Maternal mental health conditions affect women during pregnancy and the year after birth, but estimates vary by definition, population, and measurement method. The figures below bring together global estimates, U.S. survey data, and modelled and cohort evidence from England.
Contents
- Global and U.S. burden
- U.S. postpartum symptoms by location
- Screening and provider discussions
- Perinatal mental health in England
- Age and deprivation in England
- Mental health, adversity, and substance use
Global and U.S. burden
The World Health Organization estimated in 2022 that almost 1 in 5 women experience a mental health condition during pregnancy or in the year after birth. Among women with perinatal mental health conditions, 20% experience suicidal thoughts or engage in acts of self-harm. These are broad global estimates and should not be read as a diagnosis rate for every country. (WHO, 2022)
U.S. figures illustrate how different measures capture different parts of the burden. The CDC cited mental health conditions as an underlying cause in approximately 9% of U.S. pregnancy-related deaths in an estimate published in 2020. In a national survey covering 2005–2009, past-year major depressive episodes affected 7.7% of pregnant U.S. females of reproductive age. (CDC, 2020)
The global WHO estimate covers a broad perinatal mental-health category, while the U.S. depression figure concerns major depressive episodes and a specific survey period. Neither statistic is a direct substitute for the other. The mortality statistic also describes an underlying cause cited for pregnancy-related deaths, not the prevalence of mental health conditions among all pregnant people.
U.S. postpartum symptoms by location
The CDC’s 2018 Pregnancy Risk Assessment Monitoring System analysis measured self-reported postpartum depressive symptoms among women with a recent live birth across 31 U.S. PRAMS sites. The overall prevalence was 13.2%. This is a screening-symptom measure rather than a clinical diagnosis. (CDC, 2020)
Selected site results show substantial geographic variation:
| PRAMS site | Self-reported postpartum depressive symptoms, 2018 |
|---|---|
| Mississippi | 23.5% |
| Michigan | 16.4% |
| Louisiana | 15.9% |
| Alaska | 14.8% |
| Kansas | 14.7% |
| Kentucky | 14.0% |
| Missouri | 13.7% |
| Georgia | 13.6% |
| Delaware | 13.1% |
| Connecticut | 11.7% |
| Colorado | 11.1% |
| Maine | 10.9% |
| Minnesota | 10.6% |
| Massachusetts | 10.3% |
| Illinois | 9.7% |
Within these listed results, Mississippi recorded 23.5%, while Illinois recorded 9.7%. Alaska recorded 14.8%, Colorado 11.1%, Connecticut 11.7%, Delaware 13.1%, Georgia 13.6%, Kansas 14.7%, Kentucky 14.0%, Louisiana 15.9%, Maine 10.9%, Massachusetts 10.3%, Michigan 16.4%, Minnesota 10.6%, and Missouri 13.7%. These percentages come from the 2018 analysis and reflect the populations and survey methods used at each site.
The geographic figures are useful for showing that a national average can conceal different local results. They do not, by themselves, explain why the percentages differed, and the CDC analysis should not be used to rank current state conditions because the measurement period was 2018.
Screening and provider discussions
The same 31-site PRAMS analysis measured whether providers asked about depression and whether women attended a postpartum visit. Among women who received prenatal care, 79.1% reported that a provider asked about depression during pregnancy. The site range was 51.3% in Puerto Rico to 90.7% in Alaska. (CDC, 2020)
Among women who attended a postpartum visit, 87.4% reported that a provider asked about postpartum depression. The site range was 50.7% in Puerto Rico to 96.2% in Vermont. Overall, 90.1% of women in the 31-site analysis attended a postpartum visit.
| Measure | Result | Population or sites |
|---|---|---|
| Prenatal depression inquiry | 79.1% | Women with prenatal care, 31 PRAMS sites, 2018 |
| Prenatal inquiry range | 51.3%–90.7% | Puerto Rico to Alaska |
| Postpartum depression inquiry | 87.4% | Women attending a postpartum visit |
| Postpartum inquiry range | 50.7%–96.2% | Puerto Rico to Vermont |
| Attendance at a postpartum visit | 90.1% | 31 PRAMS sites |
Trend results were also reported for sites that continuously contributed data. Among 22 continuously reporting sites, prenatal provider inquiry rose from 76.2% in 2016 to 79.3% in 2018. Postpartum provider inquiry rose from 84.1% to 88.0% over the same period. Among 16 continuously reporting sites, postpartum depressive symptoms increased by 0.22 percentage points per year from 2012 to 2018.
