Background Around one in five women will experience depression in the perinatal period. This is a period of transition for women’s identities, social networks and relationships. Growing evidence suggests that loneliness, isolation and lack of social support are risk factors for depression. However, little research has explored pathways between these and perinatal depression, or whether women themselves connect loneliness and isolation to their mental health. Methods This project involved secondary data analysis only. We analysed qualitative interviews with fourteen women diagnosed with perinatal depression to see whether they described isolation and loneliness as contributing to their distress. We also examined the relationship between social support and depression, using quantitative data from 525 women interviewed in pregnancy and postnatally. We analysed all data collaboratively with a group of women with lived experience of perinatal mental health difficulties. Findings Qualitatively, we found that motherhood interacted with other aspects of women’s identities, such as being young, single, deprived, or a woman of colour, to result in isolation and feelings of 'dislocated' self and relationships, particularly for some mothers. Women felt confined to their homes by the mothering role, isolated from wider social networks, and unsupported by their partners/families. Fears of being seen as ‘bad mothers’ provoked feelings of inadequacy and made it hard to make authentic connections with others, increasing isolation and depression. Quantitatively, we found that a lack of social support antenatally was related to postnatal depression, and this relationship was stronger for women who were not living with a partner. Conclusions Our findings suggest that isolation, loneliness and social support are important in relation to perinatal depression. Our analysis highlights a need to: develop support which addresses interpersonal/social networks; advocate for social change to lessen pressures on perinatal women and their families; and challenge the social constructions of the ‘good mother’.Background Around one in five women will experience depression in the perinatal period. This is a period of transition for women’s identities, social networks and relationships. Growing evidence suggests that loneliness, isolation and lack of social support are risk factors for depression. However, little research has explored pathways between these and perinatal depression, or whether women themselves connect loneliness and isolation to their mental health. Methods This project consisted of secondary data analysis. We analysed qualitative interviews with fourteen women diagnosed with perinatal depression to see whether they described isolation and loneliness as contributing to their distress. We also examined the relationship between social support and depression, using quantitative data from 525 women interviewed in pregnancy and postnatally. We analysed all data collaboratively with a group of women with lived experience of perinatal mental health difficulties. Findings Qualitatively, we found that motherhood interacted with other aspects of women’s identities, such as being young, single, deprived, or a woman of colour, to result in isolation and feelings of 'dislocated' self and relationships, particularly for some mothers. Women felt confined to their homes by the mothering role, isolated from wider social networks, and unsupported by their partners/families. Fears of being seen as ‘bad mothers’ provoked feelings of inadequacy and made it hard to make authentic connections with others, increasing isolation and depression. Quantitatively, we found that a lack of social support antenatally was related to postnatal depression, and this relationship was stronger for women who were not living with a partner. Conclusions Our findings suggest that isolation, loneliness and social support are important in relation to perinatal depression. Our analysis highlights a need to: develop support which addresses interpersonal/social networks; advocate for social change to lessen pressures on perinatal women and their families; and challenge the social constructions of the ‘good mother’.

Qualitative and quantitative secondary data analysis.