Pregnant without a Husband—Anxious and Depressed

Psychologists have devoted a good deal of attention to the postpartum depression and “baby blues” found among many new mothers. But researchers have also conducted numerous studies to investigate the predictors of antenatal mental distress—that is, mental distress during pregnancy. And in a systematic review of such studies, scholars at King’s College London find strong evidence that it is mothers without husbands who are particularly exposed to this distress.

Understanding of psychological distress among pregnant women matters a good deal to the King’s College scholars, who recognize that pregnancy is a time of “joy and positive expectations but also of stress and difficulties” and that it is a time of “increased vulnerability for the onset or relapse of a mental illness.” Aware that “depression and anxiety are the most common psychiatric disorders during pregnancy,” these scholars emphasize that “maternal depression, anxiety and stress during pregnancy have powerful long-term effects on both mother and baby,” perhaps by causing “a decrease in blood flow to the foetus . . . [and] an increased exposure of the foetus to cortisol [a biochemical triggered by stress].” These scholars further remark that antenatal depression and anxiety may make pregnant women more vulnerable to “inadequate nutrition and weight gain, increased alcohol consumption, substance abuse and smoking” and less conscientious in receiving prenatal medical care.

Clearly, medical professionals need to understand when and why pregnant women suffer from psychological problems. However, the King’s College scholars begin their survey of the relevant professional literature admitting that “we still do not know why some women are more ‘at risk’ of developing depression or anxiety symptoms while others remain resilient.” To illuminate the circumstances in which expectant mothers are at risk of these psychological problems, the King’s College scholars examine the professional literature published between 2003 and 2015, finding 97 relevant peer-reviewed studies meriting attention.

As the scholars tabulate the findings, they identify a number of circumstances—including medical complications in the pregnancy, the death of a close relative, and the unexpected loss of economic resources—as predictors of antenatal depression and anxiety. But nothing stands out more clearly in this review of literature as a predictor of such depression and anxiety than does “lack of partner support and of social support.”

Partner is an antiseptic and gender-neutral term that aligns nicely with the dictates of political correctness that now govern most social-science commentary. But the social reality behind that term emerges when the King’s College scholars examine studies concluding that the women especially likely to experience “depressive symptoms in the antenatal period are [those who are] . . . not married, . . .  [that is, those who are] single or . . . have a partner not living in the same household.” Indeed, the King’s College scholars identify 14 different studies finding “single marital status” as a predictor of antenatal psychological malaise.

Of course, marital status alone is not the whole story: the scholars point to “marital satisfaction” as one of the most important “protective factors for maternal mental health during pregnancy.” The researchers comment that this protective factor is “not surprising, since social support can help the woman to cope with negative emotions and stressors associated with pregnancy and to prepare positively for the birth and the postpartum period.”  

Sadly, not all married pregnant women experience the marital satisfaction that provides such protection. But even more sadly—in a world of falling marriage rates and high divorce rates—no unmarried pregnant women enjoy such marital satisfaction, such protection. Consequently, far too many unmarried pregnant women endure long months of depression and anxiety.

(Alessandra Biaggi et al., “Identifying the Women at Risk of Antenatal Anxiety and Depression: A Systematic Review,” Journal of Affective Disorders 191 [2016]: 62-77.)