Medication of Postpartum Depression and Maternal Outcomes Evidence from Geographic Variation in Dutch Prescribing

We use data on over 420,000 first-time Dutch mothers to examine the effects of postpartum antidepressant use. Dutch general practitioners (GPs) must be available for house calls. We therefore instrument a woman’s receipt of antidepressants postpartum with local practitioners’ propensity to prescribe antidepressants to women 46 to 65. Ordinary least squares suggests negative effects of postpartum antidepressants but this is due to selection into treatment. Instrumental variables estimates indicate that the marginal treated patient is likely to continue taking antidepressants long term and is less likely to be employed in the year after birth, with little evidence of other effects.