Mental Health and Pregnancy by Dr. Philippa Kaye

Maternal mental health. Perhaps a topic which is spoken about more than previously, but definitely a topic which is still surrounded in stigma and taboo. Yet we all have mental health, sometimes good, sometimes less so and this remains true during pregnancy and beyond. Sobering as the statistic is, it is important to note that suicide is a leading cause of maternal deaths, this is how serious an issue maternal mental health can be.

What is maternal mental health?

It is often thought that maternal mental health means postnatal depression. While postnatal depression (PND) is a maternal mental health issue, it can also start perinatally, during pregnancy. Other maternal mental health issues include perinatal anxiety and perinatal obsessive compulsive disorder (OCD). It is also possible to have postnatal post traumatic stress disorder (PTSD) and more rarely postpartum psychosis.

Postnatal depression

Symptoms of depression can include low mood, tearfulness, difficulties sleeping and appetite changes as well as social withdrawal and lack of pleasure in activities and difficulties bonding with your baby. Thoughts about hurting your baby can also occur and can be intrusive and frightening.

'Baby blues'

Postnatal depression is different from the ‘baby blues’. The baby blues are common and tend to occur at approximately day 3-10 after giving birth. You may feel tearful and overwhelmed, though this generally passes. Postnatal depression tends to start within about 6 weeks of giving birth and is both deeper and longer lasting.

The realities of maternal mental health

A study carried out by the Royal College of Obstetricians and Gynaecologists reported that 2 in 5 women were concerned that if they spoke about their mental health this would be documented in their medical records. But sharing information about your mental health during pregnancy means that you will get the help that you need and will not be judged for it. Documenting your needs in your notes is not to cause harm, but to help you, and your medical notes are always confidential. Around 1 in 3 women were concerned about the stigma around mental health in pregnancy and were not aware that there are treatments for mental health conditions. Just over a quarter of people thought that it was normal to experience mental health issues during pregnancy and beyond. While mental health is a spectrum and it is normal to feel anxious or low at some points during or after your pregnancy, if you are having these thoughts and feeling consistently or severely it is important to ask for help.

Help and support

It is thought that about 1 in 5 women will have some form of maternal mental health issue so it is hugely important to raise awareness of these issues so that people can come forward for the help that they need, without stigma or shame. If you are concerned about your own mental health or that of someone close to you, please see your GP or encourage them to see their doctor.

Support and information is also available from the Samaritans helpline 116 123 (24 hours a day, 7 days a week), Mind – helpline 0300 123 3393 (Monday to Friday 9am-6pm). NHS Choices can also give advice by calling 111 and if you feel your life is in danger then attend A+E.