Postpartum mental health in mainland China: A call for action

Objectives: Previous studies of postpartum depression (PPD) conducted in mainland China are scarce and have used inconsistent measures of PPD. This study uses a standard measure of PPD that has been widely validated, even in Mandarin Chinese. The relationship between current PPD and prior mental health treatment is also explored. Methods: A cross-sectional study was conducted in a convenience sample of postpartum Chinese women in an urban obstetric outpatient clinic. Anonymous, self-administered questionnaires were collected at regular 6 to 8 week postpartum visits to assess demographics and mental health history. The validated Mandarin Chinese Edinburgh Post-natal Depression Scale (EPDS) was used to screen for PPD. Results: A total of 365 questionnaires were completed (response rate=77%; completion rate=92%). Among married, singleton birth women, between 15.5% (most conservative cutpoint 12/13) and 38.9% (original cutpoint 9/10) showed signs of PPD, although most women (95.6%) had never before consulted a mental health practitioner or taken prescription or traditional medications for emotional issues. Having any history of mental health treatment was not associated with having PPD symptoms (cutpoint 12/13; p=0.26, Fisher's exact test). Conclusions: Although very few pregnant women in mainland China have ever sought treatment for emotional issues in the past, PPD appears to be a widespread problem among new mothers. The postpartum visit would be an appropriate opportunity to address the mental health needs of new mothers. Important implications are the need for more screening, greater access to mental health resources, and more research on mental health in mainland China.