Psychosocial Causes of Postpartum Depression

According to this perspective, the main risks or causes of postpartum depression include: (4-7)

• a history of depression or other mental illness
• certain cognitive or personality styles (e.g., perfectionist tendencies, low self esteem, "maladaptive" coping styles)
• marital problems
• a lack of social support and/or toxic support relationships
• an "overload" of stressful life events
• financial hardship
• large discrepancies between the expectations and realities of motherhood

This approach shows us that PPD exists along a continuum of postpartum emotional health. It also teaches us that postpartum depression is directly tied to the connection between:

• the degree and type of stress a person is faced with; and
• their ability (or inability) to effectively cope with that stress. (3-4)

Bio-medical Causes of Postpartum Depression

Therefore, in as much as there is a continuum of postpartum emotional wellbeing, certain biological characteristics of mothers located at the extreme end of that continuum may very well be hormonally or chemically distinct from mothers experiencing postpartum “sadness” or less severe levels of distress.

In other words, the main contribution of the bio-medical perspective is not so much in helping to understand the foundational causes of postpartum depression.

Rather, the bio-medical model is really helpful in teaching us what the biology of postpartum depression looks like (i.e., PPD's actual biological characteristics). (3)

Cultural Causes of Postpartum Depression

Specifically, this research demonstrates that advanced industrial countries (like Canada, United States, Australia, England, France, Germany, etc.) socially organize mothers’ postpartum expectations and experiences in such a way that we have actually created a cultural environment ripe for the proliferation of emotional difficulties. (9-13)

The two biggest "cultural culprits" for causing postpartum emotional problems are:

• Overly idealistic expectations and philosophies about parenting and mothering

  There is no doubt that we have a lot of idealistic cultural beliefs about “good mothering” that are unrealistic and unattainable (e.g., think about the whole "supermom" idea, the idea of the "perfect parent," even some of our modern parenting philosophies, like the idea about never letting your baby cry, etc.)

  The bottom line is that a lot of our "good parenting" and "perfect mother" ideals are actually risky to mothers’ health and well-being.(10)

  One reason for this is that these ideals and expectations demand a huge amount of perfectionism and self-sacrifice ~ where being "the perfect mom" requires putting your own needs for self-care, personal growth, and fulfillment at the bottom of the priority list.

  The other reason is that these idealistic standards create very high expectations about what the experiences and realities of mothering/parenting should be like.

  Unfortunately, when reality does not meet the standards of such expectations, it can contribute to the development of emotional problems and distress, including postpartum depression. (10-11)

• Inadequate social rituals and practices for the postpartum period.

  PPD occurs mostly and mainly in advanced industrial societies. Why might this be? Cultures with the lowest rates of postpartum depression socially organize the postpartum period in a way that helps new mothers adjust positively and healthily to their new roles, responsibilities, and identities as mothers. (12)

  Although the specific practices and rituals vary, societies with low rates of postpartum depression tend to structure the postpartum period according to the following general practices:

  • they recognize a distinct period in which mothers' regular duties are interrupted (ranging typically between three to eight weeks)
  • there is a period of mandated rest for the mother (mothers can actually follow this mandate because other people are responsible for many of the mother's other tasks during this period)
  • some degree of social seclusion (for a specified period of time only -- this is to facilitate rest, recovery, and emotional adjustment)
  • social recognition of the mother's new, typically elevated, status (in our culture, motherhood is often experienced as a sense of status loss -- we don't seem to value motherhood as much as other cultures do)
  • social practices to protect the perceived vulnerability of the new mother (to help to channel powerful emotions -- such as grief, ambivalence, anger and fear --- that are common aspects of the adjustment process)
  • assistance with tasks (to help facilitate rest and recovery, and to allow the mother to properly focus on her new baby and the adjustment process)

  These kinds of social rituals create a postpartum environment that helps protect the health and emotional well-being of new mothers.(12-13) We also know they offer important protections against PPD.

  A recent American study (cited by Stern and Kruckman), for example, compared Chicana women living in Chicago on the basis of whether or not they practiced the traditional Mexican postpartum ritual known as "la cuarentena."

  The custom of "la cuarentena" involves a rest period of approximately 40 days, eating of special foods, assistance from other female relatives with household tasks and child care, restrictions on visitors, as well as bathing and hair washing restrictions.

  The women who practiced "la cuarentena" had lower incidences of PPD and more positive responses to their pregnancies than those who didn’t practice la cuarentena".

If many of the main causes of postpartum depression are psychosocial and cultural in nature, we can do a lot of good simply by understanding, acknowledging, and acting upon this knowledge about the psychosocial and cultural causes of postpartum depression.

Click here for more information about the symptoms,
prevalence, and definition of PPD.


How do you know if you have PPD?
Click here for more information


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