A new literature review by The George Institute for Global Health and UNSW published in Reproduction, has uncovered a worrying gap in postpartum care, with women who experience medical complications during pregnancy facing a higher risk of developing mental health problems, such as depression, after birth.
The study found that that even without prior mental health issues, women with preeclampsia - a pregnancy complication marked by high blood pressure and signs of organ damage - are at significantly higher risk of postnatal depression, often for months or even years after birth.1
In Australia, hypertensive disorders affect up to 10% of pregnancies,2 with preeclampsia occurring in around 5-8%.3,4 Preeclampsia also contributes to 15% of direct maternal deaths and 10% of perinatal deaths.5 It is also a major reason for labour and birth interventions, including labour inductions and both planned and emergency caesarean sections.5
Both gestational diabetes (59% increased risk) and anaemia during pregnancy (24% increased risk) were also linked to a greater chance of developing postnatal depression, although the evidence was more mixed than for risk after preeclampsia.1
Despite the clear risks, current postpartum care continues to focus almost solely on physical recovery, often ignoring mental health - and leaving many women unsupported, potentially leading to long-term harm for both mother and child.
While the 2023 Australian Clinical Practice Guidelines now recommend routine mental health checks at 6-12 weeks and again at 6-8 months postpartum, researchers say more must be done to screen and support women's mental health before and after pregnancy.
"While postpartum care is primarily focused on physical recovery, usually stopping at six weeks, psychological support continues to be overlooked at this critical stage.
Maternal mental health is vital for both mother and baby - without early screening and support, mothers and their children can face lasting harm. Mental health checks and comprehensive support must become a standard part of postpartum care for all women.
By:Amanda Henry
Program Head, Women's Health at The George Institute for Global Health and Professor of Obstetrics, UNSW Medicine and Health
The researchers are calling for routine mental health screening and personalised care for women with complicated pregnancies, with a focus on early detection and evidence-based care ranging from lifestyle and psychological therapies to medications and trauma-focused treatments. They also recommend multidisciplinary, personalised care - led by midwives, obstetricians, and mental health specialists - and better access to evidence-based treatments, and culturally sensitive, trauma-informed support throughout the postpartum period.
References
1. Roberts LM, Gow M, Graham B, Hackett ML, Harris K, Roth H, et al. Postpartum mental health after medically complicated pregnancy. Reproduction. 2025 Sep 16; doi: https://doi.org/10.1530/REP-25-0092
2. Fowosere V. Hypertensive disorders in pregnancy [Internet]. Australian Journal of General Practice. 2023. Available from: https://www1.racgp.org.au/ajgp/2024/supplement-december/hypertensive-disorders-in-pregnancy
3. The Sydney Children's Hospitals Network. Preeclampsia [Internet]. The Sydney Children's Hospitals Network. 2025. Available from: https://www.schn.health.nsw.gov.au/kids-health-hub/pregnancy/preeclampsia
4. Better Health Channel. Pregnancy - preeclampsia - Better Health Channel [Internet]. www.betterhealth.vic.gov.au. 2022. Available from: https://www.betterhealth.vic.gov.au/health/healthyliving/pregnancy-preeclampsia
5. Australian Action on Preeclampsia. Australian Experience of Preeclampsia - Australian Action on Preeclampsia [Internet]. AAPEC.org.au. 2025 [cited 2025 Oct 1]. Available from: https://www.aapec.org.au/australian-experience-of-preeclampsia
