Introduction to perinatal mental health

Perinatal mental health refers to a woman's emotional and psychological state during pregnancy and up to one year after giving birth.

This period represents a highly vulnerable stage for the development of psychiatric disorders, such as depression and anxiety disorders. Although the DSM-5 defines this stage as lasting only until the first month postpartum, clinical and epidemiological evidence shows that the impact can extend considerably longer, affecting the well-being of the mother, the baby, and the family.

Perinatal mental health is therefore a public health priority that must be addressed with a preventive, diagnostic, and therapeutic approach. It is estimated that between 10% and 16% of women develop major depression during pregnancy, and the risk increases after childbirth, especially in vulnerable contexts.

The consequences of not intervening appropriately include not only the deterioration of maternal health, but also negative effects on the neuroemotional development of the newborn, the mother-child bond, and the family environment in general.

Differentiating between postpartum sadness (baby blues) and postpartum depression

A common phenomenon in the first few days after childbirth is the “baby blues” or postpartum sadness, a temporary emotional state that affects between 26% and 84% of women. It is characterized by tearfulness, irritability, emotional sensitivity, insomnia, and loss of appetite.

These symptoms usually appear between the third and fifth day after childbirth and disappear on their own by the second or third week, without the need for medical treatment.

In contrast, postpartum depression is a more serious and persistent disorder that can begin around the second or third week and last for months if left untreated. It shares symptoms with major depression, such as deep sadness, anhedonia, feelings of guilt, hopelessness, and sleep and eating disturbances.

However, in the perinatal context, it is also associated with obsessive thoughts about the baby's well-being, intense anxiety, and difficulty bonding with the newborn. In more severe cases, intrusive thoughts of harming the baby or oneself may arise, requiring urgent clinical attention.

Historical review of the clinical recognition of mental disorders in motherhood

The recognition of mental illness related to motherhood has ancient roots. Hippocrates already described symptoms consistent with psychiatric disord