The relationship of women's postpartum mental health to employment, childbirth, and social support.

BACKGROUND This study was conducted to examine changes in women's mental health over the first postpartum year and factors that are associated with mental health. METHODS Participants included women who were married, employed, English-speaking, and giving birth to their first child at one of two hospitals in St Paul, Minnesota. Women who were eligible and willing to participate were mailed questionnaires at 1, 3, 6, 9, and 12 months postpartum. RESULTS There were significant changes in mothers' general mental health, depression, and anxiety over the first postpartum year (P < or = .01), with least favorable outcomes at 1 month and most favorable outcomes at 12 months postpartum. Poor mental health was related to work factors, such as longer work hours and maternity leave of less than 24 weeks, and to variables often associated with recent childbirth, such as maternal fatigue, loss of sleep, concerns about appearance, and infant illnesses. In addition, postpartum symptoms were predicted by physical illness, previous mental problems, poor general health, poor social support, fewer recreational activities, young age, and low income (R2 = 37% to 57%). CONCLUSIONS In this select group of women, postpartum mental health was found to be least favorable 1 month after delivery and related to factors associated with employment, recent delivery, and level of social support.