Introduction: A Hidden Struggle for Mothers of Twins
Raising twins is often seen as a double blessing, but for many South Korean mothers, it also brings a double burden. Recent research reveals that nearly 40% of new mothers of twins in South Korea experience depression in the weeks following childbirth, a rate significantly higher than that observed among mothers of singletons. This article explores the findings of recent studies, the unique challenges faced by parents of twins, and the urgent need for enhanced support systems.
What the Latest Research Reveals
The Korea Population, Health and Welfare Association (KoPHWA), under the Ministry of Health and Welfare, conducted a comprehensive study involving 459 couples either raising twins or expecting them. Using validated tools such as the Patient Health Questionnaire-9 (PHQ-9) and the Korean version of the Edinburgh Postnatal Depression Scale (EPDS-K), researchers assessed the mental health of both mothers and fathers during pregnancy and after childbirth.
The results were striking:
- Within 12 weeks postpartum: 30.2% of mothers of twins experienced severe depression, and 9.3% had mild depression.
- All mothers of twins (regardless of time since birth): 55.1% showed symptoms of depression, though most did not meet the clinical threshold for a formal diagnosis. Of these, 9.7% had severe depression, 6.6% moderate, and 11.5% mild.
- Mothers pregnant with twins: 20.4% were depressed, with 8.3% experiencing severe symptoms.
- Fathers raising twins: 2.6% were severely depressed, 9.1% mildly depressed, and 26% showed subclinical symptoms.
These rates are notably higher than those found in the general population of new mothers in South Korea. For comparison, a 2024 study by CHA Bundang Medical Center found that 16.3% of new mothers overall experienced postpartum depression.
Why Are Mothers of Twins at Greater Risk?
Postpartum depression (PPD) is a well-documented complication of childbirth, affecting between 10% and 22% of new mothers globally. In South Korea, the prevalence among all new mothers ranges from 16.3% to 24.3%, depending on the study and diagnostic criteria used. However, mothers of twins face unique stressors that can amplify their risk:
- Physical Demands: Caring for two infants simultaneously means double the feeding, diaper changes, and sleepless nights, leading to chronic exhaustion.
- Emotional Stress: The pressure to meet the needs of two babies can lead to feelings of inadequacy, anxiety, and guilt, especially if one child requires more attention due to health issues.
- Financial Strain: The cost of raising twins is significantly higher, from medical expenses to childcare and daily necessities.
- Lack of Social Support: Traditional family structures in South Korea are shifting, with more nuclear families and less extended family support. This leaves many mothers feeling isolated.
- Medical Complications: Twin pregnancies are more likely to involve complications such as preterm birth or neonatal intensive care, which are themselves risk factors for parental depression and anxiety.
Comparing Depression Rates: Twins vs. Singletons
The stark difference in depression rates between mothers of twins and those of singletons is a cause for concern. While about 16.3% of all new mothers in South Korea experience postpartum depression, the rate among mothers of twins within the first 12 weeks after birth is nearly 40%. Even as time passes, a significant proportion of mothers of twins continue to experience depressive symptoms.
Fathers are also affected, though to a lesser extent. The KoPHWA study found that 37.7% of fathers raising twins showed some signs of depression, with 2.6% experiencing severe symptoms. This highlights that the mental health impact of raising twins is a family issue, not just a maternal one.
Understanding Postpartum Depression: Symptoms and Consequences
Postpartum depression is more than just the “baby blues.” It is a serious mental health condition characterized by persistent sadness, loss of interest in activities, changes in appetite and sleep, anxiety, irritability, fatigue, difficulty concentrating, feelings of guilt or worthlessness, and sometimes thoughts of self-harm or suicide. In severe cases, mothers may struggle to care for their babies or themselves.
Untreated postpartum depression can have long-term consequences for both mother and child. It can impair mother-infant bonding, negatively affect the child’s emotional and cognitive development, and strain family relationships. Early identification and intervention are crucial to prevent these outcomes.
