Motherhood is one of the most cherished phases in any woman's life. It brings about various changes physically, emotionally and socially in a mother's life. It may require many adjustments especially if it is the first time. At times the onset of psychiatric illness at such juncture in time may be missed. It is important that we are aware of such psychiatric disorders as they concern both mother & newborn baby. Very young infants can be affected by and are highly sensitive to the environment and the quality of care.  Prolonged or severe psychiatric illness affects the mother-infant attachment, breastfeeding and infant care. WHO states that in developing countries mental health issues might be seen in 15.6% during pregnancy and 19.8% after childbirth.  

Psychological issues seen around delivery time: 

  1. Before delivery:- Anxiety related to pregnancy & delivery, pre-existing mood or anxiety or psychosis, the onset of a new psychiatric disorder during pregnancy
  2. After delivery:- Baby blues ( most common), Postpartum depression, Postpartum psychosis

Risk factors:

  1. First time as a mother
  2. Young age
  3. Single mother
  4. Family history of psychiatric illness
  5. Previous history of postpartum illnesses or other psychiatric illnesses in mother
  6. Environment
  7. Stressful pregnancy or delivery related to mother
  8. Stressful events after delivery related to a newborn baby
  9. Poor family support
  10. Poverty
  11. Migration
  12. Victims of violence

Maternal mental health issues:

1) Baby Blues

  • Most common ( 50 to 80% postnatal women)
  • Mood swings ( crying spells, Irritability)
  • Inability to sleep
  • Confusion
  • Anxiety (heartbeat racing, shaking, sweating, dry mouth, constant worrying)
  • Starts within a few days of delivery and resolves with good rest and sleep, adequate family and/or spouse support and counselling
  • Milder than Postpartum depression rarely may exceed more than 15 days

2) Anxiety in Puerperium

  • Constant worrying about the baby
  • Constantly checking on the baby
  • Fear of cot death
  • Staying awake & hypervigilant through the night
  • Insomnia
  • Also called maternity neurosis 

3) Postpartum Depression

  • Starts within 2 weeks to 3 months post delivery
  • Seen in 10-15% of postnatal women
  • Constant low and sad mood
  • Poor energy levels
  • Decreased physical activity
  • Negative thinking about child & his/her wellbeing
  • Suicidal ideation
  • Poor interest in previously pleasurable activities
  • Disturbed sleep & appetite
  • Repetitive guilty thoughts regarding parenting techniques  and caring for the baby

Depression causes decreased functioning & decreased care for child. Treating the depression of mothers leads to improved growth and development of the newborn and reduces the likelihood of infection and malnutrition among them.


  1. Admission to hospital in cases of suicidal ideas
  2. Medication
  3. Counselling to patient & relatives

Postpartum psychosis

  • Psychosis seen within days to 4 weeks post pregnancy
  • Patient shows signs of delusions and/or hallucinations 
  • Increased physical or decreased physical activity
  • Disorganised or withdrawn behavior
  • Irrelevant talking
  • Irrational fears
  • Thoughts of harming baby


  1. Admission to hospital
  2. Medication
  3. Counselling

Let us care for mother and baby both. Postpartum psychiatric disorders are treatable. With awareness we will be able to get them help sooner and provide a better environment for mother & child both.