Can stress during pregnancy lead to postpartum depression?

Recently, I talked about postpartum depression and baby blues. I highlighted the impact of postpartum depression on new moms and why it's best to seek help quickly.

But today, let's discuss an even more fundamental question: can stress during pregnancy lead to postpartum depression?

This question is fundamental as it can help us uncover risk factors for postpartum depression, consequently allowing us to buffer against it before it gets the chance to occur after childbirth.

Interestingly, the answer is as you might have expected.

Mothers who were more stressed during pregnancy had worse postpartum depression symptoms. Also, older mothers from low-income homes, with less education, and from minority populations were more at risk of postpartum depression. Knowing that low-income and minority women experience more stress, it's not surprising that the rate of postpartum depression is 80% higher among African American women and 40% higher among Hispanic-American women, compared to White-American women.

Conversely, being a younger, educated mother from a financially stable home buffered against depression after giving birth.

Social support from family and friends during pregnancy can help prevent postpartum depression resulting from stress. But its impact is only limited to certain kinds of stress. Interesting, isn't it?

What kinds of stress impact postpartum depression the most?

The study, led by researcher Shayna Coburn, explored the role of stress on postpartum depression and how support from loved ones can help buffer against it.

The study identified four major kinds of stress common among pregnant moms, and how they impact postpartum depression:

• Daily stressors: the hassle of shopping, domestic chores, etc.
• Family interpersonal stress: issues with family members
• Partner interpersonal stress: problems with their partner, such as arguments and discussions about divorce or separation.
• Culture-specific stress: such as concerns about immigration and not knowing enough English language, which is common among Hispanic women.

The study results show that the four types of stress before birth all increased depression after birth. However, daily stressors and interpersonal stress with partner had the strongest impact on postpartum depression.

Also, the first three types of stress all impacted postpartum depression in different ways. So, a pregnant woman experiencing only stress from daily hassles may feel postpartum depression differently from another pregnant woman battling personal issues with their spouse.

So out of these kinds of stress, which type can social support help us deal with?

The study found that social support from family and friends could only fight against family interpersonal stress, and not any other kind of stress.

Logically, it makes sense, seeing that family interpersonal stress is caused by negativity from the family. So if the same or other family members were to show support rather than make life difficult for the soon-to-be mom, stress is reduced, lowering the chances or severity of postpartum depression symptoms.

But having strong social support from loved ones didn't offset postpartum depression in women who experienced other stressors from daily chores or their romantic partner.

This is interesting because we have always considered social support to be key in combating stress and depression, no matter the kind.

Stress and social support

The relationship between stress and social support may be more nuanced than we think after all.

Your supportive loved ones may be able to help you deal with some kinds of stress.

But having to battle daily hassles and a troubled relationship, an empathetic listening ear may just not cut it. More practical help (such as seeing a relationship counselor or mental health expert, or help with daily tasks) may be required to manage stress and the problems it heralds.

The bottom line

Postpartum depression is connected to the stress the mother goes through before delivering the child. But different kinds of stress impact her depression symptoms differently.

So if you want to help as a friend or family, identify what kind of stress the soon-to-be mom is experiencing, and try to address it. Do they need help with cooking and shopping? You might want to do it for them, rather than simply offering a listening ear when they're tired.

And as a soon-to-be mom, preventing postpartum depression is crucial if you want to be emotionally strong to give yourself and your baby the best care.

So, now that you're preparing to deliver, identify what stress you're battling and find ways to address it practically.

Author

Satu H. Woodland, PMHCNS-BC, APRN Satu Woodland is owner and clinician of Hope Mental Health, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults.  Ms. Woodland with her background in nursing, prefers a holistic and integrative approach to mental health care that addresses the mind and body together. While Ms. Woodland provides medication management services in all her patients, she believes in long-lasting solutions that include a number of psychotherapies, namely cognitive behavioral therapy, exposure and response prevention therapy, attention to lifestyle, evidenced based alternative psychiatric care and spirituality. If you’d like to gain control over your mental health issues, call Hope Mental Health at 208-918-0958, or use the online scheduling tool to set up an initial consultation.