It’s no secret that the United States falls behind many other countries when it comes to maternity leave. We offer 12 weeks of unpaid, job-protected leave while Bulgaria, for example, provides 410 days, beginning 45 days before the due date. 

Now plenty of countries fall in between these two extremes and there are certainly many factors contributing to the requirements, and also plenty of variability within companies creating their own maternity leave protocols. Nevertheless, we can’t deny that the expected quick recovery may add pressure to new mothers. 

While lack of paid leave may be the most obvious contributor to significant PPD rates in the U.S., it’s actually not the most common cause that these experts hear from their clients. Instead, the notable disparity between the U.S. and other countries lies in the significant lack of community around childbirth and postpartum care in this country. 

Some families may live together in one household, and some new mothers may have wide groups of ready-to-help friends, but plenty of others don’t have anyone except themselves or a partner to assist with care. As Oreck stresses, “A baby doesn’t happen to just one person,” and outside help is simply critical.

Financial concerns are another contributor to PPD onset and severity, Oreck says. In the U.S., it’s common to pay thousands upon thousands of dollars just to birth a child (whether you have insurance or not), undeniably worsening financial stress for so many Americans. Forbes recently reported an average of over $18,000 in childbirth hospital bills in 2023.

Not to mention, the conversation about postpartum depression is still relatively hush-hush—at least when it comes to the severe end of the spectrum. For some women, postpartum depression is similar to the feeling of mild “baby blues,” but for many others, it’s debilitating depression, violent thoughts toward one’s child and oneself, and a feeling of pure hopelessness—hence why the term “baby blues” can be seen as dismissive in some cases. 

Safe to say, there are plenty of factors unique to the United States that contribute to increasing rates of postpartum depression—but still, many other countries have even higher rates of PPD and significantly less access to essentials (like health care) in the first place. This doesn’t change the experience of women in America, but it’s still important to consider.