出産の前後に暗い気持ちになるのは、ほぼ万国共通である(Dark thoughts before and after giving birth are almost universal – now psychologists want to find out why)

From the covers of parenting magazine to frescos of supremely serene mothers, advertising and most cinematic and visual arts paint the peripartum as a state of perpetual maternal bliss. For many women (due to word limits this article refers to birthing people as mothers and women, but we acknowledge that people of all genders can give birth and nonbirthing parents can be mothers) the peripartum, which extends from conception through pregnancy and childbirth to early motherhood, is indeed associated with much joy and positive life changes. However, for nearly all women, it is also a period associated with increased exposure to stressors (e.g., financial impact on earning) and higher levels of perceived stress, which increase throughout pregnancy and peak in the first months of motherhood . Heightened stress levels are reliably associated with increased risk for anxiety disorder symptoms . The prevalence of perinatal anxiety disorders is rising, now exceeding perinatal depression, especially in low- and middle-income countries . What’s more, the burden of disease from perinatal anxiety extends across the maternal lifespan and intergenerationally to the child’s mental health, making perinatal anxiety a global public health issue.

Yet, despite the scale of the issue, little is known about why women are more susceptible to the onset of anxiety and stress-related mental health problems during this phase in the reproductive lifespan. This is in part because perinatal mental health has long been considered niche. It is not. By the age of 44, 85% of women will have given birth, making perinatal anxiety disorders a clinical and research priority for women and children worldwide.

We propose that perinatal intrusions offer a unique window into the etiology and maintaining factors in anxiety disorders during the peripartum. While not all parents will develop mental health problems during the peripartum, almost 100% of women will experience perinatal intrusions . Perinatal intrusions are intrusive thoughts and images of accidental child-related harm. Around 50% of mothers will also experience intrusions of intentionally harming their child . These intrusions feel uncontrollable and are extremely distressing to parents. They are also associated with maternal anxiety and with poor child mental health outcomes. Studying perinatal intrusions offers a unique window into perinatal anxiety disorders, because intrusive cognitions (i.e., unwanted past- or future-oriented thoughts, memories, and images) are a core feature of anxiety disorders. Identifying determinants of the progression from normative to functionally impairing intrusions can help identify women at risk for perinatal anxiety disorders.