Prenatal Training May Lower Postpartum Depression Risk for Women Who Have Given Birth Before

Postpartum depression arrives after the baby does, but a research team in Copenhagen tried to get ahead of it while women were still pregnant. Their tool was a high-tech training program that asked expectant mothers to practice responding to a baby’s emotions before the baby arrived, a rehearsal for difficult moments.

The findings were first presented at the European College of Neuropsychopharmacology (ECNP) Congress in Munich, and ECNP announced them on October 9. One result stood out so much that the researchers say they didn’t expect it.

The trial’s results across all participants were less clear-cut, and the researchers are careful about how far they take any of them.

Postpartum depression is a serious mood condition that can affect a mother’s wellbeing and how a family functions, so any sign of a way to prevent it deserves attention.

It also deserves a careful read, because the headline number comes with fine print.

Inside the Five-Week Program

Participants practiced difficult baby moments before the baby was born.

The trial enrolled 147 pregnant women from the Copenhagen area who were considered at heightened risk of postpartum depression. Some were assigned to prenatal affective cognitive training (PACT), while others received usual care.

Women in the PACT group completed individual computerized and virtual reality-based sessions over five weeks. They practiced noticing and interpreting a baby’s emotional cues, then tried different ways to respond to challenging situations so they would be ready when those moments arrived.

Study author Anne Juul Bjertrup of the NEAD Center in Copenhagen says participants were also asked to imagine their future baby and their interactions with that baby. At the same time, they worked through emotional and cognitive exercises. Follow-up data were available for 121 women, 54 in the training group and 67 in the usual-care group.

Related: 9 Brutal Truths About Motherhood Nobody Warns Women About

The Number That Made Researchers Look Twice

The strongest result came from a group the researchers did not expect.

Among women who had previously given birth, 5.3% of those in the training group developed postpartum depression. In the usual-care group, 34.6% did, a gap of roughly 29 percentage points that the study reports as statistically significant.

Across all participants, the training group also did better, but that difference did not reach statistical significance. The study also provides no separate figure for first-time mothers, even though ECNP’s headline suggests the benefit applies only to women who have had a baby before.

That framing goes beyond what the numbers show. Nothing released so far shows that first-time mothers can’t benefit; the results simply aren’t reported.

Bjertrup says several things need clarifying before anyone considers introducing the training more widely, and that the findings should be treated as “interesting, but indicative”.

Why Previous Births Might Matter

One possible explanation is what a mother already knows from experience.

Bjertrup’s possible explanation is that women who had already given birth may have had a more concrete reference point for the imagining exercises. The trial did not show this.

Dr. Benedetta Vai, an adjunct professor of psychiatry at Università Vita-Salute San Raffaele in Italy and a core member of ECNP’s perinatal psychiatry network, commented on the work. She called it “an encouraging study, suggesting that pregnancy may be a window to prevent postpartum depression with a brief training that could reach many women.”

Researchers also note that some women carry difficult experiences from a first pregnancy, and that tuning in to a newborn with a toddler around is not easy. The findings do not say whether participants had toddlers at home.

What Is Postpartum Depression?

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It is a serious mental illness that can begin during pregnancy or as late as a year after birth.

Postpartum depression is a serious mental illness, according to the U.S. Office on Women’s Health. ECNP’s general estimate is that it affects around 1 in 7 women after giving birth. It usually begins within the first month, but it can start during pregnancy or as late as a year after giving birth.

The baby blues are different. Most women feel sad, tearful, or overwhelmed within a few days of giving birth, and those feelings usually fade in three to five days. Postpartum depression lasts longer and is more severe.

Symptoms that last more than two weeks are the cue to call a doctor. They include persistent sadness or hopelessness, loss of interest in things once enjoyed, trouble sleeping or focusing, pulling away from family and friends, feeling disconnected from the baby, and thoughts of hurting the baby or oneself.

Hormonal shifts after birth are thought to play a part, along with exhaustion and stress. Treatment can include talk therapy, antidepressants, or both, and having the condition does not make someone a bad mother.

The Details Still Missing

The result that grabbed attention is also the one with the least detail behind it.

The standout percentages come without their denominators. How many women with previous births were in each group, and how many cases of depression sit behind each rate, has not been shared.

Confidence intervals and exact significance values are also missing, as is any indication of whether the previous-birth comparison was planned before the results came in.

Twenty-six enrolled women, about 18% of the total, have no follow-up data, and no reason is given.

Other basics are unclear as well, including how heightened risk was defined, what usual care involved, how many sessions the program included, and when postpartum depression was assessed.

What Comes Next

Bigger trials are the obvious next step, and none has been announced yet.

Researchers want larger trials to confirm the result in women who have previously given birth and to identify who is most likely to benefit. Another open question is which ingredient does the work: the computerized exercises, the virtual reality, the imagined baby, or some combination.

They also recommend future trials to measure the mother-infant relationship directly, and she calls the research a promising direction.

No start dates, funding, or enrollment plans have been shared for any of those follow-up studies. Nothing says whether the program would work outside Copenhagen or in women not considered at heightened risk, and the announcement is silent on cost and availability beyond the research setting.

If you’ve been through pregnancy more than once, did preparing for a second baby feel different from the first?