In 2021, two months postpartum, 16.7% (95% CI [15.7–17.7]) of women who had given birth in mainland France exhibited symptoms of depression, 27.6% [26.5–28.8] experienced anxiety, and 5.4% [4.7–6.1] had suicidal thoughts. These psychological symptoms sometimes occurred concurrently, and ultimately, two months after childbirth, more than one in three women experienced psychological distress. The percentage of women reporting at least one of these three psychological symptoms decreased significantly at 6 months postpartum, with 11.7%, 21.0%, and 3.7% of women exhibiting symptoms of depression, anxiety, or suicidal ideation, respectively. The proportion of women with symptoms of depression remained stable at 12 months postpartum (11.9%), the proportion with anxiety continued to decrease significantly (18.0%), while the proportion with suicidal ideation began to rise significantly again (5.0%). There are regional disparities within France, with some regions showing significantly lower prevalences of depressive symptoms two months postpartum (Hauts-de-France: 14.1%, Grand Est: 13.7%, Burgundy -Franche-Comté: 11.4%, Nouvelle-Aquitaine: 13.9%) or higher (Île-de-France: 19.3%, Centre - Val de Loire: 21.7%, and Provence-Alpes-Côte d’Azur: 20.5%) than the national average in France. The same was true for anxiety two months postpartum, for which significantly lower prevalence rates were observed (Normandy: 21.2%, Nouvelle-Aquitaine: 24.1%) or higher (Centre-Val de Loire: 33.9%, Provence-Alpes-Côte d’Azur: 32.0%) than the average prevalence in mainland France. Among the overseas departments and regions (DROMs) studied, Guadeloupe stands out with a prevalence of depressive symptoms two months postpartum of 30.6%, nearly double that observed in mainland France (16.7%, p<0.0001). Nearly three-quarters of women (73.1%) who gave birth in mainland France and reported experiencing psychological difficulties during their pregnancy said they had not sought prenatal mental health care. Women who received professional support during pregnancy through home visits by a midwife, a consultation with a social worker, and/or participation in childbirth preparation classes were more likely to seek prenatal mental health care when experiencing psychological difficulties during pregnancy. In practice, these findings suggest: i/ promoting and strengthening the identification and early screening of perinatal psychological difficulties (depressive symptoms, anxiety, suicidal thoughts), particularly among women at higher risk of developing symptoms of postpartum depression or anxiety, ii/ for women who report experiencing psychological difficulties during their pregnancy, to consider prenatal mental health care as equally important as care for somatic conditions such as gestational diabetes or high blood pressure iii/ strengthen the use of certain support measures for pregnant women that our research indicates improve access to prenatal mental health care for women experiencing psychological distress during pregnancy.