Does Childbirth Qualify as a General Mental Health Risk Factor?

Does Childbirth Qualify as a General Mental Health Risk Factor?Recent findings from a Danish research team indicate that even women who plan their pregnancies have increased chances of developing new mental health problems in the aftermath of childbirth.

Small but significant numbers of women in the U.S. and throughout the world develop serious mental health issues in the aftermath of pregnancy. Researchers have long believed that risks for such postpartum issues largely affect women who didn’t expect to get pregnant. However, in a study published in January 2015 in the journal Epidemiology, researchers from Denmark’s University of Aarhus concluded that elevated risks for new-onset mental illness also commonly appear in women having planned pregnancies.

Postpartum Mental Health Issues

There are three main mental health issues for women in the aftermath of pregnancy: the relatively common condition known as postpartum blues, the far less common condition known as postpartum depression and the rare condition known as postpartum psychosis. In the U.S., the rate for postpartum blues—a fairly mild form of depression—ranges from 50 percent to 85 percent. The condition occurs so often that many experts classify it as an expected outcome of childbirth, not as any kind of disorder. About 12 percent of American women develop the much more serious depression symptoms associated with postpartum depression; these symptoms are largely functionally identical to major depression, although they may manifest in unique ways in the context of recent childbirth and new motherhood. Only roughly 0.1 percent to 0.2 percent of new mothers develop postpartum psychosis, a severe ailment characterized by hallucinations and delusional thinking in the weeks immediately following childbirth.

Women with postpartum blues experience temporary, notably unpleasant changes in mood but do not lose their ability to care for themselves or their children. Like a person with major depression, a woman with postpartum depression can lose the ability to care for her own welfare, in addition to losing the ability to care for the welfare of her newborn child. Women with this illness rarely act on any negative feelings toward their newborns. However, women with postpartum psychosis make actively seek to harm their infant children.

Unplanned Pregnancy and Mental Health

In the U.S., unplanned pregnancies account for almost 50 percent of all pregnancies. In addition to experiencing the hormone-related stress and other forms of stress associated with all cases of pregnancy, a woman with an unplanned or unwanted pregnancy may experience substantial additional stress associated with such issues as the unexpected need to make substantial lifestyle chances, unexpected financial pressure and (in some cases) the decision of whether to carry a pregnancy to term. Statistically speaking, a woman carrying an unplanned child may have significantly increased chances of experiencing depression symptoms. In addition, when stress remains a factor, some of these symptoms may not fully resolve for years after an unplanned child is born.

Is Childbirth a Mental Health Risk Factor?

In the study published in Epidemiology, the University of Aarhus researchers used data gathered from a large group of Danish women from 1994 to 2005 to help determine if women who plan their pregnancies have the same types of risk for previously undiagnosed mental illness as women dealing with unplanned, potentially unwanted pregnancies. All of the participants in the study were women who conceived their children through in vitro fertilization or IVF. The researchers compared the rate for new, postpartum mental illness in these women to the rate of new mental illness in a second group of Danish women who had never been pregnant.

After completing their comparison, the researchers concluded that in the aftermath of childbirth, the women who planned their pregnancies through IVF had a roughly 200 percent higher chance of experiencing new-onset mental health issues than the women who had never been pregnant. This increased risk remained in effect for about three months. After the three-month window closed, the women who had planned their pregnancies developed new mental health problems at a slightly lower rate than their counterparts with no experience of childbirth.

The study’s authors believe their findings show that new mothers who plan their pregnancies do not escape the postpartum mental health risks more typically associated with unplanned or unwanted pregnancies. This finding indicates that childbirth in general may qualify as a substantial, albeit temporary, mental health risk for all women, regardless of their preexisting desire to have a child.18

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