Depression in Pregnancy: Social Factors in PostPartum Depression

What social factors are linked to depression in pregnancy? Image by kamuelaboy

What social factors are linked to depression in pregnancy? Image by kamuelaboy.

Depression can occur while you’re pregnant (antenatal) or shortly after the birth of a child (postpartum).  Postpartum depression is a serious condition, and is listed in the Diagnostic and Statistical Manual V or DSM V.

Researchers have linked several social factors to the ‘baby blues’ – and this condition may be more widespread than we think. What can you do to reduce your chances of feeling depressed when you’re having a baby?

DSM V: Pregnancy Depression

What is pregnancy depression, technically-speaking? The DSM V lists postpartum depression as, “Major Depression with peripartum onset.” DSM V is the current book of diagnoses for psychiatric disorders, and explains this condition as a major depression starting in pregnancy, or up to four weeks after delivery.

The DSM V states that 3% to 5% of women who have babies experience the condition.

Depression During Pregnancy: More Prevalent Than We Think?

Katherine Stone, founder of Post-partum Progress, however, believes the percentage listed is too low, and the time frame is too brief. She blogs that evaluating based on the shorter time frame prevents women who experience depression surrounding a pregnancy from getting a correct diagnosis.

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Research supports Stone’s view. Katherine L. Wisner, M.D, a researcher at Northwestern University, conducted the largest study of postpartum women yet to date, and published the results earlier this year. After interviewing 10,000 women following birth, Dr. Wisner reported one in seven women ‘screened positive for depression.” That’s 14%, much higher than the 3-5% suggested in the DSM V.

Of those women who had depressive symptoms, 19.3% “thought of harming themselves.”  The study also associated a diagnosis of an anxiety disorder before pregnancy with developing depression during or after pregnancy.

PostPartum Depression Research: Social Support and Social Conflict

The DSM V states that about half of peripartum depressions occur before birth. Researchers have studied a variety of factors to see if they contribute to the likelihood of depression in pregnancy, and found that a lack of social support and social conflict are key.  In a 2007 study, Dr. Westdahl and colleagues conducted interviews with 1047 pregnant women and girls from in the period that ranges from early pregnancy up through 1 year after their baby was born.

Perhaps it is not surprising that pregnant women with the least social support were more likely to be depressed. Researchers measured social support on a seven-item scale, including whether you have someone to talk to about a problem, or borrow money from in an emergency.

Another social issue the researchers measured was social conflict. The researchers measured the intensity of the conflict within the pregnant women’s social interactions on another scale and found that social conflict increased risk of depressive symptoms like crying and feelings of hopelessness even more than a lack of social support.

This study found rates of depressive symptoms varied from 11% to those with few risk factors to 78% of those with more risk factors.

Having depressive symptoms is not the same as being diagnosed with major depression, which is part of the reason the percentages are so much higher than the percentage of those the DSM 5 expects to have a diagnosis of major depression associated with pregnancy.

Pregnancy Depression: Implications of the Research

How common are depressive symptoms in pregnancy? Image by grietgriet.

How common are depressive symptoms in pregnancy? Image by grietgriet.

If you’re pregnant, and have little or no social support, seek it out. As a society, we should encourage community programs, religious organizations, and even friends and neighbors to provide support for pregnant women, even if the support is just a sympathetic ear.

Social conflict in pregnancy is a red flag signaling a higher potential for depression. For the sake of the mother, and the sake of the baby, efforts to insulate pregnant women from social conflict should be high priority.


Paul, Marla. Surprising Rate of Women Have Depression After Childbirth: One in Every Seven Women have Significant Depressive Symptoms. Northwestern University. (2013) Accessed October 16, 2013.

Stone, Katherine. What The New DSM-V Says About Postpartum Depression & Psychosis. Postpartum Progress. (2013). Accessed October 16, 2013.

Westdahl, C. et al.  Social Support and Social Conflict as Predictors of Prenatal Depression. Obstetrics and Gynecology (2007). Accessed October 16, 2013.

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