Fewer than 10 percent of women seek medical help for postpartum depression
(Sara Novak) — Postpartum depression is the most common complication of childbirth, affecting about 1 in 7 women after delivery. It causes bouts of severe depression and anxiety, makes bonding with a newborn especially difficult, and can lead to thoughts of self-harm. Suicide is a leading cause of maternal death in the United States.
Yet, only about 6% of women with postpartum depression seek medical help. Shame, stigma, and lack of awareness can delay or deter diagnosis, causing long-term effects on both mother and child.
But a simple blood test that could predict the condition before symptoms appear is offering new hope – hinting at a future where treatments could shift from response to prevention.
The Value of a Predictive Test for Postpartum Depression
Research paving the way for the blood test has been piling up for a decade. Scientists have identified epigenetic biomarkers (indicators in our DNA that reflect changes in how genes are expressed) that can predict postpartum depression with 80% accuracy in the third trimester of pregnancy, according to a 2020 study in the journal Psychiatry Research.
These biomarkers were able to predict postpartum depression in women with a history of depression and in those who, at the time of the test, didn’t show any signs of depression, according to results from several studies. If these findings can be used to create a standardized blood test, then high-risk patients would be able to seek treatment before symptoms occur, said Lauren Osborne, MD, second author of the 2020 study and vice chair of clinical research in the Department of Obstetrics and Gynecology at Weill Cornell Medicine in New York City.
Such a test “would alert the clinical care team to the potential risk,” helping guide early and targeted intervention and bringing the power of precision medicine to psychiatry, said Jamie Maguire, PhD, a professor of neuroscience at Tufts University School of Medicine in Boston. (Maguire did not take part in the study.)
It could also go a long way toward ending stigma, said Jennifer Payne, MD, a professor at the University of Virginia and an expert in reproductive psychiatry. A blood biomarker provides an objective measure and a biological cause, highlighting the condition as a medical issue that needs treatment.
Two studies led by Payne and Osborne – one local, already underway, and one national, planned for the summer – will explore the test’s potential. If they are successful, the test could become available in as little as a few years.
Research suggests there are at least two forms of postpartum depression, each responding to different treatments, said Payne. One is more likely to happen in women with a history of depression, while the other, described as “hormone-dependent,” affects patients with no previous mental health issues. The latter is more likely to respond to hormone-based medications.
How Existing Treatments Could Work With a Blood Test
Treatment for postpartum depression typically uses medication along with therapy.
For patients with a history of depression or anxiety, continuing or resuming medications through pregnancy can be an option. Many common antidepressants – including citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), and sertraline (Zoloft) – are often prescribed during pregnancy and generally considered safe, with benefits largely outweighing the risks to both mom and baby.
Patients with hormone-dependent postpartum depression have a dedicated drug treatment: In 2023, the FDA approved zuranolone (Zurzuvae) for postpartum depression. The drug contains neuroactive hormones that help improve mood regulation.
With a biomarker test, patients with positive results could start the two-week zuranolone treatment in the hospital after giving birth, said Morgan U. Patterson, MD, director of the Perinatal Mood and Anxiety Disorders Program at the University of North Carolina School of Medicine.
Psychotherapy, especially interpersonal therapy and cognitive behavioral therapy (CBT), can give patients better coping tools and help moms identify and change negative thought patterns.
“Therapy can help normalize a mother’s experience, help her to process her emotions, and address any possible reproductive trauma,” said Marilyn Cross Coleman, a therapist, perinatal treatment specialist, and owner of Shameless Mama Wellness in California. Trauma caused by a serious birth complication that endangers either the mother or child can increase the risk of postpartum depression.
In some cases, group therapy is especially effective. Many women suffer in silence due to feelings of shame, and sharing their experience with other moms helps them know they’re not alone.
A biomarker test could lead pregnant people to seek mental health support early, which is crucial because finding care can take months, Osborne said.
How to Lower Your Risk of Postpartum Depression
Another huge thing that helps with postpartum depression is also hard for most new moms to come by: sleep.
Research shows that sleep disturbances put women at a higher risk of postpartum depression. A nightly four- to five-hour block of uninterrupted sleep can effectively stave off symptoms, according to a 2024 study.
That’s not easy to achieve with newborns. Hiring a “night nurse” – a caregiver who watches the baby overnight – could help, though at $40-$50 per hour, it’s cost-prohibitive for many new parents. You can ask friends and family to contribute through baby nurse registries. Payne also recommends accepting offers from friends and family to help with night feedings, relying on the proverbial village for help.
Have a plan to prevent or treat postpartum depression, Cross Coleman said, because the longer symptoms fester, the more serious the condition can become. “A mother’s environment and support network will play a large part in her recovery,” she said.