A very high percentage of women experience emotional difficulties that are never identified
In the quiet space between expectation and reality, millions of women navigate pregnancy and new motherhood while carrying invisible burdens that go unnamed and untreated. Three-quarters of perinatal mental disorders are never diagnosed, not because medicine lacks the tools, but because stigma silences both the women who suffer and the clinicians who might ask. Experts convening in Zaragoza have made clear that a mother's emotional world is not separate from her child's developing one — what goes unaddressed in her ripples forward into the next generation.
- Between 7 and 19 percent of pregnant women experience depression, yet the true scale of perinatal mental illness is far larger because stigma keeps most cases from ever surfacing.
- Untreated maternal mental disorders set off a cascade of consequences in children — from attachment failures and hyperactivity to language delays and oppositional behavior — that begin before birth and persist long after.
- Clinicians across obstetrics, pediatrics, psychiatry, nursing, and social work gathered in Zaragoza to confront a shared failure: mental health has been treated as peripheral to maternal care rather than central to it.
- The path forward demands that mental health screening be embedded into every prenatal visit and postpartum check — not siloed as a specialty referral, but woven into the standard of care.
- The obstacle is not a lack of knowledge or tools; it is the absence of institutional will to treat maternal mental health as the urgent public health crisis it already is.
A mother carries two lives at once, yet three-quarters of women who develop mental illness during pregnancy or the postpartum period never receive a diagnosis. The numbers are significant — depression affects up to 19 percent of pregnant women and 15 percent of new mothers — but the real prevalence runs deeper than what gets counted, because most cases stay invisible.
The barrier is not medical complexity. It is stigma. Shame keeps women from speaking, and it keeps clinicians from asking. The consequences extend well beyond the mother: untreated perinatal mental disorders are linked to serious developmental outcomes in children, including attachment difficulties, ADHD, attention deficits, oppositional defiant disorder, and language and learning problems. These are not minor variations — they are lasting effects that begin before birth.
At the Eighth Symposium on Perinatal Mental Health in Zaragoza, clinical psychologist Julio Arbej put it plainly: mental health problems during this period are dramatically underdiagnosed and undervalued, and the failure to identify them creates a cascade of harm for both mother and child. The tragedy, he noted, is not that these conditions are untreatable — it is that they are not being treated at all.
The symposium united professionals from across the care spectrum — obstetricians, midwives, psychiatrists, pediatricians, pharmacists, and social workers — around a single message: mental health screening must become a standard, central feature of prenatal and postnatal care, not an afterthought. What is needed now is not new science, but the institutional commitment to act on what is already known.
A mother carries two lives at once—her own and the one growing inside her. Yet three-quarters of the women who develop mental illness during pregnancy and the months after birth never receive a diagnosis, let alone treatment. The numbers are stark: between 7 and 19 percent of pregnant women experience depression, and between 10 and 15 percent struggle with it after delivery. But the actual prevalence of perinatal mental disorders is far higher than what gets counted, because most cases remain invisible.
The barrier is not medical mystery. It is stigma. The shame and silence surrounding mental illness during pregnancy and the postpartum period keeps women from speaking up and keeps clinicians from asking the right questions. This silence has consequences that ripple far beyond the mother herself. Experts gathered recently in Zaragoza at the Eighth Symposium on Perinatal Mental Health to sound an alarm about what gets lost when these conditions go untreated.
Julio Arbej, a clinical psychologist at the Psychiatric Service of Zaragoza's Clinical Hospital, frames perinatal mental health as something larger than symptom management. It is about creating the conditions for maximum physical and emotional wellbeing for the mother, the baby, and the entire family unit. But that vision cannot be realized if the mental health piece is missing from the picture.
The science is clear: a mother's emotional state during pregnancy and early infancy shapes her child's development in measurable ways. When maternal mental disorders go untreated, children face elevated risks of attachment problems, hyperactivity, attention deficits, oppositional defiant disorder, and difficulties with language and learning. These are not minor variations in development. They are serious, lasting consequences that begin before birth.
Arbej has watched this pattern repeat. "Mental health problems are dramatically underdiagnosed and undervalued," he said. "A very high percentage of women experience emotional difficulties during this period of their lives that are never identified, and therefore never treated. And that creates a whole cascade of problems down the line." The tragedy is not that these conditions are untreatable. It is that they are not being treated at all.
The symposium brought together professionals from across the medical spectrum—obstetricians, pediatricians, psychiatrists, family medicine doctors, nurses, midwives, social workers, occupational therapists, and pharmacists. The message from this diverse group was unified: healthcare systems need to change how they approach maternal care. Mental health screening and support must be woven into prenatal visits and the early months after birth. It cannot be an afterthought or a specialty service tucked away in a corner. It has to be central to how we care for pregnant women and new mothers.
The work begins with training. Healthcare providers need to understand not just the symptoms of perinatal depression and anxiety, but the barriers that keep women from seeking help. They need to know how to ask, how to listen, and how to connect women with treatment without judgment. The infrastructure exists. The knowledge exists. What is missing is the will to make it standard practice, to treat maternal mental health as the urgent public health issue it is.
Citas Notables
Perinatal mental health is the discipline that promotes maximum physical and emotional wellbeing for the mother, baby, and entire family unit— Julio Arbej, clinical psychologist, Zaragoza Clinical Hospital
Mental health problems are dramatically underdiagnosed and undervalued, and this creates a whole cascade of problems down the line— Julio Arbej
La Conversación del Hearth Otra perspectiva de la historia
Why does stigma matter so much here? Aren't there other reasons women don't get diagnosed?
Stigma is the wall. A woman might feel ashamed to admit she's struggling, or she might worry that saying she's depressed will make people think she's an unfit mother. And clinicians, even well-meaning ones, often don't ask because they're not trained to see mental health as part of their job during pregnancy.
But the consequences for the baby—those are real, right? Not just in the mother's head?
Completely real. We're talking about measurable impacts on how a child's brain develops, how they attach to their mother, how they regulate their emotions later. The fetal brain is shaped by the mother's neurochemistry. This isn't metaphorical.
So what would actually change things? What did the experts say?
They were clear: you need every specialty in the room—obstetricians, pediatricians, psychiatrists, midwives, everyone. And they all need training. Mental health can't be siloed. It has to be part of routine prenatal care, the same way they check blood pressure.
Is there resistance to this? Do doctors push back?
The symposium suggests the opposite—that when you get professionals from different fields together, they see the problem clearly. The resistance comes from the system itself, from how care is organized and funded. Changing that is harder than convincing individual doctors.
What happens to the women who slip through the cracks?
They suffer in silence, often for months or years. Their children may struggle with attention, behavior, learning. The mother might blame herself. And no one ever connects the dots back to the untreated depression during pregnancy.