Nearly 40% of South Korean Mothers of Twins Report Depression Soon After Birth

The first 12 weeks bring a heavy emotional burden

Nearly 40% of mothers of twins in South Korea experienced depression during the first 12 weeks after childbirth, according to research by the Korea Population, Health and Welfare Association (KoPHWA). The survey of 459 couples raising twins or expecting them found that 30.2% of mothers in that early period had severe depression and another 9.3% had mild depression.

Together, those figures amount to 39.5%, drawing attention to the mental health needs of families caring for two babies at once. For comparison, a 2024 study by CHA Bundang Medical Center found postpartum depression among 16.3% of new mothers generally. Other South Korean research has put the proportion between 16.3% and 24.3%, depending on the study and the criteria used.

The demands extend beyond the weeks immediately after delivery. Across mothers raising twins, regardless of how much time had passed since birth, 55.1% showed some symptoms of depression. Fathers also reported difficulties, while one in five women pregnant with twins experienced depression.

KoPHWA, which operates under the Ministry of Health and Welfare, examined the mental health of both mothers and fathers during pregnancy and after childbirth. Its findings point to a need for support throughout that process, from preparing for two babies to managing the practical and emotional demands of raising them.

Parents themselves expressed a strong desire for help: 94.7% said families with twins needed more support from authorities than families with a single child. Yet 85.6% also said raising twins had more positive aspects than negative ones. The findings place the joy of family life alongside a substantial burden of care.

What the survey measured

Researchers used validated assessment tools, including the Patient Health Questionnaire-9 (PHQ-9) and the Korean version of the Edinburgh Postnatal Depression Scale (EPDS-K). These questionnaires help assess depressive symptoms, making it possible to identify parents who may need closer attention or support.

The survey covered couples at different stages, including pregnancy, the first weeks after birth and later periods of raising twins. The results therefore describe several groups, each facing a different part of the experience.

• Within 12 weeks after childbirth, 30.2% of mothers of twins experienced severe depression and 9.3% experienced mild depression.
• Among all mothers raising twins, regardless of time since birth, 55.1% showed depressive symptoms. The survey listed 9.7% with severe depression, 6.6% with moderate depression and 11.5% with mild depression.
• Among women pregnant with twins, 20.4% experienced depression, including 8.3% with severe symptoms.
• Among fathers raising twins, 2.6% experienced severe depression, 9.1% mild depression and 26% symptoms below the clinical threshold.

Most mothers within the broader group showing symptoms did not meet the clinical threshold for a formal diagnosis. A clinical threshold is the point at which symptoms meet the criteria used to identify a condition. Parents can still experience emotional difficulties below that point.

The timing of distress matters for families and healthcare workers. Depression was present during pregnancy as well as after delivery, while symptoms also appeared among parents further into raising their children. The findings support attention to mental health across those stages, rather than concentrating help only around the birth.

How the figures compare

Postpartum depression affects between 10% and 22% of new mothers globally. In South Korea, estimates for new mothers generally range from 16.3% to 24.3%, reflecting differences between studies and the diagnostic criteria they use.

The 39.5% recorded among mothers of twins within 12 weeks after birth is more than twice the 16.3% found by CHA Bundang Medical Center in 2024. Those figures come from different studies, with the twin survey focusing on a particular group during the early weeks after delivery.

For families, the practical concern is the concentration of distress during a period already filled with feeding, recovery and interrupted sleep. The broader finding that 55.1% of mothers raising twins had depressive symptoms also shows that emotional difficulties reach beyond the immediate period after birth.

Why caring for twins can increase the strain

Two infants require feeding, diaper changes and attention throughout the day and night. For mothers recovering from childbirth, meeting those needs can mean repeated interruptions to sleep and chronic exhaustion.

Parents may also struggle with how to divide their attention. A mother trying to meet both babies' needs can experience anxiety, guilt or feelings of inadequacy, particularly when one child needs extra care because of a health problem.

Twin pregnancies are more likely to involve complications, including premature birth or treatment in neonatal intensive care. Both can add to parental depression and anxiety. A family may therefore face the emotional pressure of a baby's medical needs alongside the ordinary demands of caring for two newborns.

Money adds another source of pressure. Medical expenses, childcare and everyday necessities make raising twins more expensive. Families need practical supplies and care for two children at the same time, increasing the financial demands of early parenthood.

Social support can be limited, too. South Korea's shift from extended families toward nuclear families means some mothers have less help from relatives. Without that support, the work of caring for twins can become more isolating.

Depression is more than the baby blues

Postpartum depression is a serious mental health condition that can affect how a mother feels, thinks and manages daily life. Symptoms include persistent sadness, loss of interest in activities, changes in appetite and sleep, anxiety, irritability, fatigue and difficulty concentrating.

Some mothers experience feelings of guilt or worthlessness. In severe cases, depression can involve thoughts of self-harm or suicide, and mothers may struggle to care for themselves or their babies.

The condition reaches beyond the temporary emotional changes often described as the baby blues. Persistent symptoms can make an already demanding period harder to manage, especially when a parent is responsible for two infants.

Untreated postpartum depression can affect the bond between a mother and her baby, place strain on family relationships and have lasting effects on a child's emotional and cognitive development. Cognitive development includes the growth of abilities such as learning and thinking. Early identification and intervention can help prevent these consequences.

