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Maternal Depression Most Common at Four Years After Birth of First Child

The number of first-time mothers suffering from depression peaks fours years after giving birth, finds a new study published in BJOG:An International Journal of Obstetrics and Gynaecology. This new research from Murdoch Children's Research Institute, shines a spotlight on the mental health and wellbeing of mothers of pre-school aged children. It concludes with a call for policy and practice in primary health care to safeguard the mental health of mothers well beyond the period immediately after birth.

The Maternal Health Study, an Australian longitudinal study of over 1500 first-time mothers, counters the commonly-held view that the perinatal period — the weeks  before and soon after birth—is the peak time for vulnerability to maternal depression. Dr Hannah Woolhouse, lead author, said the prevalence of depressive symptoms was higher at four years post partum than any point in the first  year after birth. While many women in the study experienced depression as a recurring and/or episodic condition, 40 percent of mothers reported depressive symptoms for the first time at the four year mark.

The strongest predictor of depressive symptoms at four years postpartum was having previously reported depressive symptoms either in early pregnancy, or in the first 12 months after birth. And women with one child four years after birth were more than twice as likely to report  higher levels of depressive symptoms than women who had two or more children by the same time. Other factors associated with maternal depression at 4 years postpartum were:

  • being under 25 at the time of a first birth;
  • intimate partner abuse;
  • having a low income;
  • having multiple social health issues, such as housing problems,separation or divorce, losing your job, or a close family member having a major illness or passing away.

While other studies have reported on maternal depression in the perinatal period and up to two years post partum, this study exposes the extent of postnatal depression up to four years after the birth of a first child. Researchers found almost one mother in three reported depressive symptoms at some stage in the first four years after birth. "The fact that almost one in three first time mothers reported depression on at least one occasion from early pregnancy to four years, coupled with the finding that the prevalence of depressive symptoms was highest at four years, suggests a need to rethink current models for maternal health surveillance and primary care support," said Dr Woolhouse.

Associate Professor Brown suggests that greater attention to the emotional wellbeing of mothers of pre-school age children is warranted. And the researchers add that current systems of mental health monitoring may not be targetting mothers at higher risk of mental health issues. "The high prevalence of depression amongst mothers of four year olds suggests there may be a need to extend the monitoring of maternal mental health to at least four years postpartum, and provide women with ongoing support extending well beyond the first 12 months postpartum."

Other factors known to increase the risk of maternal depression are common physical health issues experienced by many mothers such as back pain and chronic exhaustion.

For parents needing help with depression:
Lifeline offers crisis support Ph:13 11 14
Post and Antenatal Depression Association has a helpline Ph:1300 726 3061300 726 306.