Archives of Women's Mental Health

, Volume 21, Issue 6, pp 765–775 | Cite as

Socioeconomic status and treatment of depression during pregnancy: a retrospective population-based cohort study in British Columbia, Canada

  • Gillian E. HanleyEmail author
  • Mina Park
  • Tim F. Oberlander
Original Article


Women at the lower end of the socioeconomic distribution have higher rates of depression in pregnancy; however, we know little about the role of socioeconomic status (SES) in determining their treatment. Herein, we investigate the relationships between income and the use of health services for depression in pregnancy. This retrospective cohort study using population-based administrative datasets included all women who delivered a live infant in the province of British Columbia, Canada (population of 4.3 million) between April 1st, 2000 and December 31st, 2009. We restricted to women with an indication of depression during pregnancy and examined their use of health services to treat depression by income quintile. Women in the highest income quintile were significantly more likely to see a psychiatrist for depression during pregnancy and to fill prescriptions for serotonin reuptake inhibitor (SRI) antidepressants than women in the lowest income quintile. Women at the lower end of the income distribution were more likely to have a GP visit for depression. Women at the low end of the income distribution were more likely to end up in hospital for depression or a mental health condition during pregnancy and more likely to receive a benzodiazepine and/or an antipsychotic medication. Our findings suggest a critical gap in access to health services for women of lower income suffering from depression during pregnancy, a time when proper access to effective treatment has the most potential to improve the long-term health of the developing child and the whole family unit.


Perinatal depression Socioeconomic status Administrative data Health services use 


Compliance with ethical standards

Conflict of interest

Gillian Hanley, Mina Park and Tim Oberlander declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Obstetrics & GynaecologyUniversity of British ColumbiaVancouverCanada
  2. 2.Vancouver General HospitalVancouverCanada
  3. 3.BC Children’s Hospital Research InstituteUniversity of British ColumbiaVancouverCanada
  4. 4.School of Population and Public HealthUniversity of British ColumbiaVancouverCanada
  5. 5.Department of PaediatricsUniversity of British ColumbiaVancouverCanada

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