD, Yeo S Archives of women's mental health (2025)
    5. [5]
      A randomized controlled trial investigating the impact of coping strategies training for fathers during pregnancy on postnatal depression among couples. — Mozaffari R, Bahrami N, Bahramkhani M, Griffiths MD, Alimoradi Z Journal of psychosomatic obstetrics and gynaecology (2025)
    6. [6]
      Exploration of intervention strategies for alleviating maternal separation anxiety from the perspective of obstetrics and neonatology collaboration. — Chen X, Yao L, Pi X Medicine (2025)
    7. [7]
      Safety assessment of brexanolone in the FAERS database: real adverse event analysis and discussion of side effects. — Jin L, Yang K, Wu X, Zhang J Expert opinion on drug safety (2025)
    8. [8]
      Association between postpartum depression and breastfeeding self-efficacy in mothers: a systematic review and meta-analysis. — Ahmadinezhad GS, Karimi FZ, Abdollahi M, NaviPour E BMC pregnancy and childbirth (2024)
    9. [9]
      Psychological experience of patients with postpartum depression: A qualitative meta-synthesis. — Jiaming W, Xin G, Jiajia D, Junjie P, Xue H, Yunchuan L et al. PloS one (2024)
    10. [10]
      The Impacts of Intimate Partner Violence on Postpartum Depression: An Updated Meta-Analysis. — Wei X, Wang W, Law YW, Zhang H Trauma, violence & abuse (2024)
    11. [11]
      Comparative impact of exercise-based interventions for postpartum depression: A Bayesian network meta-analysis. — Wang J, Carru C, Sedda S, Fiori PL, Li Z, Chen Z International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics (2024)
    12. [12]
      The Relationship Between Adverse Childhood Experiences and Postpartum Depression: A Systematic Review and Meta-Analysis. — Fu C, Li C, Wan X, Yang Y, Zhang S, Hu J Trauma, violence & abuse (2024)
    13. [13]
      Mothers' and fathers' depressive symptoms across four years postpartum: An examination of between- and bidirectional within-person relations. — Clifford BN, Eggum ND, Rogers A, Porter CL, Gale M, Sheppard JA et al. Journal of affective disorders (2024)
    14. [14]
      Developmental trajectories of internalizing distress among ethnic minoritized mothers following childbirth: Associations with early child psychological adjustment. — Osornio AC, Lane SP, Urizar GG, Gonzalez A, Halim MLD Development and psychopathology (2024)
    15. [15]
      Prevalence of Postpartum Depression in Mothers Presenting to a Pediatric Otolaryngology Clinic. — Klatzkow H, Gitomer S, St John-Larkin C, Scholes MA, Cooper E The Laryngoscope (2024)
    16. [16]
      Experience of postpartum depression among Chinese women: A meta-synthesis of qualitative research. — Xiao G, Hu J, Wang H, Li Q, Peng S, Qin C et al. Midwifery (2023)
    17. [17]
      Association between the continuum of care and postpartum depression among Angolan mothers. — Aoki A, Mochida K, Balogun OO, Tomo CK, Tchicondingosse L, Sapalalo P et al. Journal of affective disorders (2023)
    18. [18]
      Screening fathers for postpartum depression in a maternal-child health clinic: a program evaluation in a midwest urban academic medical center. — Wainwright S, Caskey R, Rodriguez A, Holicky A, Wagner-Schuman M, Glassgow AE BMC pregnancy and childbirth (2023)
    19. [19]
      Social and Behavioral Problems in School-Aged Children After Maternal Postpartum Depression: A Secondary Analysis of Future of Families and Child Wellbeing Study. — Blair LM, Wheeler E, Hutti MH Maternal and child health journal (2023)
    20. [20]
      Association between Edinburgh Postnatal Depression Scale and Serum Levels of Ketone Bodies and Vitamin D, Thyroid Function, and Iron Metabolism. — Noshiro K, Umazume T, Inubashiri M, Tamura M, Hosaka M, Watari H Nutrients (2023)
    21. [21]
      Perinatal depression and serum vitamin D status: A cross-sectional study in urban China. — Wang Y, Zhong W, Zhao A, Szeto IM, Lan H, Zhang J et al. Journal of affective disorders (2023)
    22. [22]
      Prevalence and Risk Factors of Postpartum Depression in Women: A Systematic Review and Meta-analysis. — Liu X, Wang S, Wang G Journal of clinical nursing (2022)
    23. [23]
      An FP's guide to identifying-and treating-postpartum depression. — LeFevre NM, Buck K, Strickland DP The Journal of family practice (2022)
    24. [24]
      One-Day Workshop Beneficial for Postpartum Depression. — Rosenberg K The American journal of nursing (2022)
    25. [25]
      Effectiveness of Telehealth Interventions for Women With Postpartum Depression: Systematic Review and Meta-analysis. — Zhao L, Chen J, Lan L, Deng N, Liao Y, Yue L et al. JMIR mHealth and uHealth (2021)
    26. [26]
