Postpartum depression statistics show that depressive symptoms are common after birth and vary substantially across groups. In a 2018 CDC analysis of 31 PRAMS sites, 13.2% of women with a recent live birth reported postpartum depressive symptoms—about 1 in 8 women. These figures describe reported symptoms, not a diagnosis for every respondent.
Contents
- Key U.S. rates
- Differences by state
- Age, race, and education
- Social and health-related factors
- Screening and provider discussions
- When symptoms appear and persist
Key U.S. rates
The CDC’s Vital Signs: Postpartum Depressive Symptoms and Provider Discussions About Perinatal Depression — United States, 2018 reported an overall rate of 13.2% across 31 PRAMS sites. The same CDC analysis found that 79.1% of women said a provider asked about depression during prenatal visits, while 87.4% said a provider asked during postpartum visits.
An earlier CDC report, Trends in Postpartum Depressive Symptoms — 27 States, 2004, 2008, and 2012, found an overall rate of 11.5% in 2012 across the 27-state reporting set. Across that same reporting set, the rate fell from 15.5% in 2004 to 11.5% in 2012. In a smaller group of 13 continuously reporting states, it fell from 14.8% in 2004 to 9.8% in 2012.
These historical percentages should be read in their original measurement context. The 2004, 2008, and 2012 estimates came from a different reporting set than the 2018 estimate, so they should not be treated as a perfectly matched national time series. The CDC nevertheless found a 0.22 percentage-point annual increase among 16 continuously reporting sites from 2012 to 2018.
The CDC also reported that the rate of depression diagnoses at delivery was seven times higher in 2015 than in 2000. That measure is a diagnosis at delivery, rather than the same self-reported postpartum-symptom measure used in the PRAMS findings.
Differences by state
The 2018 CDC results varied widely among the 31 reporting sites. Mississippi had the highest listed rate, at 23.5%, followed by West Virginia at 19.4%. Georgia and Virginia each reported 18.0%. Louisiana reported 16.5%, Puerto Rico 16.2%, and Alaska 16.1%.
Other sites reported rates close to the overall estimate or below it. Kansas reported 15.8%, Arizona 15.0%, New Jersey 14.6%, Missouri 14.3%, and New York City 14.4%. Wisconsin reported 14.0%, Utah 13.9%, Washington 13.8%, Kentucky 13.6%, Wyoming 13.5%, and New Mexico 13.4%.
The lower reported rates included Delaware at 12.8%, Maine and Nebraska at 12.0%, Rhode Island at 11.8%, Michigan and South Dakota at 11.7%, Connecticut at 11.3%, Colorado at 11.1%, Minnesota and Pennsylvania at 10.9%, and Massachusetts at 10.3%. Illinois, North Dakota, and Vermont each reported 9.7%.
| 2018 PRAMS site | Reported postpartum depressive symptoms |
|---|---|
| Mississippi | 23.5% |
| West Virginia | 19.4% |
| Georgia | 18.0% |
| Virginia | 18.0% |
| Louisiana | 16.5% |
| Alaska | 16.1% |
| Overall, 31 sites | 13.2% |
| Colorado | 11.1% |
| Massachusetts | 10.3% |
| Illinois | 9.7% |
| North Dakota | 9.7% |
| Vermont | 9.7% |
The earlier 2012 report also showed geographic variation: Georgia reported 8.0%, while Arkansas reported 20.1%. Because these are estimates for specific reporting systems and years, a state’s percentage should not be generalized to every year or to every person living there.
Age, race, and education
Age differences were pronounced in the 2018 CDC analysis. Women aged 19 years or younger reported postpartum depressive symptoms at 21.4%. The rate was 17.1% among women aged 20 to 24, 12.8% among women aged 25 to 34, and 9.8% among women aged 35 or older.
The 2012 CDC report showed a similar age pattern, although the percentages were different. The rate was 18.3% among women aged 19 or younger, 11.5% among women aged 20 to 24, 8.6% among women aged 25 to 34, and 8.9% among women aged 35 or older.
In 2018, non-Hispanic American Indian/Alaska Native women reported a rate of 22.0%, and non-Hispanic Black women reported 19.0%. Hispanic women reported 13.4%, while non-Hispanic Asian/Pacific Islander women reported 11.5%. The 2012 estimates were 17.5% for American Indian/Alaska Native women, 10.8% for non-Hispanic Black women, 10.5% for Hispanic women, and 14.0% for Asian/Pacific Islander women.
Education also corresponded with different reported rates in 2018. Women with 12 years of education or less reported symptoms at 17.7%, compared with 9.7% among women with more than 12 years of education. In 2012, women with more than 12 years of education had a reported rate of 8.0%.
