Postpartum Depression Support Groups: What They Offer

Somebody has suggested a support group. Possibly your health visitor, possibly a friend, possibly the internet at two in the morning.

Your immediate reaction was probably some version of: sitting in a circle in a church hall telling strangers about the worst year of my life, absolutely not. Or the quieter objection, which is that other people there will have real problems and you’ll be the one taking up a chair for no good reason.

Both reactions are extremely common and neither describes what these groups are usually like. Here’s what the evidence says about whether they help, what actually happens in one, and how to work out whether it’s worth your time.

Does peer support actually work?

Better than most people expect, and there’s a good trial behind the claim.

Cindy-Lee Dennis and colleagues ran a multisite randomised controlled trial across seven health regions in Ontario. They recruited 701 women in the first two weeks postpartum who screened as high risk on the Edinburgh scale, then randomised them to usual care or to telephone peer support from a volunteer who’d experienced and recovered from postnatal depression herself (Dennis et al., 2009).

At 12 weeks, 14% of the peer-support group scored above the threshold on the Edinburgh scale, compared with 25% of the control group. The number needed to treat was 8.8, meaning roughly nine women received the support for one additional woman to avoid screening positive.

Worth sitting with that for a moment, because it’s a stronger result than the phrase “peer support” tends to suggest. Nobody in that trial was a clinician. The intervention was another mother who’d been through it, on the phone.

What actually happens in one

Formats vary, but the shape is fairly consistent and much less confronting than people imagine.

A facilitator opens, usually with something administrative and low stakes. People introduce themselves, often just a first name and how old the baby is. Someone mentions something that’s been hard. Other people respond, sometimes with their own version, sometimes just by acknowledging it. It runs an hour to ninety minutes.

What tends to surprise first-timers is how ordinary the conversation is. It isn’t ninety minutes of crying. There’s a fair amount of practical detail about feeding and sleep, some dark humour, and a lot of the specific relief that comes from a room where nobody’s shocked.

You’re generally not required to speak. Most groups explicitly allow people to attend and listen, and facilitators are used to someone spending their first session saying nothing at all.

The thing a group does that a friend can’t

Your friends may be wonderful. There’s still a particular function they can’t perform.

With a friend who hasn’t been through this, every difficult thing you say requires a preamble. You explain why it’s hard, you manage their reaction, and you watch for the moment their face changes. Many people find they’re doing emotional work in the conversation that was meant to relieve their emotional load.

In a group, the preamble is unnecessary. You say the thing and several people nod, because they’ve had the same thought that week. That removal of the justification step is what people describe as the most valuable part, and it’s not something you can arrange by having better friends.

There’s a second effect that matters more than it sounds. Seeing someone six months further along, functioning, is evidence of a kind that reassurance can’t provide. Being told it gets better is weaker than watching someone for whom it visibly has.

The types, and how they differ

Three broad kinds, and they’re not interchangeable.

Peer-led groups are run by people who’ve experienced perinatal mental health difficulties themselves. Usually free, usually drop-in, no assessment to get in. The Dennis trial evidence is closest to this model.

Clinician-facilitated groups are run by a therapist or nurse. More structured, sometimes with an educational component, occasionally a fixed number of sessions. Closer to group therapy, and may cost money or require a referral.

Online groups run by video or as forums. Postpartum Support International runs free online groups covering a range of situations, including groups for partners and for people who’ve experienced loss. The obvious advantage is that you can attend from your sofa with a sleeping baby on you.

On the online question, the evidence is encouraging. A meta-analysis of nine randomised trials with 1,958 women found telehealth interventions produced significantly lower depression and anxiety scores than control conditions (Zhao et al., 2021). That’s not group-specific, but it undercuts the assumption that remote support is a watered-down version.

Specialist groups, which are worth asking about

General perinatal groups work for most people. But if your situation has a particular shape, a group built around it does something a general one can’t, and these are less advertised than they should be.

Groups exist for parents whose babies spent time in neonatal intensive care, where the shared experience isn’t depression so much as a specific kind of sustained fear. There are groups for people who conceived after infertility or loss, where the guilt of struggling with a longed-for baby is the recurring theme rather than an aside. Groups for parents of multiples, for single parents, for people whose birth was traumatic, and for parents of colour where the additional layer of how you were treated in maternity care is assumed rather than explained.

Postpartum Support International runs a number of these online, including groups for partners and for people who’ve experienced pregnancy or infant loss.

Why it matters: in a general group, the unusual part of your situation becomes the thing you have to explain, which reproduces the problem you came to escape. In a matched group it’s the baseline. If your circumstances have a name, it’s worth asking whether a group exists for it before settling for the nearest general one.

