Perinatal mental health disorders: a public health issue
The perinatal period—spanning from pregnancy to twelve months postpartum—is a time of great vulnerability for mental health. According to data from the Perinatal Mental Health Unit (USMP) at Hospital Clínic Barcelona, one in five women will experience a mental health disorder during pregnancy or the postpartum period, with depression being the most common pregnancy-related complication. Studies indicate that this is a significant public health issue due to its prevalence and its impact on the quality of life of mothers, their children, and the family as a whole.
Dr. Eva Solé, a psychiatrist at the USMP, explains that "perinatal mental health disorders are mental disorders that occur during the perinatal stage, from pregnancy up to one year postpartum." Some disorders predate pregnancy, while others "begin or flare up during the perinatal period." While postpartum depression is among the best-known, the category also includes anxiety disorders, OCD, bipolar disorder, and postpartum psychosis.
It is a major societal issue that must be taken into account to ensure prevention, diagnosis, and treatment. "Everything we work on with this woman—during pregnancy and the postpartum period—will have a positive long-term impact on her baby," the psychiatrist highlights.
When Postpartum OCD Emerges
Edurne is a patient who was treated at the Clínic’s Perinatal Mental Health Unit for perinatal OCD that began after the birth of her son.
"I suffered from what is diagnosed as impulse phobia," she explains. "These are intrusive thoughts involving a terrible fear—of everything: of what you might do, of what others might do. It is an extreme fear and very generalized anxiety."
The first symptoms appeared during childbirth. "The first time I felt something wasn't right was during the delivery." "That’s when I started having my first panic attack." From that point on, concerns focused particularly on the newborn's safety: "That was the moment I felt terrified that he might get hurt, fall, or that something might happen to him."
Specialized, multidisciplinary care
The Clínic’s Perinatal Mental Health Unit treats women with pre-existing or newly developed mental health disorders during pregnancy and the first twelve months postpartum. Clinical care is coordinated across various specialties—particularly psychiatry, psychology, obstetrics, and neonatology—to provide comprehensive care tailored to each patient's needs.
The unit has a multidisciplinary team of 30 professionals who run specific care programs based on the perinatal stage and the type of disorder; it also operates a Mother-Baby Day Hospital, a leading facility in Catalonia for managing highly complex cases.
Eva Solé explains the unit’s working model: "We always work in close consultation with the woman, and the final decision always rests with the patient. This shared decision-making model is crucial so that the woman understands the reasons for the treatment, as well as its risks and benefits."
In Edurne’s case, treatment involved various therapeutic interventions aimed at reducing anxiety and regaining the autonomy needed for daily activities related to caring for her son.
"We had to work quite hard—especially on exposure exercises, like being alone with Nathan. We worked on various aspects, but honestly, without their help, I wouldn't have made it through," she explains.
The weight of stigma
In addition to the suffering caused by the symptoms themselves, many women must contend with the guilt and stigma that still surround mental health issues during pregnancy and the postpartum period. This is one of the factors that often makes it difficult for women to speak about what they are experiencing and to seek specialized help.
“I had strong support at home from my sister, my parents, and my partner... But there are many people who don’t talk about it,” says Edurne. “It wasn’t hard for me to ask for help; I knew from the very first moment that I needed it.”
She also offers a message of encouragement to others who might be going through the same thing: “You can get through this. No matter what others think, ask for help—with help, determination, and the will to recover, you can overcome it.”
The importance of raising awareness about perinatal mental health
Edurne first learned about the Clínic’s Perinatal Mental Health Unit (USMP) during her six-week postpartum check-up; she was seen by gynecology and psychiatry professionals, who then referred her to the unit where she began treatment.
The unit’s professionals emphasize the need to improve public awareness regarding these disorders. “A woman suffering from this kind of anxiety or depression is already carrying a heavy burden. When you add family or society into the mix, stigma arises from all sides,” notes Dr. Solé. “We mustn't lose sight of the society we live in: we are expected to excel academically and professionally... and also at motherhood.” Edurne’s story reflects a reality that affects many women during the perinatal period and highlights the value of specialized teams—such as the Perinatal Mental Health Unit at the Clínic—that provide specific, evidence-based care centered on the needs of mothers and their babies.
Edurne has now completed her follow-up at the unit. “Everything has changed. I’m a totally different person. I’m happy. Things are great with Nathan; I really make the most of our time together—we play a lot and spend the whole day together. It’s like night and day; I’m 100% myself again.”
