Expert Voices: Christina G. Hibbert, Psy.D. on Pregnancy & Postpartum Mood & Anxiety Disorders: Are Women of Advanced Maternal Age at higher risk?

Dr. Christina Hibbert

Dr. Christina Hibbert

As mentioned in my previous contributions to The Advanced Maternal Age Project, Perinatal Mood and Anxiety Disorders (PMADs) are caused by a combination of biological and psychological factors:

  • Hormone changes in pregnancy and postpartum, coupled with sleep deprivation and the physical and psychological demands of becoming a parent can lead to depression or anxiety.
  • Genetics is also key, including previous sensitivity to hormone changes, and a personal or family history of mental illness. In fact, the most documented risk factors for postpartum depression include: a history of depression, depression or anxiety in pregnancy, poor social support, and stressful life events during pregnancy or just after the baby is born.

Are women of advanced maternal age at an increased risk for developing a perinatal mood or anxiety disorder? The short answer is “No,” at least not because of their age.

PMAD’s affect women the same regardless of age, culture, or socioeconomic status. Some research, in fact, has found that women of advanced maternal age may have more protective factors than younger mothers, including psychological advantages like greater resilience and more stable interpersonal relationships#.


However, a history of infertility does increase the risk of a Perinatal Mood or Anxiety Disorder. Since women of advanced maternal age tend to have a greater incidence of infertility, this puts them at a higher risk.

It is however well-documented that women struggling with infertility and undergoing Assisted Reproductive Technologies like In Vitro Fertilization have rates of depression almost twice the norm. 

Considering the extreme shifts in hormones, the cycle of rising and falling hopes and expectations, and the experience of multiple pregnancy loss, physically and psychologically these women have been “put through the ringer” (for more on the psychological impact of these experiences, read “Women’s Emotions: The Emotional Earthquake” article). This means that, once they finally do conceive, many  are entering pregnancy with depression or anxiety, increasing their risk for PMADs.

Once the baby is safely delivered, women who have previously struggled with infertility may also feel tremendous pressure for everything to be “great,” to feel like the “perfect mother” with a “perfect love” for their baby.

These pressures can actually lead to increased levels of depression or anxiety, which can lead to increased guilt about that depression. “I’ve always dreamed of having this baby. Now I’m not even happy. What is wrong with me?” many women tell themselves, and shame themselves over feelings that are beyond their control.

The Benefits of Knowing You’re At Risk

But just because a mother is at risk doesn’t mean she needs to panic. In fact, knowing you are at risk for a Perinatal Mood or Anxiety Disorder can be a huge benefit: It can motivate you to do the following:

  1. Get prepared for the possibility of a PMAD (see Part 1 of this series), and
  2. To seek support and treatment early (see Part 2).

The most important thing you can remember is this: You are not alone. You are not to blame. With help, you will be well. As a 4-time postpartum survivor myself, trust me as I repeat: You will be well.

For information on PMAD Treatment, visit my site.

Dr. Christina Hibbert is a Clinical Psychologist, Founder of the AZ Postpartum Wellness Coalition and Producer of the DVD Postpartum Couples. A 4-time Postpartum Depression survivor, Christina had her most trying experience in 2007, when her sister and brother-in-law died, she and her husband inherited their two children, and she gave birth to their fourth baby, going from 3 to 6 kids practically overnight (an experience she shares in her forthcoming book, This Is How We Grow) A speaker, blogger, and singer-songwriter, Dr. Hibbert keeps her practice, her family, and her heart in Flagstaff, AZ. Visit Dr. Hibbert at or