ADHD in Pregnancy and After Birth: An Overlooked Issue in Women’s Health | Blog

Introduction

In recent years, there has been growing recognition of neurodevelopmental conditions across the lifespan. Yet, attention deficit hyperactivity disorder (ADHD) continues to be underdiagnosed and undertreated in women, particularly during the perinatal period, a time of profound biological, psychological, and social change.

Why ADHD Can Be Missed in Women

For many women, the neurodevelopmental nature of ADHD is obscured. Gender-specific symptom patterns, such as inattentiveness rather than hyperactivity, can be subtle. In addition, overlapping features with mood and anxiety disorders frequently lead to diagnostic overshadowing, delaying accurate recognition and treatment.

The Perinatal Period: A Time of Heightened Vulnerability and Perfect Storm

Pregnancy and the postnatal phase bring transitions that can exacerbate ADHD symptoms. Physiological changes during pregnancy may independently affect memory, attention, and executive function. For women with pre-existing ADHD, these changes compound baseline vulnerabilities, often leading to significant functional impairment.

The Impact of Pregnancy and Early Parenthood

Pregnancy itself can affect memory, concentration, and executive function. For women with ADHD, these changes can add to existing vulnerabilities, leading to increased difficulties with daily functioning.

Why This Matters for Maternal and Infant Outcomes

Research shows that maternal ADHD is linked with functional impairments that affect antenatal care, adherence to health advice, and overall wellbeing. Left unrecognised, ADHD can also increase vulnerability to postnatal depression and anxiety, and place additional strain on parent and infant relationships. Early recognition and tailored support can therefore make a meaningful difference not only for the mother’s mental health but also for family outcomes.

Maternal ADHD is increasingly linked with functional impairments that influence antenatal engagement, adherence to health advice, and overall perinatal outcomes. Left unrecognised, ADHD may contribute to a heightened risk of depression, anxiety, and difficulties in parent and infant bonding. Early identification and support have the potential to improve maternal wellbeing, strengthen parent and infant relationships, and reduce long-term risks.

Beyond cognitive effects, the practical and emotional demands of pregnancy and early parenthood, from attending appointments and preparing the home to managing finances, lifestyle adjustments, and infant care, place sustained pressure on organisational and time management skills. For women with ADHD, these demands collide with core difficulties in decision making, distractibility, forgetfulness, and planning.

The Role of Social Support

Research highlights further challenges: women with ADHD often report lower levels of social support, poorer relationship quality, increased rates of intimate partner violence, and higher likelihood of separation or divorce. Such vulnerabilities can compound the emotional toll of the perinatal period, further perpetuating cycles of stress and isolation.

Moving Forward

ADHD in the perinatal context remains under-recognised, yet its impact is far-reaching. Timely identification and tailored interventions could significantly improve maternal mental health, enhance family relationships, and promote healthier developmental outcomes for children.

As awareness grows, clinicians, researchers, and policymakers must ensure that ADHD in women, and particularly in the perinatal period, receives the attention it deserves.

 

This blog was written by Dr Mano Manoharan FRCPsych, Consultant Perinatal Psychiatrist at South London and Maudsley NHS Foundation Trust, Lewisham Perinatal Service. She also serves as Joint Academic Secretary and Equity Champion for the Faculty of Perinatal Psychiatry at the Royal College of Psychiatrists.