What causes perinatal mental health problems?

I think the fact that I had had 6 years of often traumatic infertility treatment before getting pregnant and that I had had a number of miscarriages contributed to my mental health issues…

Don't worry if you aren't sure exactly why you're not feeling ok. Sometimes problems can develop suddenly with no obvious reason. We all deserve understanding and support.

Past experience of mental health problems

Your experience of mental health will be personal to you. As will your experience of being pregnant and having a baby.

But if you've had mental health problems in the past, being pregnant or having a baby can increase the risk of those problems happening again. This includes any previous perinatal mental health problems.

It's important to understand what might trigger another episode. And what support you may need during this time. You can speak to your doctor about this.

See our pages on types of mental health problems for more information.

Biological or hormonal causes

Some people suggest that perinatal mental health problems have a biological cause. This includes changes in your body during and after pregnancy, such as changes to your hormones.

Some studies suggest that changes to your hormones during pregnancy and after giving birth can cause differences in your mood. But not everyone who gets pregnant and experiences these changes goes on to develop a perinatal mental health problem.

So changes in hormones are unlikely to be the only cause.

Lack of support

Having a baby is a major life event. It can be stressful, exhausting and overwhelming. If you don't have people around to help, this could affect how well you cope. It may mean that you're more likely to develop a mental health problem.

The charity Gingerbread gives advice and practical support to single parent families. Home-Start can pair you with a volunteer who can visit to offer practical and emotional support.

Our page of useful contacts has details of other organisations who can help you find support.

Stigma and discrimination

Some groups can face stigma and discrimination which can affect our mental health. We have information that may help if you experience stigma or discrimination based on your sexual or gender identity. Or on your race or ethnicity.

Difficult childhood experiences

Some of us have difficult experiences in our childhood, such as:

• Physical, sexual or emotional abuse
• Neglect
• An unstable family situation
• Losing someone close to us

Research shows that these experiences could make you more vulnerable to perinatal mental health problems later in life. These problems include depression and anxiety.

Childhood experiences can also have a big effect on how you feel about becoming a parent. For example, if your own parents didn't have good parenting skills, you may find it hard to adapt to your new role as a parent.

You might feel unsure of how to interpret your baby's needs. You may even fear that you're not going to be there for them, because you aren't sure how to take care of them.

For some people, these experiences can also make them more determined to be a better parent.

However you feel, getting the right support can help. NAPAC supports anyone who's experienced abuse in childhood. This includes sexual, physical or emotional abuse, and neglect.

I have PTSD due to trauma experienced in childhood... I worked so hard to fight my anxiety and accept my experiences, and to realise that these were very different to the circumstances in which I would be bringing up my daughter.

Experience of abuse

Experiencing abuse can sometimes cause:

• Anxiety
• Depression
• Low self-esteem
• Post-traumatic stress disorder (PTSD)

So if you've experienced abuse, you may be more likely to develop perinatal mental health problems.

Types of abuse include:

• Domestic violence
• Verbal abuse
• Emotional abuse
• Sexual assault and rape
• Violent assault
• Financial abuse – for example, if a partner tries to have power over you by stopping you having control over your own money

Experiencing abuse could also affect how you feel about becoming a parent. For example, if you experienced abuse while growing up, you may now struggle to trust or relate to other people. This may mean that you find it difficult to relate to your baby, or bond with them.

You might also have fears of abandonment related to abuse or trauma. This could make you worry about leaving your baby, or your baby coming to harm.

See our pages on abuse for details of organisations who support people with experience of abuse.

Low self-esteem

If you have low self-esteem, you may doubt your ability to cope as a parent. For example, when your baby cries you may think it's because of something you've done wrong. Or because of something important you haven't done.

The way you think about yourself can make you more likely to develop perinatal mental health problems. For example, depression and anxiety.

Our pages on self-esteem have more information. This includes ways to improve your self-esteem. Some of these tips might feel difficult while you're pregnant or have a new baby. But even small changes can make a big difference to how you feel.

I was angry, sad, irrational, indifferent towards my husband... I lied and said things were better than the reality out of fear of being laughed at and being judged as a bad mother.

Stressful living conditions

It can be difficult for anyone to deal with stressful living conditions. If you're pregnant or recently had a baby, this may feel even harder. These conditions can make you more likely to develop a perinatal mental health problem.

For example, you may be struggling with:

• Money problems
• Insecure or poor housing
• Insecure employment

These problems can feel even more difficult if you live alone. Or if you have little or no support from other people. Our information about peer support and tips to manage loneliness might help.

If you're living in these conditions, you may worry that you're unable to provide your baby with everything that they need. Or you might feel like you're failing your baby. See our pages on on housing and mental health and money and mental health for ways to find support.

Major life events

Major life events can increase the level of stress in your life. Examples of major life events include:

• An illness or death in the family
• The break-up of a relationship
• Moving house
• Losing your job

If you experience these while you're pregnant or after having a baby, you may be more likely to develop a perinatal mental health problem.

Having a baby is also a major life event. It's likely to involve many changes in your life. You may leave your job or change your working hours. This can have a big impact on your finances. 

Or you may need to give up or reduce social activities, and find it difficult to spend time with friends. This can make you feel lonely, which could contribute to mental health problems.

Our information on bereavement, money and mental health and loneliness may help.

If your baby is unwell

Some babies become unwell after birth or are born early, and have to spend more time in hospital. This may be in a neonatal intensive care unit (NICU). For many parents, this can come as a shock.

Having a baby on a neonatal unit can have a big impact on your mental health. It can be very distressing and can lead to symptoms of anxiety and postnatal PTSD, however long your baby is in hospital.

You may feel powerless and guilty about not being able to do more to help. You may have to spend time away from your baby. And you're likely to be experiencing lots of different emotions at once, which can be challenging to manage. Or you may be grieving for what you imagined your birth or the first few days with your baby would be like.

These are all very common feelings and experiences when having a baby in neonatal care. But they can develop into a mental health problem.

The charity Bliss has more information for parents who have a baby in neonatal care.

I looked at this little, tiny baby in an incubator, and I felt numb. Then the guilt and shock quietly took over. Where was that all-consuming love people talked about? I felt sick. I didn’t know what to do. At the time I felt so ashamed.

Infant loss and mental health

Experiencing infant loss can be extremely traumatic and can have a big effect on your mental health. This includes losing your baby through miscarriage, still birth or sudden infant death syndrome (SIDS).

It's important to remember that you don't have to cope alone. There is support out there. You can get more information and support from these organisations:

• The Lullaby Trust
• Tommy's
• The Miscarriage Association
• Sands

Or see our pages on bereavement to find support for coping with your loss.

Published: April 2024

Next review planned: April 2027

References and bibliography available on request.

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