‘Child penalty’: Postpartum depression not just short term, keeps women from returning to work

Postpartum depression has long been treated as a short-term clinical concern, but new data from Denmark and Canadian parent-child health research show it can quietly shape women’s employment, earnings and promotion prospects for years after birth — especially when workplaces are inflexible and support is thin.

In Denmark, economists recently followed thousands of first-time mothers from four years before birth to four years after. By linking national employment and earnings records to validated postpartum depression screenings, they were able to measure how a mental health event at childbirth changes women’s work trajectories over time.

They found that all mothers face a substantial “child penalty” in employment and earnings after a first birth – but women who experience postpartum depression take an extra, lasting hit.

Co-author Mircea Trandafir, senior researcher at the Rockwool Foundation Research Unit in Copenhagen, explains that this finding counters the conventional perception that for most women, postpartum depression is “a relatively temporary shock to mental health.”

“The employment rate of women who suffered from postpartum depression (PPD) is still lower than women who did not,” Trandafir says.

“That was a bit surprising to me, that there are such long-lasting effects.”

The study estimates that postpartum depression adds roughly a third to the existing motherhood employment penalty, and Trandafir notes that the underlying child penalty is significantly larger in Canada than in Denmark.

Double penalty keeps mothers from returning

An international “child penalty” atlas published in 2025 found a larger motherhood employment hit in Canada than in Denmark, numbers which Trandafir, who has lived and done research in Canada, uses to estimate Canada’s PPD penalty compared to Denmark’s.

“[Canadian] women who have a kid and suffer from postpartum depression are 30 percent less likely to return to work, which is an even larger number,” he says, adding that women with PPD are “doubly hit”: postpartum depression adds another significant barrier on top of the well-documented “motherhood penalty” of lost income and employment due to childbirth.

The team found that the extra motherhood penalty linked to PPD is driven mainly by women not returning to work at all. It’s a finding that Nicole Letourneau, professor in the Faculty of Nursing and the Cumming School of Medicine at the University of Calgary, agrees with.

Letourneau has spent decades studying maternal depression, child development and parent–child attachment. She points out that the daily trade-offs for mothers in lower-income, high-stress jobs directly affect return-to-work decisions.

For many depressed new mothers, she says, staying home feels like the only way to reduce relentless stress about childcare quality and separation from their baby.

“The work, while it might bring in money, makes you more stressed because you're away from your child, you can't afford good childcare, you don't trust the childcare that you're getting, and so on,” she says.

“You'd be less likely to go back to work full time … that's the trade-off. They will probably not go back to the workforce because they'll have some comfort at least that they know that their child's getting the care that they need.”

She agrees with Trandafir that compared to the results of the Danish study taking place in a country with “really good childcare”, the conditions for women in Canada with PPD are likely even more difficult, because of the differences in public perinatal healthcare.

Social support at work for new parents, pregnant child bearers

While good in comparison to countries such as the United States, both researchers agree that Canada’s public childcare system is not sufficient to keep women with PPD in the workforce.

In addition to more flexibility in scheduling, Letourneau recommends employers encourage open discourse around PPD and other perinatal issues occurring in their workplaces – pointing out that women who are working full-time do not have many opportunities to share information and support with other mothers — a crucial aspect of mental health which she says employers can easily provide.

As an example, she shares a personal story of experiencing PPD at work and starting a “Parents with little kids activity group (POLKA group, she calls it),” at her workplace, and how helpful that was, with a small budget from the employer to do some activities together.

“A social support network around new parents would be a really great strategy for employers to use,” she says, but points out an important caveat: “It should begin during pregnancy,” so relationships and sharing of support can start early and be a reason for women to return to work.

Postpartum depression lasts longer than expected

Letourneau’s own longitudinal work shows that PPD rarely ends neatly after a few months – rather than the generally accepted three- to six-month postpartum depression, women can continue to experience symptoms up to two years later.

Those women will continue to choose less or no work at all, Letourneau says – a type of self-protection or therapy.

“It's almost like women are choosing a treatment for their depression. It reduces their stress, enables them to build supports that in turn improve their mental health,” she says.

“My own and others’ research show that depression in women postnatally, prenatally, is around the balancing supports and stress – if you can reduce the stress, you reduce the likelihood of depression. If you can increase the support, you reduce the likelihood of depression. It's like a teeter totter.”

‘Tournament’ style org design harms women with PPD

The Danish data provides perspective on how job design and workplace culture shape these choices. In “tournament” style organizations, Trandafir says, “people need to signal how hard they work and how productive they are and what they're doing, and one way they do that is by working longer,” he says.

“And in general, women are not really able or willing to do that, because of the demands that are put on them from the home, and they tend to be harmed by this kind of competition at every level.”

Trandafir and his co‑authors used occupation‑ and sector-level gender gaps to determine how family ‑friendly a job is – if it relies on long, inflexible hours and tournament-style promotions or more forgiving schedules and linear pay structures.

“If we see in an occupation that the gender gap is smaller, that tells us that there isn't that much emphasis in that occupation on working longer hours … because in those kinds of occupations, men tend to fare better than women,” he says.

“Women with postpartum depression are not really harmed in these kinds of occupations.”

What to do differently for postpartum depression

Both researchers stress that postpartum depression is not just a women’s issue or a short-term medical concern as is commonly thought — it shapes family dynamics, child development and long-term talent pipelines.

However, as Trandafir stresses, that doesn’t mean workplace strategies should be all-encompassing. Rather, tactics to counter PPD effects should be specifically targeted to women.

Gender-neutral strategies don’t work, he says, and he has a simple explanation as to why that is: “Because childbirth hits men and women differently.

“Having gender-neutral approaches to return-to-work actually does not eliminate the gender gap in returning to work.”

He goes on to explain the nuance, which boils down to how employees respond to strategies such as more flexible work; while it might seem equal in the workplace, he says, when it is taken home, that is where the disparity emerges.

“What happens is that gender-neutral strategies are going to result in men taking advantage of what [flexible work] gives them, while not really changing the allocation of work at home,” he says.

“The idea of a lot of these gender-neutral things is that ‘We are going to reduce the burden on men at work, so that they can take more of the work at home.’ And typically what happens is that they don't take more of the work at home, they just take advantage of having less demands on them at work. That is why it does not help.”