Risk Factors for Postpartum Depression in South Korea
Research in South Korea and across Asia has identified several risk factors for postpartum depression, including:
- History of depression or anxiety
- High levels of stress during pregnancy
- Poor marital satisfaction or lack of partner support
- Low socioeconomic status
- Unplanned or unwanted pregnancy
- Medical complications during pregnancy or delivery
- Lack of social support
For mothers of twins, many of these risk factors are intensified. The demands of caring for two infants, potential medical complications, and the need for greater financial and emotional support all contribute to higher rates of depression.
The Role of Postpartum Care Centers (Sanhujoriwons)
South Korea has a unique system of postpartum care centers known as Sanhujoriwons, where mothers can recover after childbirth and receive support. These centers offer physical recovery services, education on infant care, and opportunities for rest. In 2021, over 80% of new mothers in South Korea used a Sanhujoriwon.
Studies show that satisfaction with these centers is influenced by the mother’s perceived health status, the quality of partnerships with care staff, and the educational support provided. However, mothers of twins may find that standard services do not fully address their unique needs, particularly regarding emotional support and practical assistance with two infants.
Calls for Greater Support: What Parents Say
The overwhelming majority of parents of twins in South Korea—94.7% according to the KoPHWA survey—believe they need more support from authorities than parents of single children. This support could take many forms, including:
- Expanded access to affordable childcare services
- Increased financial assistance for families with multiples
- Enhanced psychological counseling and mental health services
- Parenting education tailored to the challenges of raising twins
- Community support networks and peer groups
Despite the challenges, 85.6% of parents surveyed said that raising twins had more positive aspects than negative ones. Many cited the joy of having multiple children through a single birth and the unique bond shared by twins.
Expert Perspectives and Policy Implications
Dr. Lee Sam-sik, president of the KoPHWA, emphasizes the need for comprehensive support:
“The recent survey showed that it is necessary to provide psychological and emotional support for the parents in the pregnancy, birth, and child-raising process of twins. The association will work with the related government agencies to reduce the burden of child rearing.”
Experts agree that early screening for depression, especially among mothers of twins, is essential. Nurses and healthcare professionals play a crucial role in identifying at-risk mothers and connecting them with appropriate resources. Training programs for nurses, as highlighted in international research, can improve detection and support for postpartum depression.
Broader Context: Depression, Urbanization, and Family Structure
While the focus here is on mothers of twins, the findings reflect broader trends in mental health among new parents in South Korea and other developed countries. Urbanization, changing family structures, and increased economic pressures all contribute to rising rates of depression and anxiety among parents.
Research from other countries suggests that environmental factors, such as urban living conditions and lack of green spaces, can also influence mental health. In South Korea, the shift from extended to nuclear families means that many mothers lack the traditional support networks that once helped buffer the stresses of childbirth and early parenting.
What Can Be Done? Recommendations for Action
Addressing the high rates of depression among mothers of twins requires a multi-faceted approach:
- Policy Initiatives: Government agencies should expand financial and practical support for families with multiples, including subsidies, childcare services, and parental leave policies that recognize the unique challenges of raising twins.
- Healthcare System Improvements: Routine screening for depression should be integrated into prenatal and postnatal care, with special attention to mothers of twins. Training for healthcare providers can improve early detection and intervention.
- Community and Peer Support: Creating networks of parents of twins can provide emotional support, practical advice, and a sense of solidarity.
- Public Awareness: Reducing stigma around postpartum depression and promoting mental health literacy can encourage more parents to seek help when needed.
In Summary
- Nearly 40% of new mothers of twins in South Korea experience depression in the first 12 weeks after childbirth, a rate much higher than among mothers of singletons.
- Unique challenges—physical, emotional, financial, and social—contribute to the elevated risk of depression among parents of twins.
- Fathers of twins also experience higher rates of depression than the general population.
- Most parents of twins believe they need more support from authorities, including financial aid, childcare services, and mental health resources.
- Despite the difficulties, the majority of parents find raising twins to be a positive experience overall.
- Experts and policymakers are calling for enhanced support systems, early screening, and targeted interventions to address the mental health needs of families with twins.
