Maternal mental health is a nuanced topic involving many diverse factors which shapes different outcomes from woman to woman. Women with maternal mental health concerns should practice gentle care with themselves to support themselves and their babies. Image Credit: RHN Team Picture Bank
Introduction
Maternal mental health during the perinatal period, defined as the time spanning pregnancy through the first year postpartum, is an essential yet frequently underrecognized aspect of maternal recovery and infant health. The physiological, hormonal, and psychological changes during this time can increase the risk that a new or expectant mother may develop a range of mental health conditions, including common conditions such as depression or anxiety, or potentially more severe psychiatric disorders such as postpartum psychosis, perinatal eating disorders, or postpartum rage.
Breastfeeding is widely promoted for its nutritional, immunological, and relational benefits, functioning not only as a method of infant feeding but also as a complex mind-body process between mom and baby. The relationship between maternal mental health and breastfeeding is bidirectional. Mental health challenges can affect breastfeeding initiation, duration, and experience, and in some cases, contribute to or result in psychological distress and decline. In others, breastfeeding may support psychological health through the deep bonding often experienced with one’s baby, and can also promote relaxation, stress reduction, and anxiety relief.
Understanding maternal mental health is essential as mothers navigate the early stages of parenthood while balancing their own well-being alongside the demands of infant care. Due to the complex relationship between breastfeeding, this blog will be presented as a series.
Part one will explore the perinatal mental health landscape and address key risk factors for developing a perinatal mental health condition, as well as the need to prioritize maternal self-care. Part two will examine key perinatal mental health conditions, including prenatal (during pregnancy) and postpartum (after pregnancy) depression and anxiety, postpartum rage, postpartum psychosis, birth trauma, perinatal eating disorders, perinatal obsessive-compulsive disorder, and a physiological phenomenon called dysphoric milk ejection reflex. Each topic will have an examination on the effects of these conditions on breastfeeding outcomes, along with guidance on recognizing symptoms and seeking appropriate support.
Overview of the Perinatal Mental Health Landscape
“Perinatal” refers to the period spanning pregnancy through the first year after childbirth, a time marked by significant physical, emotional, and social changes that can affect mental health and infant feeding outcomes. Perinatal mental health disorders are among the most common yet misunderstood complications of pregnancy and the postpartum period. These conditions affect individuals throughout diverse backgrounds and populations; however, the World Health Organization (WHO) reports that higher rates of maternal mental health concerns are observed in under-resourced settings, such as low-income communities or developing countries. Globally, it is estimated that approximately 10% of pregnant women and 13% in the postpartum period experience a mental health condition, with depression being the most prevalent diagnosis.
In the United States, approximately 1 in 10 women of childbearing age experience symptoms of major depressive disorder, and approximately 1 in 8 women experience postpartum depression. However, these rates are likely underestimated due to the stigma often associated with mental health care, limited screening resources, and barriers to care influenced by social determinants of health. These may include factors such as race, socioeconomic status, geographic location, educational attainment, employment status, access to food, and availability of safe housing. In South Carolina alone, 19% of women received a perinatal mental health diagnosis, and 1 in 3 women experienced a mental health condition. When left untreated, these conditions can impact the maternal-infant bond and result in disrupted infant feeding practices and increased risk of long-term developmental challenges.
Multiple risk factors can lead to the development of perinatal mental health disorders. These may include:
Risk Factors for Developing a Perinatal Mental Health Disorder
- Life stress
- Lack of support from family, friends, partners, or community networks
- Personal or family history of depression or anxiety
- Discontinuation of mental health medications during the perinatal period (always talk with a clinician before starting or stopping medications)
- Unplanned or unintended pregnancy
- Intimate partner violence or past trauma or abuse
- Health conditions during pregnancy, including high-risk pregnancies
- Young age, including pregnancy during adolescence
- History of hormone-driven mood disorders, such as premenstrual dysphoric disorder or premenstrual syndrome
- Inadequate sleep quality or duration, including sleep deprivation
- Birth trauma or emergency interventions, including pre-term birth or instrumental birth
It is important that individuals with a history of mental healthcare needs have an open and honest conversation with their prenatal providers so that adequate support can be offered.
Conversely, several protective factors can mitigate the onset or severity of perinatal mental health challenges. These include:
Protective Factors for Perinatal Mental Health
- Strong support systems
- This may include partners, family members, friends, peers, and community networks and resources.
- Support networks are consistently linked to improved mental and emotional health outcomes and increased resilience among new mothers.
- Access to integrated care (combined medical and mental health care)
- Finding providers who understand the complexities of childbirth experiences and maternal mental health can help address the overlapping needs of postpartum individuals.