Which parents may need closer attention?

Research in South Korea and across Asia has identified several factors associated with postpartum depression. Some involve a parent's earlier mental health, while others concern relationships, financial circumstances or events during pregnancy and delivery.

• A history of depression or anxiety.
• High levels of stress during pregnancy.
• Poor marital satisfaction or limited support from a partner.
• Low socioeconomic status.
• An unplanned or unwanted pregnancy.
• Medical complications during pregnancy or delivery.
• A lack of social support.

Mothers of twins may face several of these pressures together. Greater care demands can coincide with medical complications, higher expenses and a need for more emotional and practical help.

The survey's finding that 20.4% of women pregnant with twins experienced depression, including 8.3% with severe symptoms, makes pregnancy an important period for identifying distress. Support before delivery can address difficulties already present as families prepare for the demands ahead.

Fathers also face mental health difficulties

Among fathers raising twins, 37.7% showed some signs of depression. The survey recorded severe depression in 2.6%, mild depression in 9.1% and symptoms below the clinical threshold in 26%.

Fathers were affected to a lesser extent than mothers, but the findings place their mental health within the same family concern. The burden of raising twins can involve both parents, including the emotional demands, financial pressure and repeated work of caring for two children.

Fathers of twins also face elevated depression compared with the general population. The figures presented here do not include a numerical comparison for that population, leaving the size of that difference unspecified.

Support for fathers matters alongside support for mothers. Partner support and marital satisfaction are among the factors associated with maternal depression, making the wellbeing of both parents relevant to family life.

Can postpartum care centers meet twin families' needs?

South Korea has a system of postpartum care centers, known as Sanhujoriwons, where mothers can recover after childbirth. More than 80% of new mothers used one in 2021.

These centers provide services for physical recovery, education about infant care and opportunities to rest. For a mother preparing to care for twins, those services can address immediate needs during the transition from childbirth to daily parenting.

Studies have found that satisfaction with the centers is influenced by a mother's perception of her health, the quality of her relationship with care staff and the educational support she receives. Rest is one part of the experience; communication and preparation for caring for a baby also matter.

Mothers of twins may find that standard services do not fully meet their needs. Emotional support and practical assistance with two infants are particular concerns. The wider survey findings point to needs that continue through pregnancy, birth and childrearing, extending beyond a period of recovery in a center.

Parents want more help and still see joy

The 94.7% of surveyed parents who wanted greater support from authorities expressed a broad need for assistance beyond that available to parents of single children. The pressures described in the research span money, care, emotional health and access to help.

Potential forms of support include affordable childcare, greater financial assistance for families with multiple children born together, psychological counseling, mental health services, education tailored to raising twins and community groups where parents can share experiences.

The same survey found that 85.6% of parents saw more positive aspects than negative ones in raising twins. Parents cited the joy of having multiple children through one birth and the special bond between twins.

Those positive experiences sit alongside the need for assistance. A family can value raising twins while also needing help with exhaustion, costs and depression. Support can respond to the daily workload without overlooking what parents cherish about their children.

What stronger support would involve

Lee Sam-sik, president of KoPHWA, called for psychological and emotional support throughout pregnancy, birth and the years of raising twins. He also described the association's intention to work with government agencies to reduce the burden on families.

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.

Early screening for depression, particularly among mothers of twins, is a central response. Integrating screening into prenatal and postnatal care would give healthcare workers opportunities to identify parents experiencing difficulties and connect them with appropriate resources.

Nurses and other healthcare professionals have an important role in recognizing mothers at risk. International research has highlighted training programs for nurses as a way to improve the detection of postpartum depression and the support available afterward.

Government responses could include expanded financial assistance, childcare services and parental leave policies that recognize the demands of raising twins. Education tailored to caring for two infants could address practical concerns, while counseling and other mental health services could respond to emotional distress.

Community networks and peer groups offer another form of help through shared experiences, practical advice and contact with other parents of twins. Public awareness and mental health education can also reduce stigma and encourage parents to seek assistance.

Family changes shape the pressure on parents

South Korea's changing family structure forms part of the setting for these findings. As nuclear families become more common, mothers may have less access to the relatives who traditionally helped with childbirth and early parenting.

Urbanization and economic pressure also contribute to depression and anxiety among parents in South Korea and other developed countries. Research from other countries suggests that urban living conditions and limited access to green spaces can influence mental health.

For families with twins, the most immediate needs remain concrete: enough rest, help caring for two children, manageable costs and access to emotional support. Responding across those areas would address several of the pressures identified in the survey, while making room for both parents' mental health.

Key Points

• KoPHWA surveyed 459 couples raising twins or expecting them.
• Within 12 weeks after birth, 30.2% of mothers of twins experienced severe depression and 9.3% mild depression, a combined 39.5%.
• A 2024 CHA Bundang Medical Center study found postpartum depression among 16.3% of new mothers generally.
• Across mothers raising twins, 55.1% showed depressive symptoms; 20.4% of women pregnant with twins experienced depression.
• Among fathers raising twins, 37.7% showed some signs of depression.
• Greater support from authorities was sought by 94.7% of parents, while 85.6% said raising twins had more positive aspects than negative ones.
• Screening, counseling, financial assistance, childcare and support tailored to twins are key areas for action.