Bad times make mothers depressed.

Abstract

This research conducts the first comprehensive analysis of how prenatal economic fluctuations affect postpartum depression and documents its counter-cyclicality. Using population-based claims data, we examine outpatient utilization related to mental disorders among women in Taiwan during the six-month, nine-month, and one-year postpartum periods from 1998 to 2012. The results indicate that medical utilization for postpartum depression within the six-month and nine-month postpartum periods is influenced by economic conditions during the second trimester of pregnancy. This study also aims to understand the mediating channels behind the relationship between postpartum depression and prenatal economic activity. We find that negative prenatal economic shocks lead to higher outpatient expenses for conditions such as excessive weight gain, nutritional deficiency, depressive disorders, hypertension, and sleep disorders during pregnancy, all of which can deteriorate maternal postpartum mental health. Furthermore, our study highlights that postpartum depression medical utilization among low-income mothers is particularly sensitive to prenatal economic fluctuations. These findings suggest that low-income mothers, who may have limited resilience and fewer resources during economic downturns, are more likely to experience nutritional deficiencies and increased maternal stress, ultimately leading to a deterioration in postpartum mental health.