Why support beyond the first year matters: understanding extended perinatal mental health
Perinatal mental health has rightly received increasing attention in recent years. While most discussions focus on pregnancy and the first twelve months postpartum, data suggests many women continue to experience significant distress beyond that timeframe, highlighting the importance of extended care and awareness.
1. Mental health can persist well into the second year
Research using UK primary care data shows that the prevalence of mental illness likely requiring specialist support in the second postpartum year rose from 3.1% in 1995 to 7.4% in 2018, with new-onset cases increasing from 1.9% to 3.8% in the same period PMC. In reality, around 5.9% of women are recorded with mental illness in that second year, and 3.3% are experiencing new symptoms PMC.
As many as 10–15% of new mothers in England may have experienced postnatal depression in 2024 — an estimated 56,000 to 85,000 women www.rcpsych.ac.uk. Yet specialist care currently available may only cover up to 24 months, leaving that continued support vulnerable to cuts.
2. Why anxiety and depression linger
Several factors contribute to mental health struggles that extend beyond the first postpartum year, including prior mental health history, multiple pregnancies, premature births, smoking or substance use, and socioeconomic disadvantage. These risks were found to elevate women's odds of experiencing persistent or new mental health problems. Stress and uncertainty, whether related to finances, employment or care arrangements, can prolong depression and anxiety long after the baby is born.
The Royal College of Psychiatrists also warns that planned cuts in perinatal funding (affecting as many as 64% of Integrated Care Boards in 2024–25) could reduce crucial resources precisely when demand remains high. www.rcpsych.ac.uk+2Open Access Government.
3. What this means for someone in real life
Imagine a new mother who found support through Talking Therapies in her first postpartum year. But as services wind down, she still feels overwhelmed - low mood, persistent worry, difficulty bonding, perhaps even flashbacks from a traumatic birth. She may feel dismissed: told it “just happens” or that she should have recovered by now. Without access to ongoing psychological support, she might struggle in silence or face a delayed crisis.
Extended emotional care, including tailored therapy, helps prevent low‑grade chronic anxiety and depression from becoming more damaging. Therapy methods such as CBT, EMDR (for trauma), ACT and compassion‑focused approaches can support recovery and restore hope.
4. How talking therapies can support extended perinatal recovery
Therapy offers much more than reassurance. Here’s how structured approaches help:
CBT supports practical reframing of unhelpful thoughts (e.g., “I shouldn’t still feel this way”) and builds coping strategies for persistent anxiety or overwhelm.
Compassion‑focused therapy helps mothers replace harsh self‑criticism (“I’m a failure”) with self‑understanding and care.
EMDR can gently resolve distressing experiences such as birth trauma or flashbacks.
ACT encourages living in line with personal values - gradually re‑engaging with meaningful activity, even when mood or motivation is low.
These approaches help restore self‑trust, calm inner turmoil, and guide movement towards recovery, even when emotional struggles feel deeply entrenched.
5. What the landscape looks like, and why private therapy still matters
Despite NHS efforts, funding pressure remains real. In 2024–25 nearly two‑thirds of NHS areas planned real‐terms cuts of around 2.9 per cent, while demand continues to rise Open Access Government. This can mean long waiting lists and fragmented support, especially beyond the 12‑month window.
Private therapy offers continuity, flexible timing, and person‑centred guidance that bridges gaps. Choosing a therapist trained in CBT, EMDR or compassion‑focused therapy helps clients benefit from evidence‑informed support tailored to ongoing perinatal struggles.
6. When to consider seeking help beyond year one
Be alert to these signs:
Feelings of sadness, guilt, overwhelm or anxiety that persist beyond the first year.
Loss of pleasure, motivation, or meaningful connections.
Lingering trauma or intrusive memories of birth.
Guilt or shame around needing help again after thinking “I should be fine.”
Difficulty bonding with your child, or feeling detached.
If any of this sounds familiar, talking to a therapist can be an important step, even if you’ve accessed support before.
7. Final thoughts
Extending awareness around perinatal wellbeing beyond the first postpartum year honours the complexity of becoming a parent. It sends a message that challenges rooted in anxiety or depression don’t magically end at 12 months and that recovery deserves time, understanding and accessible care.
Whether you are a woman facing ongoing emotional struggle, a partner, family member or friend, recognising the need for continuing support is powerful. Therapy is not a luxury, it is a resource for healing. With approaches grounded in evidence and compassion, recovery remains possible, even when the timeline feels longer than expected.