These results distinguish access to a visit from the experience of being asked about depression. They also distinguish provider inquiry from a diagnosis or treatment outcome. A question about depression can support identification, but the percentages do not show whether every person with symptoms received follow-up care.
Perinatal mental health in England
The Office for Health Improvement and Disparities estimated modelled perinatal mental health condition prevalence at 25.8% among females with a birth event in England in the 2019 cohort. That represented an estimated 155,660 females. Common mental disorders accounted for an estimated 25.3% prevalence and 152,358 affected females. (OHID, 2016–2019 estimates)
The combined group of severe mental illness, personality disorders, and eating disorders had an estimated prevalence of 1.2%, representing 6,960 females in the same 2019 birth cohort. These categories overlap conceptually with the broader mental-health picture but should not be added to it as separate, non-overlapping totals.
Modelled prevalence varied by geography. At upper-tier local-authority level, the range was 20.8% to 29.4%. At integrated-care-board level, the range was 22.6% to 28.2%. Regional estimates included 27.5% in North East England, 27.1% in Yorkshire and the Humber, 24.7% in London, and 24.6% in the South East of England.
Several local examples show the scale of the modelled variation:
- Blackpool had the highest listed upper-tier local-authority prevalence at 29.4%, affecting an estimated 456 females.
- Kingston upon Hull had a listed prevalence of 29.2%, affecting an estimated 921 females.
- Richmond upon Thames had the lowest listed upper-tier local-authority prevalence at 20.8%, affecting an estimated 446 females.
- NHS Black Country had the highest listed integrated-care-board prevalence at 28.2%, affecting an estimated 4,129 females.
- NHS Surrey Heartlands had the lowest listed integrated-care-board prevalence at 22.6%, affecting an estimated 2,420 females.
- NHS Greater Manchester had a listed prevalence of 27.1%, affecting an estimated 9,221 females.
- NHS South West London had a listed prevalence of 23.3%, affecting an estimated 4,446 females.
The English figures are modelled estimates for females with a birth event, not a direct count of clinically assessed cases. Local percentages and counts therefore describe the OHID modelling framework for the 2019 cohort.
Age and deprivation in England
The OHID report also included perinatal mental health prevalence by age in the 2016 Clinical Practice Research Datalink birth cohort. The highest listed percentage was 39.58% among females aged 15–19, followed by 36.79% among those aged 20–24. The percentages were 28.22% for ages 25–29, 21.27% for ages 30–34, and 20.30% for ages 35–39. For females aged 40 and over, prevalence was 22.32%.
| Age group | Perinatal mental health prevalence, 2016 CPRD cohort |
|---|---|
| 15–19 | 39.58% |
| 20–24 | 36.79% |
| 25–29 | 28.22% |
| 30–34 | 21.27% |
| 35–39 | 20.30% |
| 40 and over | 22.32% |
The same cohort showed variation across English deprivation deciles. Prevalence was 31.98% in the most deprived decile, 27.31% in decile 2, 25.70% in decile 3, 26.15% in decile 4, and 24.48% in decile 5. In the least deprived decile, prevalence was 20.15%.
These age and deprivation results come directly from a 2016 CPRD cohort, whereas the national and geographic modelled results above refer to the 2019 birth cohort. They should not be treated as a single current estimate or as proof that age or deprivation alone caused the observed differences.
Mental health, adversity, and substance use
A separate CDC analysis examined postpartum substance use in a seven-state PRAMS recontact sample. The sample covered 2019–2020 analysis of 2019 births and included states with high opioid-overdose death rates. Postpartum substance use was reported by 25.6% of respondents, while postpartum polysubstance use was reported by 5.9%. (CDC, 2023)
The analysis found different reported substance-use percentages according to mental-health status. Postpartum substance use was 48.5% among respondents with recent depressive symptoms, compared with 24.0% among those without recent depressive symptoms. It was 42.8% among respondents with current depression, compared with 21.9% among those without current depression.
Stressful life events were also associated with higher reported use in this sample. Among respondents reporting six or more stressful life events before giving birth, postpartum substance use was 67.1% and polysubstance use was 20.8%.
These associations do not establish that depression or stressful life events caused substance use. The results apply to the seven-state recontact sample and its 2019–2020 analysis period, not to every postpartum population in the United States. Taken together with the screening findings, they show why maternal mental health statistics need careful attention to the population studied, the definition used, and the period measured.