More to lose? Longitudinal evidence that women whose social support declines following childbirth are at increased risk of depression

Objective: We examined the dynamic relationship between life changes (pregnancy and childbirth) and social support during the postpartum period. Methods: A large, nationally representative sample of Australian women (N=806) who completed the Household Income and Labour Dynamics in Australia Survey (HILDA) in the year immediately before and immediately after giving birth to a child reported on measures of perceived social support and mental health. Results: Analyses indicated a decrease in both social support and mental health after having a baby. Social support during the postpartum period – controlling for social support and mental health prior to the birth of a baby – predicted better mental health in women. However, for women who experienced a decline in social support, prenatal social support was a risk factor for a decline in mental wellbeing rather than a protective factor. Conclusions: Women who have ‘more to lose’ are at increased risk of mental ill-health if they cannot maintain existing sources of social support. Implications for public health: Loss of social support during pregnancy and the postpartum period should be considered as a significant risk factor for postpartum depression in its own right and one that warrants screening and intervention.