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Paternal postpartum depression: emotional and social availability for women in the early postnatal period

02 January 2025
Volume 33 · Issue 1

Abstract

Midwives are in an optimum position to address the mental health of new fathers and paternal perinatal mental health is a recognised concern. However, the mechanisms that exist to recognise, escalate and intervene appropriately are limited in scope and effectiveness. Screening tools may have the potential to identify fathers at risk of postpartum depression, but they are limited in sensitivity and specificity, meaning that when there may be deterioration in a partner's mental health, diagnosis may not follow. This has implications for the health and wellbeing of the family, especially if male partners are relied upon as the mainstay of emotional and social support for women in the early postnatal period. To actualise strategies to address these issues, changes in policy, education and practice are required. Recommendations for research, education and patient engagement are made to assure early intervention and to ensure that emotional and social support in the family is optimised.

Postpartum depression is a mental health condition that affects both men and women following childbirth (Gedzyk-Nieman, 2021). Paternal postpartum depression is less recognised; in comparison to maternal postpartum depression, research remains limited and screening is not routine (Swami et al, 2020). It has been reported that around 8% of fathers experience paternal postpartum depression, but factors such as associated stigma may reduce the accuracy of prevalence estimates (Rao et al, 2020). Furthermore, a recent evidence review by the Scottish Government (2024) highlighted the varience in reported prevalence, with quoted rates ranging from 4–25% in first-time fathers, emphasising the lack of accuracy in determining the extent of the issue.

The incidence of paternal postpartum depression increases incrementally with maternal postpartum depression, with rates as high as 50% reported in this context (Wang et al, 2021). Although imprecise, these rates suggest that there may be opportunities to recognise the risk of paternal postpartum depression early, when midwifery care is being provided. This article discusses the extent to which paternal postpartum depression is considered by midwives in the childbearing journey and suggests that changes are required to enhance recognition and early intervention.

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