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Mental health, at the opposite end of the spectrum from mental illness, is an important yet understudied aspect of maternal well-being. We sought to characterize aspects of emotional, social, and functional well-being in the postpartum period and perceived facilitators and barriers to mental health following a high-risk pregnancy.

We conducted 28 in-depth interviews with people 3 to 6 months postpartum who experienced a pregnancy complicated by hypertension or diabetes in Atlanta, Georgia. We conducted a thematic analysis to examine dimensions of mental health and prevalent challenges to attaining it.

Participants described how social well-being (including interpersonal relationships, functional support, and social support) facilitated positive functioning and emotional well-being. Challenges to well-being included difficulties with infant feeding and care, housing and financial insecurity, and personal health. Facilitators of well-being included robust and positive relationships with female relatives and male partners. Participants described a limited role of the perinatal care team in supporting mental well-being.

Postpartum mental health is a distinct construct from mental illness that, when adequately supported through family networks and health care teams, can benefit both woman and infant.