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Perinatal mental disorders are among the most common complications of childbearing. While perinatal mental health has traditionally been understood primarily as a consequence of the biological and physiological changes associated with pregnancy and childbirth, growing attention has highlighted the importance of social determinants. Yet, although socioeconomic conditions shape both mental health and birth outcomes, limited research has examined how these factors jointly shape maternal mental health around childbirth.

Using longitudinal, linked clinical data from Spain (BDCAP-RAE) and the Basque Country (Osakidetza), we examine maternal perinatal mental health and its demographic and socioeconomic determinants. First, using data on psychotropic medication dispensations and fixed-effects event-study models, we examine trajectories of medication use around childbirth among women giving birth in 2020–2021 in Spain (N=34540) and assess how these vary by age, income, and country of birth. Second, using clinical data covering all births in the Basque Country in 2023 (N=12,391), we examine whether increases in medication use after childbirth are associated with adverse birth outcomes, including low birth weight and prematurity. We find a significant increase in psychotropic medication use following childbirth, particularly among mothers in the youngest and oldest age groups and from the most deprived background, and among those experiencing adverse birth outcomes.