Marital status showed a similar difference in the 2018 data: 18.0% among unmarried women and 11.3% among married women. The 2012 report found a 12.7% rate among unmarried women. These comparisons describe group-level survey results and do not establish that any one demographic characteristic causes postpartum depression.
Social and health-related factors
Several 2018 CDC comparisons involved access, behavior, prior mental health, or stressful experiences. Women who participated in WIC during pregnancy reported symptoms at 16.2%, compared with 11.9% among women who did not participate. Women with Medicaid at delivery reported 16.3%, compared with 11.6% among women with private insurance.
Smoking was also associated with different reported rates. Women who smoked during the last three months of pregnancy reported symptoms at 20.4%, compared with 12.2% among women who did not. Among women who smoked postpartum, the rate was 23.7%; among those who did not smoke postpartum, it was 12.5%.
Women who experienced intimate partner violence before or during pregnancy reported symptoms at 20.6%, compared with 12.9% among women who did not report that experience. The 2012 CDC report found 14.4% among women reporting three to five stressful life events before birth and 24.2% among women reporting six to 13 such events.
Prior depression was one of the largest differences in the 2018 CDC comparisons. Women with self-reported depression before pregnancy reported postpartum depressive symptoms at 24.2%, compared with 12.7% among women without self-reported depression before pregnancy. Women with self-reported depression during pregnancy reported 23.6%, compared with 12.8% among women without depression during pregnancy.
The 2012 report also examined birth and newborn factors. Women with preterm births reported symptoms at 11.7%, compared with 9.5% among women with term, normal-birthweight infants. Women whose infants were admitted to a NICU reported 12.5%.
Screening and provider discussions
Provider questions about depression were common but not universal in the 2018 CDC analysis. Overall, 79.1% of women reported being asked about depression during prenatal visits, and 87.4% reported being asked during postpartum visits.
Among women aged 19 or younger, 86.9% reported being asked during prenatal visits and 91.3% during postpartum visits. Among non-Hispanic American Indian/Alaska Native women, the corresponding percentages were 91.5% and 92.2%.
Among women with Medicaid at delivery, 84.3% reported a prenatal question and 87.9% a postpartum question. Among women who self-reported depression during pregnancy, 90.7% reported being asked about depression during postpartum visits.
The survey measures whether respondents reported being asked, not whether screening was completed with a particular instrument or whether treatment followed. It also does not show that a discussion prevented symptoms or produced a diagnosis.
When symptoms appear and persist
Timing matters because postpartum depression can emerge beyond the earliest weeks after birth. NIMH states that most episodes of perinatal depression begin within four to eight weeks after the baby is born. It describes mild baby blues as generally occurring during the first two weeks after giving birth and says mood changes or anxiety lasting longer than two weeks may indicate postpartum depression. ACOG says postpartum depression can occur up to one year after birth and most commonly starts about one to three weeks after childbirth.
In the 2019 PRAMS-linked follow-up study, 11.9% of respondents reported postpartum depressive symptoms at two to six months postpartum, while 7.2% reported symptoms at nine to ten months. A further 3.1% reported symptoms during both periods. Of women with symptoms at nine to ten months, 57.4% had not reported symptoms at two to six months, showing why a single earlier check may not capture every later case.
The same study reported that 24.8% of respondents had prior depression before or during pregnancy. Prior depression was associated with a 4.03 prevalence ratio for symptoms at nine to ten months, and current postpartum anxiety was associated with a 3.58 prevalence ratio. Postpartum Medicaid insurance was associated with symptoms at nine to ten months being 2.34 times as prevalent. These are associations from that study, not individual predictions.
The follow-up study’s state estimates ranged from 3.8% in Massachusetts to 12.4% in West Virginia. It also reported that more than 60% of pregnancy-related deaths due to mental health conditions occurred 43 to 365 days postpartum.
A 2020 Pediatrics study identified four symptom trajectories: low-stable, 74.7%; low-increasing, 8.2%; medium-decreasing, 12.6%; and high-persistent, 4.5%. In that study, mothers with college education had a maximum odds ratio of 2.52 for being in groups other than the high-persistent group, while older mothers had a maximum odds ratio of 1.10. History of mood disorder had a minimum odds ratio of 0.07, and gestational diabetes diagnosis had a minimum odds ratio of 0.23, in comparisons with the high-persistent group described by the study.
NIH researchers followed more than 4,500 women and children after birth, measuring symptoms at four months and at one, two, and three years. About three-quarters of participants were in a low-symptom trajectory. NIMH notes that symptoms can range from mild to severe and, in rare cases, can put the health of the mother and baby at risk.