Postpartum Depression and Infertility

An Interview with Dr. Deborah Issokson

On whether women being treated for infertility are at any greater risk for postpartum depression (PPD):

First, any major life stressor that occurs around the time of childbearing becomes a risk factor for PPD. A woman going into childbearing who is already dealing with issues of loss, depression, anxiety, relationship problems, health problems, or problems connected to economics, career, social isolation, or lack of social support is at higher risk for PPD.

Therefore, given that infertility includes many of these stressors, I would say that yes, on some level, women being treated for infertility and who bear a child are at greater risk for developing postpartum difficulites.

We already know from research that women dealing with infertility have a higher rate of depression during the course of treatment. A successful pregnancy in and of itself does not dissolve the depression.

In fact, bearing a child after infertility brings with it a lot of pressure for the woman to never complain about the stress of new motehrhood. After all, shouldn't she just be grateful she finally has a baby? Doesn't the stress of new parenthood pale in comparison to the stress and angst of infertility? This puts the woman at greater risk for not letting others know of her struggles, depression symptoms, etc.

Many women feel let down after the baby is born following infertility. Suddenly, all of her support and all of the attention she was receiving as she struggled to conceive and carry the baby to term is gone. She is on her own, considered "normal" by others.

Often, there is a lot of pent up emotion that needs expression. Many women become overly protective of their babies, overly vigilant about their babies' health and add more stress to themselves.

So, I would say that yes, women who have struggled with infertility and then carry a baby to term are at risk for PPD.

On whether fertility medications play a part in this greater risk:

As I said, we know that just dealing with infertility itself can bring on depression. I believe that many of the medications used in the treatment for infertility cause some women to feel out of sorts emotionally. This makes sense because they are being given large doses of hormones in their medications. Whether anyone has been able to say that "x" medication causes depression, I do not know.