Mental health in pregnancy
It is normal to feel a range of emotions when you are pregnant. Pregnancy, birth and the postnatal period are all significant changes for you, your partner and your family. This can cause many emotions, thoughts, and feelings which may impact your mental health and how you manage day-to-day.
Around 20 to 30% of women and birthing people have problems with their mental health during the perinatal period. Perinatal means the time you are pregnant and up to 12 months after giving birth.
Anxiety is the most common condition, but there are many other conditions that can affect your sleep, appetite, bonding with your baby, or your ability to function as you normally do.
Symptoms of a mental health problem
Symptoms can include:
- constant worry that does not go away
- low mood that is persistent, affecting you more days than not, or making you feel like you are not yourself
- tearfulness
- irritability
- feelings of being disconnected from your unborn or newborn baby
- not wanting to do things you normally enjoy
- difficulty sleeping
- loss of appetite.
Occasionally some women can experience more severe and frightening symptoms of mental illness. This can include thoughts of self-harm or thoughts of suicide. If this happens to you, get urgent support and make sure you speak to a family member or friend you trust.
The NHS website has details of urgent mental health support near you.
Getting extra support for your mental health
If you feel that you may need support with your mental health, speak to your midwife as soon as possible. Lots of options will be available to you. Your midwife will talk these through with you and help you decide what feels right.
You can also speak to your GP or Health Visitor.
Options include:
- a local talking therapy service. Your midwife can refer you, or you can refer yourself
- more appointments with your midwife
- medication is sometimes offered and can be helpful
- a referral to the perinatal mental health team
- peer support
- signposting to support services and useful resources.
Some women feel worried about talking to a healthcare professional if they notice changes in their mental health, as they can be worried that a social care referral will be made. Most women with a mental health condition do not need support from social care. However, if the midwife feels that social care may be able to offer some support to you, this will always be discussed with you first.
Specialist Perinatal Mental Health Midwife
If you need more support with your mental health, one of the options is an appointment with the Perinatal Mental Health Midwife. Depending on the support you need, you might have one appointment, or a series of appointments with the wider perinatal mental health team.
They can:
- give more advice about your mental health
- make a care plan for your mental health during pregnancy.
If you have a pre-existing mental health condition
If you had a mental health condition before pregnancy, tell the midwife at your booking (first) appointment. This is important, as it makes sure we put the right support in place for you during your pregnancy.
If you have a mild or moderate condition, like mild to moderate anxiety or depression, we will offer you a referral to:
- a GP
- talking therapy
- or a mental health charity or third sector organisation.
If you have a severe condition, such as bipolar disorder, schizophrenia, or severe depression, we will offer you a referral to:
- the perinatal mental health team
- or a similar secondary mental health service that is suitable for you.
We will offer to refer you even if you are currently well and not taking medication for your condition. This is because there is a higher chance of becoming unwell during and after pregnancy.
If you take medication for a mental health condition, do not stop when you become pregnant without speaking to a healthcare professional first. They will discuss the risks and benefits of your medication with you, to decide whether to stop or continue it during pregnancy.
After the birth
Postpartum psychosis
Postpartum psychosis is a very severe but rare and treatable mental health condition. It affects around 1 in 1,000 women in the perinatal period.
Some conditions can increase the chance of postpartum psychosis. However in some cases it can happen to women who have never had a mental health condition before.
Support services
Home-Start – charity offering friendship and support to families with babies and children under the age of 5:
Parent Action – have a number of peer support groups, including free antenatal classes and groups for mums to go with their babies and children
Mindful Mums – helps pregnant women and new parents in southeast London look after their mental and emotional wellbeing during pregnancy and their baby’s first year. Part of Mind, the mental health charity.
Support for Dads
The DadPad – support guide for new dads
Best beginnings app – section on support for dads
PANDAS – Specific groups for dads
Dad Matters – online workshops for new dads
Campaign against living miserably (CALM) – free and confidential help for anyone who is struggling or in crisis. Have a webchat service from 5pm to midnight
Resources
PANDAS – antenatal and postnatal depression advice and support charity
The Survivors Trust – supports survivors of sexual trauma and have resources about planning a pregnancy, pregnancy, and preparing for birth and parenthood
BUMPS – Best use of medicine in pregnancy
Healing Experience of Loss and Trauma Service (Helix) – includes psychoeducational resources for people affected by loss or trauma in pregnancy