Mental Health After Second Births in Sweden: The Role of First Birth Experiences, Birth Spacing, and Temporal Trends

Ognjen Obucina , Institut National d'Études Démographiques (INED)
Eleonora Mussino, Umeå University
Ann-Zofie Duvander, Stockholm University
Sol Pía Juárez, Stockholm University
Siddartha Aradhya, Stockholm University

Childbearing is a critical period for mental health, yet research has predominantly focused on first births. Considerably less is known about mental health following second births, despite the likelihood that earlier birth experiences, accumulated stressors, and family dynamics shape parental wellbeing across parities. This study examines mental health diagnoses after second births among mothers in Sweden between 2005 and 2020, with a particular focus on the role of mental health before and after the first birth, birth spacing, and temporal trends. We draw on REFU-GEN, a newly available population-based dataset linking Swedish administrative registers, including detailed information on dispensed prescriptions for anxiolytics, sedatives/hypnotics, and antidepressants. Using event history analysis, we follow mothers from the birth of their second child for up to two years, censoring at emigration, death, or subsequent childbirth. A piecewise exponential model estimates associations between timing and patterns of psychotropic drug use, controlling for pre-existing conditions and prescriptions between births. Preliminary findings indicate that women with prior mental health diagnoses, either before the first birth or in the postpartum period after the first birth, are at substantially elevated risk of receiving psychotropic prescriptions after their second birth. These results highlight the importance of continuity of mental health care across the reproductive life course, suggesting that postpartum mental health support should not be limited to first-time parents.

See extended abstract

 Presented in Session P2. Families, Fertility, and the Life Course 2