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New research is calling for mental health screening for all pregnant women early on, to prevent serious problems for mothers and babies later.
Researchers from the University of Auckland's Koi Tū: Centre for Informed Futures have released a new paper looking at mental distress before and after pregnancy.
They say universal screening is urgently needed, and it must be designed specifically for Aotearoa.
Felicia Low leads the centre's maternal and infant health research and said there was growing evidence that serious mental health problems after birth often began in pregnancy or earlier.
For many women, the symptoms could not simply be dismissed as "the baby blues," something temporary that would resolve itself over time.
Her team, backed by former prime minister's science advisor Sir Peter Gluckman, said about 15 percent of New Zealand women were affected by perinatal mental distress - that covers the period from conception to a year after birth.
It was not only traumatic for the mothers, but had potentially life-long, intergenerational impacts on children who may have developmental, behavioural or emotional problems.
The results could be devastating so prevention was best, Low said.
Screening everyone would pick up problems earlier, before they were obvious, she said.
"It has to be early so that we can identify any women who may have possible issues, mental distress before it gets worse, and we want it to be universal so it's not just women who are displaying overt symptoms."
Their research found existing screening tools were likely to be inadequate for some cultures, so it was important better ones were designed.
"We know that Māori and Asian women may experience somewhat different symptoms when they experience mental distress."
The cause of perinatal mental distress was complex, she said.
It could be exacerbated by a number of factors including poverty, racism, family violence, a complicated birth, a temperamental child, genetics or hormonal changes.
Her team said increased screening and spreading the word about the high prevalence of the issue would reduce stigma and make it easier for women and their families to seek help.