If there’s nothing near you

Plenty of places have no local group, and the answer isn’t to give up on the idea.

Online groups eliminate geography, and there are more of them than a casual search suggests, running at various times to cover different time zones. A group at 9pm your time run from another country is still a group.

Helplines are the other underused option. Postpartum Support International runs one, and unlike a group it’s available at the hour you’re most likely to need it, which for most new parents is not during the working day.

And peer support in the Dennis trial wasn’t a group at all. It was one person on the phone. If a group feels like too much but you know someone who’s been through this, asking them directly whether you can talk occasionally is a legitimate version of the same thing, and closer to what the trial tested.

What a group is not

Worth being clear, because conflating these leads people to expect the wrong thing.

A support group is not treatment. There’s no treatment plan, no diagnosis, no clinical responsibility for your care. Nobody in the room is monitoring your symptoms.

For moderate or severe depression, the evidence points towards therapy, and the US Preventive Services Task Force specifically names cognitive behavioural therapy and interpersonal therapy (US Preventive Services Task Force, 2019). A group can sit alongside that comfortably and for many people does. It shouldn’t replace it.

If you’re weighing up both, our guide to finding a therapist who works in perinatal mental health covers the search, and our fuller piece on postpartum depression, what it looks like and what helps, covers the condition itself.

Where to find one

Postpartum Support International runs a directory covering the US, Canada, the UK and Australia that lists support groups alongside providers, and runs its own free online groups.

Beyond that: your health visitor, midwife or obstetric team usually know what’s running locally, and children’s centres or community health services often host groups that aren’t listed anywhere online. Hospitals with maternity units sometimes run their own.

One practical note. If the first group you try doesn’t suit you, that’s information about the group rather than about groups. They vary enormously in tone, and people who’ve found a good one have often tried more than one.

When a group isn’t the right call

It isn’t universal, and it’s better to know the exceptions in advance.

If you’re in crisis, a group is not the right resource today. If you’re experiencing symptoms that suggest postpartum psychosis, meaning confusion, not sleeping across several days, or beliefs about your baby that feel true rather than intrusive, that’s an emergency department rather than a group.

Some people also find groups actively unhelpful, and that’s legitimate. If hearing other people’s difficulties reliably leaves you worse, individual work suits you better. And if you’re someone who copes by comparing, a group can turn into a ranking exercise, which is the opposite of the point.

None of that makes you bad at groups. It makes a group the wrong tool.

Making the first one survivable

The first session is the hardest and there are ways to lower the cost of it.

Email the facilitator beforehand. Say it’s your first time and that you’d rather not speak. Facilitators get this constantly and will usually make sure nobody puts you on the spot.

Go with the explicit intention of attending once. Committing to a weekly thing at a point when you can’t reliably commit to a shower is a good way to never start. One session, then decide.

Ask about babies. Most perinatal groups assume you’ll bring one, and the sound of a baby during a session is completely normal.

And if online feels more manageable than in person, start there. A group you attend from home beats a better group you never get to.

The takeaway

The version of a support group that lives in most people’s heads, all confession and circle of chairs, isn’t what these mostly are. They’re a room, physical or virtual, containing people who don’t need an explanation.

The trial evidence is real and reasonably strong for something this low-cost and this low-risk. Nine women supported for one additional woman to avoid a positive screen is a return most interventions would be pleased with, and the intervention was another mother on the phone.

You don’t have to be struggling enough to earn a chair. The bar is that this is hard and you’d rather not do it by yourself, which is roughly everyone in the room.

Frequently asked questions

Sources

1. Centers for Disease Control and Prevention. (2020). Vital Signs: Postpartum depressive symptoms and provider discussions about perinatal depression, United States, 2018. Morbidity and Mortality Weekly Report, 69(19).
2. Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150, 782–786.
3. Dennis, C.-L., Hodnett, E., Kenton, L., Weston, J., Zupancic, J., Stewart, D. E., & Kiss, A. (2009). Effect of peer support on prevention of postnatal depression among high risk women: Multisite randomised controlled trial. BMJ, 338, a3064.
4. Postpartum Support International. Online support groups and the PSI Perinatal Mental Health Provider Directory.
5. US Preventive Services Task Force. (2019). Interventions to prevent perinatal depression: US Preventive Services Task Force recommendation statement. JAMA, 321(6), 580–587.
6. Zhao, L., Chen, J., Lan, L., Deng, N., Liao, Y., Yue, L., Chen, I., Wen, S. W., & Xie, R.-H. (2021). Effectiveness of telehealth interventions for women with postpartum depression: Systematic review and meta-analysis. JMIR mHealth and uHealth, 9(10), e32544.