Postnatal depression and reproductive success in modern, low-fertility contexts

Background and objectives: Postnatal depression (PND) presents a puzzling phenomenon to evolutionary

anthropologists as it is highly prevalent and yet detrimental to child development and maternal

health. Adaptive explanations have been proposed, but have not been tested with data that directly link

PND to female fertility.

Methodology: A survey was designed to gather complete reproductive histories and retrospective measures

of PND to measure the effects of PND on fitness. Respondents were born between 1930 and 1967,

with the majority based in the UK during their childrearing years. The hypothesis that PND is detrimental

to fitness is assessed using Mann–Whitney U tests on completed fertility. Binary logistic regression

modelling is used to test the hypothesis that PND reduces the likelihood of parity progression.

Results: Women experiencing PND at their first or second birth have lower completed fertility, with PND

at the first birth leading to lowered fertility. Logistic regression analyses show that this is the result of

reductions in the likelihood of parity progression to a third birth when PND is experienced at the first

birth or when repeat bouts occur.

Conclusions and implications: Our results call into question adaptationist arguments, contribute to the

growing understanding of the importance of emotional wellbeing to fertility decision making, and given

the economic consequences of markedly below replacement fertility, highlight a potential new source of

financial incentive to invest in screening and preventative measures to ensure good maternal mental

health.