Bringing a new life into the world is often portrayed as a time of joy and fulfillment. Yet, for many birthing people, the perinatal period—encompassing pregnancy and the first year postpartum—can be marked by overwhelming sadness, anxiety, and exhaustion. Perinatal depression is a serious mental health condition that affects 1 in 7 birthing people in the United States (Wisner et al., 2013), yet it remains widely misunderstood and under diagnosed.

At Beyond The Birth, LLC, we specialize in perinatal mental health because we recognize that the well-being of birthing people directly impacts infants, families, and society at large.

In this post, we’ll explore:

The contributing factors to perinatal depression
Its symptoms and real-life impact
The caregiver-infant dyad and how untreated depression affects infant mental health
The economic and societal costs of perinatal depression in the U.S.
How systemic changes—not just individual treatment—are necessary for prevention
Evidence-based treatments and holistic approaches
Community and policy-level solutions

What Causes Perinatal Depression?

Perinatal depression doesn’t stem from a single cause but rather a combination of biological, psychological, and social factors:

Hormonal fluctuations: Rapid shifts in estrogen and progesterone can affect mood regulation (Schiller et al., 2015).
Genetic predisposition: A personal or family history of depression increases risk.
Sleep deprivation: Chronic exhaustion disrupts emotional regulation.
Trauma or past mental health struggles: Previous anxiety, depression, or birth trauma heighten vulnerability.
Lack of support: Isolation, inadequate partner or family help, and financial stress contribute significantly.
Societal pressures: Unrealistic expectations of "perfect motherhood" and the lack of paid parental leave in the U.S. exacerbate stress (Dagher et al., 2014).

What Does Perinatal Depression Feel Like? A Personal Perspective

Imagine waking up exhausted, not from the baby’s cries, but from a heaviness you can’t shake. You love your child, but joy feels out of reach. Simple tasks—diaper changes, feeding, even showering—feel monumental.

Guilt gnaws at you: "I should be happier. What’s wrong with me?"

Perinatal depression isn’t just "baby blues" (which typically resolve within two weeks). Symptoms may include:

Persistent sadness or numbness
Irritability or anger (often directed at partners or other children)
Intrusive thoughts (e.g., fears of harming the baby, though actual risk is low)
Withdrawal from loved ones
Physical symptoms (headaches, digestive issues, or extreme fatigue unrelated to sleep deprivation)

One mother who joined our local support group, Sarah*, described it as: "I was drowning, but everyone kept saying I should be grateful. I felt like a failure."

The Ripple Effect: How Perinatal Depression Impacts Families and Infants

Primary caregivers and infants exist in a dyad—a connected unit where the infant’s emotional and cognitive development is deeply influenced by the caregiver’s mental state (Sroufe, 2005). When a caregiver is depressed:

Infant attachment may be disrupted, leading to difficulties in emotional regulation and social development (Tronick & Reck, 2009).
Cognitive delays are more likely due to reduced interactive engagement (Field, 2010).
Behavioral issues (e.g., excessive crying, sleep disturbances) may emerge in infants.

Families also suffer. Partners may feel helpless, and older children may internalize a caregiver’s withdrawal as rejection.

The Economic and Societal Costs of Perinatal Depression

The U.S. has the highest perinatal depression rates among industrialized nations (15-20% compared to 10% globally) (Fawcett et al., 2019).

Why? Despite being the 9th richest country in the world…

No federal paid leave: The U.S. is one of only seven countries without it (OECD, 2023).
Healthcare disparities: Marginalized communities face higher rates due to systemic inequities.
Capitalist pressures: The expectation to "bounce back" financially and physically is unrealistic.

Untreated perinatal depression costs the U.S. $32,000 per mother-infant pair in healthcare, lost productivity, and child developmental interventions (Luca et al., 2020).

Why Treatment Alone Isn’t Enough: The Need for Systemic Change

While therapy (especially Cognitive Behavioral Therapy and Interpersonal Therapy) and medication help, they’re reactive.

Prevention requires societal shifts, such as:

Mandatory paid parental leave (countries with longer leaves have lower rates).
Universal mental health screenings during and after pregnancy.
Community-based support (peer groups, postpartum doulas, home-visiting programs).
Workplace protections for new parents (flexible hours, lactation support).

Holistic and Evidence-Based Treatments

At Beyond The Birth, LLC, we integrate:

Trauma-informed therapy (addressing past birth trauma or childhood wounds).
Mindfulness and somatic therapies (to regulate the nervous system).
Support groups (reducing isolation).
Collaboration with healthcare providers (ensuring comprehensive care).

A Call to Action: How Communities Can Help

Normalize the struggle: Share stories to reduce stigma.
Advocate for policy change: Support bills for parental leave and maternal mental health funding.
Check on new parents: Simple acts—meals, childcare, listening—can be lifesaving.

Perinatal depression is not a personal failure—it’s a societal one. Healing requires both individual care and collective action.

If you or someone you love is struggling, reach out. You are not alone.

Additional Resources For Families Struggling:

Postpartum Support International | https://postpartum.net/

Text “Help” to 800-944-4773 (EN)
Text en Español: 971-203-7773

Lifeline Suicide & Crisis Hotline | Call/Text 988

CoAbode - Communal Housing For Single Mothers | https://www.coabode.org/

Sources:

Dagher, R. K., et al. (2014). Maternal Depression and Economic Well-Being.
Field, T. (2010). Infant Depression and Developmental Risks.
Luca, D. L., et al. (2020). Economic Burden of Perinatal Depression.
Wisner, K. L., et al. (2013). JAMA Psychiatry.

*Name changed for privacy.

This blog is original content written for Beyond The Birth, LLC. If you wish to share or republish, please credit appropriately.

For more resources, visit https://www.beyondthebirth.co/

Beyond The Birth, LLC specializes in perinatal mental health, offering therapy that recognizes the political roots of parental stress. We are in network with several private insurance plans and offer affordable tiered private pay fees for services. Return to our home page on this site to learn more.

Understanding Perinatal Depression: Causes, Symptoms, and the Path to Healing