- Education and anticipatory guidance during pregnancy
- For individuals with a history of mental health concerns, setting realistic expectations for the postpartum period, infant feeding, and emotional adjustment can help establish support systems before childbirth.
- Working with clinicians or social workers can help pregnant and postpartum individuals access resources such as counseling and other supportive interventions to promote mental health.
Open and honest communication with prenatal providers is essential, especially for individuals with a history of mental health concerns. When pregnant and postpartum individuals are informed, supported, and connected to care, they are better equipped to manage the challenges of the perinatal period and engage in health-promoting behaviors that benefit both maternal and infant health outcomes.
Preserving Mental Health While Breastfeeding
Practicing self-care while breastfeeding is essential for both maternal well-being and long-term feeding success. Breastfeeding can be physically and emotionally demanding, and challenges such as a painful latch or concerns about milk supply may increase stress and negatively affect mental health. These feelings should not be ignored, as they can contribute to more significant mental health concerns over time.
Maintaining confidence in one’s ability to nourish and care for an infant is an important component of a positive breastfeeding experience. Consider the points below for guidance on when to seek support during breastfeeding challenges and how to prioritize mental health during the perinatal period.
When to Seek Support or Guidance from a Professional
- Persistent pain caused by latch difficulties, engorgement, or conditions like mastitis (inflammation of breast tissue that may involve infection)
- Cracked, bleeding nipples or other nipple damage
- Difficulty with infant positioning
- Anxiety about milk supply or feeding adequacy
- Sleep disruption or fatigue beyond what is typically expected during new parenthood
- Feelings of loss of autonomy or bodily control
- Feelings of isolation or lack of support
- Difficulty balancing breastfeeding with daily responsibilities and life demands
For individuals who have recently given birth, prioritizing mental health is an important component of recovery after childbirth. Both first-time and experienced mothers should feel empowered to seek support when experiencing mood changes, emotional distress, or difficulty coping. Incorporating simple self-care strategies can also help support mental and emotional well-being during the perinatal period.
Self-Care Strategies May Include:
- Resting when possible
- Staying nourished and hydrated
- Accepting help from others
- Setting realistic expectations
- Creating a calm, comfortable feeding environment
- Journaling
- Gentle, slow walks
- Deep breathing
- Meditation or prayer
Setting realistic goals and initiating self-care strategies, such as those mentioned above, can promote physical recovery and emotional resilience. Seeking support is not a sign of failure, but rather an important step in protecting both maternal and infant health.
Learn More About Stress Managment Strategies: HGIC 4368
Mental Health Resources for the Breastfeeding Mom
South Carolina Mental Health Resources
Prisma Health: Mother-Infant Wellness Program – A perinatal partial hospitalization program in South Carolina designed to keep mothers and babies together while treating mental health conditions during pregnancy and the postpartum period.
Medical University of South Carolina (MUSC): Mom’s IMPACTT Program – A program designed to support individuals experiencing perinatal mood disorders. The program connects pregnant and postpartum individuals with resources such as psychiatric evaluation, counseling, and other mental health support services.
General Mental Health Resources
The National Maternal Mental Health Hotline: Call (1-833-TLC-MAMA) or (1-833-852-6262) – A free, confidential, 24/7 hotline that provides support for pregnant and postpartum individuals experiencing mental health challenges or emotional distress.
988 Suicide & Crisis Lifeline: Call or text 988 – Free, confidential support is available 24/7 for individuals experiencing emotional distress, a mental health crisis, or thoughts of self-harm or suicide.
In part two of this maternal mental health series, we will take a closer look at common perinatal mental health conditions and how they may affect breastfeeding experiences, maternal recovery, and infant care.
References:
- American College of Obstetricians and Gynecologists. (2026). Perinatal mental health. https://www.acog.org/programs/perinatal-mental-health/summary-of-perinatal-mental-health-conditions
- Centers for Disease Control and Prevention. (2024). CDC activities: Improving maternal mental health care. https://www.cdc.gov/reproductive-health/depression/cdc-activities.html
- Law, S., Ormel, I., Babinski, S., Plett, D., Dionne, E., Schwartz, H., & Rozmovits, L. (2021). Dread and solace: Talking about perinatal mental health. International Journal of Mental Health Nursing, 30 Suppl 1(Suppl 1), 1376–1385. https://doi.org/10.1111/inm.12884
- World Health Organization. (2026). Perinatal mental health. https://www.who.int/teams/mental-health-and-substance-use/promotion-prevention/maternal-mental-health
Authors:
- Julianna Lyle, CLC, Rural Health and Nutrition Extension Agent, Anderson & Abbeville Counties
Reviewers:
- Paris Mebane, Extension Associate, Rural Health and Nutrition
- Ellie Lane, Extension Associate, Rural Health and Nutrition
