Postpartum Depression

Little research has been conducted on the impact of postpartum depression on family life. However, in a study of a non-postpartum group of depressed patients, the impact on partners was found to be considerable and far-reaching, including restrictions in social and leisure activities (going out less frequently, seeing people less often), a fall in family income, and a considerable strain on the marital relationship (Fadden, Bebbington, and Kuipers 1987). A questionnaire study of a small sample found the same adverse impact in the case of postpartum depression (Boath, Pryce, and Cox 1998). Interestingly, the partners of women with postpartum depression have been found to have a significantly elevated rate of depression themselves (Ballard et al. 1994).

There have been a number studies on the impact of postpartum depression on the early mother-infant relationship. These have consistently shown difficulties in the interactions between depressed mothers and their infants, most notably either withdrawn and disengaged behavior in the mother, or intrusive and hostile mother-infant communication (Field et al. 1990). These difficulties are most apparent in groups with high adversity levels, but even in low risk samples depressed mothers have been found to respond less sensitively to their infants than well mothers (Murray et al. 1993; Murray et al. 1996a), particularly when the mood disturbance persists (Campbell, Cohn, and Meyers 1995). Follow-up studies also indicate an association between the maternal mood disorder and aspects of child development. Thus, one study conducted in Cambridge, U.K., found an adverse effect on child cognitive performance among eighteen-month-old infants of mothers who had had a postpartum depression (Murray 1992; Murray et al. 1996b). Although cognitive disturbance was not found to persist in this study, two London studies found cognitive deficit persisting in boys of mothers with postpartum depression when the children were aged four to five (Cogill et al. 1986; Sharp et al. 1995). Poor emotional adjustment in children has reliably been shown to be associated with postpartum depression. Thus, the majority of studies which have systematically examined infant attachment in the context of postpartum depression have found an elevated rate of insecure attachments (Martins and Gaffan 2001). There is evidence that these emotional problems persist into later childhood. A follow-up study of the Cambridge cohort found that the five-year-old children of mothers who had had postpartum depression were significantly more likely than controls to be rated—by both their teachers and their mothers—as behaviorally disturbed (Sinclair and Murray 1998; Murray et al. 1999). One major conclusion from these studies is that the mechanism mediating the association between postpartum depression and adverse child developmental outcome is the impaired pattern of communication between the mother and her infant.