      Postpartum Blues. — Mullins CH Patient education and counseling (2021)
    27. [27]
      Prevalence of postpartum depression at the clinic for obstetrics and gynecology in Kosovo teaching hospital: Demographic, obstetric and psychosocial risk factors. — Zejnullahu VA, Ukella-Lleshi D, Zejnullahu VA, Miftari E, Govori V European journal of obstetrics, gynecology, and reproductive biology (2021)
    28. [28]
      Cesarean section is associated with increased risk of postpartum depressive symptoms in Japan: the Kyushu Okinawa Maternal and Child Health Study. — Yokoyama M, Tanaka K, Sugiyama T, Arakawa M, Miyake Y Journal of affective disorders (2021)
    29. [29]
      Emergency C-section, maternal satisfaction and emotion regulation strategies: effects on PTSD and postpartum depression symptoms. — Deninotti J, Denis A, Berdoulat É Journal of reproductive and infant psychology (2020)
    30. [30]
      Associations of job type, income, and education with postpartum depressive symptoms: The Kyushu Okinawa Maternal and Child Health Study. — Miyake Y, Tanaka K, Arakawa M Psychiatry research (2020)
    31. [31]
      Association of antepartum vitamin D deficiency with postpartum depression: a clinical perspective. — Szpunar MJ Public health nutrition (2020)
    32. [32]
      Outcomes of Implementing Routine Screening and Referrals for Perinatal Mood Disorders in an Integrated Multi-site Pediatric and Obstetric Setting. — Puryear LJ, Nong YH, Correa NP, Cox K, Greeley CS Maternal and child health journal (2019)
    33. [33]
      The role of elective and emergency cesarean delivery in maternal postpartum anhedonia, anxiety, and depression. — Zanardo V, Giliberti L, Giliberti E, Volpe F, Straface G, Greco P International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics (2018)
    34. [34]
      Examining the Screening Practices of Physicians for Postpartum Depression: Implications for Improving Health Outcomes. — Goldin Evans M, Phillippi S, Gee RE Women's health issues : official publication of the Jacobs Institute of Women's Health (2015)
    35. [35]
      Perceived healthcare providers' responsibility with postpartum depression: whose problem is it, anyway? — Behimehr S, Curtis DA, Curtis RL, Hart CL The Journal of reproductive medicine (2014)
    36. [36]
      A nurse-led initiative to improve obstetricians' screening for postpartum depression. — Schaar GL, Hall M Nursing for women's health (2013)
    37. [37]
      Obstetrician/gynecologists and postpartum mental health: differences between CME course takers and nontakers. — Leddy MA, Farrow VA, Joseph GF, Schulkin J The Journal of continuing education in the health professions (2012)
    38. [38]
      Postpartum mental health screening and diagnosis by obstetrician-gynecologists. — Leddy M, Haaga D, Gray J, Schulkin J Journal of psychosomatic obstetrics and gynaecology (2011)
    39. [39]
      Survey of characteristics and treatment preferences for physicians treating postpartum depression in the general medical setting. — Thomas N, Sleath BL, Jackson E, West S, Gaynes B Community mental health journal (2008)
    40. [40]
      Mental health. Born under a bad sign. — Dent E The Health service journal (2007)
    41. [41]
      Use of the Postpartum Depression Screening Scale in a collaborative obstetric practice. — Mancini F, Carlson C, Albers L Journal of midwifery & women's health (2007)
    42. [42]
      The use of the Antenatal Psychosocial Health Assessment (ALPHA) tool in the detection of psychosocial risk factors for postpartum depression: a randomized controlled trial. — Blackmore ER, Carroll J, Reid A, Biringer A, Glazier RH, Midmer D et al. Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC (2006)
    43. [43]
      Raising the awareness of primary care providers about postpartum depression. — Logsdon MC, Wisner K, Billings DM, Shanahan B Issues in mental health nursing (2006)
    44. [44]
      Comment on "the effectiveness of various postpartum depression treatments and the impact of antidepressant drugs on nursing infants". — Campagne DM MedGenMed : Medscape general medicine (2004)
    45. [45]
      Postpartum depression in a maternity hospital in Nigeria. — Owoeye OA, Aina OF, Morakinyo O East African medical journal (2004)
    46. [46]
      Postpartum depression: how much do obstetric nurses and obstetricians know? — Lepper HS, DiMatteo MR, Tinsley BJ Birth (Berkeley, Calif.) (1994)
    47. [47]
      Postpartum depression. — Daw JL Southern medical journal (1988)
    48. [48]
      Postpartum depression. Identification of high-risk mothers. — Petrick JM JOGN nursing; journal of obstetric, gynecologic, and neonatal nursing (1984)
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