For families who have been through postpartum psychosis, some of the biggest questions come after the crisis. Will it happen again? What does the future look like? A study published August 14, 2026, in the Journal of Reproductive and Infant Psychology followed women treated for a first episode of postpartum psychosis at a large London mental health service, and it offers some answers, along with important reasons to plan ahead.
What the Researchers Studied
The team reviewed the records of women treated at South London and Maudsley NHS Foundation Trust for a first episode of psychosis involving mood symptoms. They compared:
- 408 women whose first episode began after childbirth
- 1,011 women whose first episode was not related to childbirth
They then looked at what happened over the following years, including hospital readmissions, later pregnancies and deaths.
What They Found
- Two different paths. Women with postpartum psychosis tended to follow one of two trajectories: one with lower future illness and one with higher future illness. In other words, a first episode does not set a single course for everyone.
- Risk can return after later births. Women with postpartum psychosis had an increased risk of being admitted to the hospital again after later deliveries, averaging 0.55 admissions per delivery.
- Fewer later births. Women with postpartum psychosis went on to have fewer subsequent children.
- Prior illness was more common. The postpartum group had more previous psychiatric admissions than the comparison group.
- Higher mortality. Deaths in the postpartum group were about 11 times the local population rate, and excess deaths were seen in both groups of women with psychosis. The study did not report causes of death, so it cannot say why.
What the Study Cannot Tell Us
- It comes from a single center in South London, so the results may not reflect care or outcomes elsewhere, including in the U.S.
- It was retrospective, relying on existing records.
- The mortality figure is not tied to specific causes, and it may partly reflect other health and social factors.
- The study does not tell any individual woman which path she is on.
What This Means for Families
Recovery Is Possible
Postpartum psychosis is a psychiatric emergency, but it is treatable. This study’s finding of a lower-morbidity path is a reminder that many women do well after the first episode.
Plan Before Another Pregnancy
Because the risk can return after later births, anyone who has had postpartum psychosis, or who has bipolar disorder, should make a plan with a perinatal psychiatrist before or early in a future pregnancy. That plan often covers medication, sleep protection in the first weeks after birth, close follow-up and who to call if symptoms start.
Stay Connected to Care
Ongoing follow-up matters, especially given the higher mortality seen in this and other studies of psychosis. Physical health checks, mental health care and support for families are all part of long-term recovery.
Know the Warning Signs
Postpartum psychosis usually begins in the first days or weeks after birth. Get emergency help if a new mother:
- Cannot sleep, or seems not to need sleep
- Is confused, agitated or unusually energetic
- Sees or hears things that aren’t there, or holds strange beliefs
- Behaves in ways that are out of character or dangerous
People with psychosis often do not realize they are ill, so partners and family members need to act. Call 911 or go to the emergency room. For thoughts of suicide, call or text 988. For support, call or text the National Maternal Mental Health Hotline at 1-833-TLC-MAMA (1-833-852-6262).
Learn how to find a perinatal psychiatrist
Sources
- Tsoumpris A, Lewis G, Lapraik A, Casanova Dias M, Patel R, Gale-Grant O. “Long-term outcomes of first episode affective psychosis in postpartum women.” Journal of Reproductive and Infant Psychology. Published online August 14, 2026. https://doi.org/10.1080/02646838.2026.2714056.