Perinatal mental illness affects up to one in five women

As many as one in five women experience a diagnosable mental health condition between conception and one year after birth, making mental illness the most common complication of pregnancy and the postnatal period, Edna Lekgabe writes in The Guardian. Depression and anxiety dominate, but the clinical spectrum also includes post-traumatic stress after birth trauma, obsessive-compulsive symptoms centred on intrusive thoughts of infant harm, and rare psychotic episodes. The headline statistic is familiar in public-health circles; the operational response, she argues, is not.

Lekgabe’s comparison is blunt: if a physical complication affected one in five pregnancies, it would be routinely screened for, generously funded, and every maternity clinician would be trained to recognise it. Perinatal mental health, by contrast, is unevenly detected and inconsistently treated. The article describes delays that can stretch to months for specialist care—time during which a deteriorating pregnancy can become a deteriorating household, and the point of intervention shifts from prevention to crisis management.

Australia is used as an example of a system that has built some dedicated infrastructure—mother-baby units and specialist perinatal psychiatry services—while still rationing access through geography and ability to pay. Organisations such as Panda and the Centre of Perinatal Excellence are active in the space, but the piece notes that services skew toward metropolitan areas and toward women who can afford private care. In the public system, waitlists can run for months, and women who worsen during pregnancy may only be assessed after birth, when sleep deprivation and family stress can further compress a clinician’s margin for error.

The cultural layer compounds the clinical one. Lekgabe writes that motherhood is romanticised, and distress is often interpreted as personal failure rather than a treatable condition, pushing women to self-blame—“just a bad mother”—instead of care-seeking. Even as new language such as “matrescence” gains traction to describe the identity shift of becoming a mother, the article warns that normalising disruption can blur the boundary between ordinary disorientation and major depressive episodes that require urgent psychiatric treatment.

The piece returns to a practical question: who gets seen, by whom, and when. In a system where specialist slots are scarce and triage is informal, the women most likely to wait are those least able to insist.

One in five is a screening rate in almost any other part of medicine. In perinatal mental health, it is still often treated as a private problem that arrives with the baby and leaves on its own.