Mental Health And Parenting: Before And During Pregnancy

Stress at the pregnant woman
Stress at the pregnant woman

It's supposed to be one of life's blissfully happy moments – when you discover you're pregnant.

But many women find it a difficult time, struggling to come to terms with physical changes, and heightened stress and anxiety.

It can be a terrifying period and many women panic and stop taking any prescribed medication or avoid seeking help because they are petrified they will harm their baby. This is absolutely NOT the thing to do.


But the advice given to mothers-to-be can be confusing, contradictory and downright wrong.


Sarah, 39, has two children. She says: "I was put on anti-depressants before I fell pregnant with my first child. I'd been on and off them for years. The GP knew I was trying to get pregnant and he told me it was safe to take these all the way through pregnancy.

"When I became pregnant, I went and saw a different GP at the same surgery who looked horrified and said I should stop taking them straight away. I wasn't ever referred to any kind of mental health team, I was just handed over to the midwives who never spoke to me about mental health issues."

The good news is that you should be able to access help and the right kind of guidance – but you have to know what to ask for and be determined.

Janet Fyle, professional policy advisor for the Royal College of Midwives, says: "If a woman becomes pregnant and she is on any drugs for mental health issues, she needs to go and see her obstetrician or her GP.

"Some GPs are very well versed in issues around mental health and pregnancy. If her GP says she needs to go to the hospital, or if she's unhappy about what she's being told, she needs to see a midwife or obstetrician at the hospital, and she may be referred to a perinatal mental health team."

She stresses: "Women should never just stop taking their drugs if they have existing mental health issues."

Midwives are now receiving more training around mental health issues but Ms Fyle acknowledges that there are still gaps in care.

"I don't want to comment on whether GPs know what they're talking about. Many pregnant women have said that they get conflicting information and I'm not going to deny that," she says.

Even if women do know what to push for, it may be hard to find the right care. "Not every place may have a perinatal mental health team," acknowledges Ms Fyle.

So should you take antidepressants during pregnancy? Well, each case is different. There are some risks associated with taking antidepressants while pregnant, but there are also risks to yourself and the baby if you are severely depressed. An expert needs to weigh up the pros and cons based on your own particular set of circumstances. That's why you shouldn't take that decision yourself. You need to push for an expert to make the right decision for yourself and your baby.

The same rule applies for women who become depressed during their pregnancy – known as pre-natal depression. This can be particularly distressing, especially as it can be totally unexpected and hit mothers-to-be like a bolt from the blue.

Rachael Dobson, CEO of Pandas Foundation, says the charity receives many requests for help from many women in this situation. "People who come to us will be feeling anxious, they might not be feeling excited about the pregnancy," she says. "People feel confusion. They might feel they're not feeling any sort of bond with the bump.

"It can happen to anybody. It can happen to people who have had depressive episodes previously, but it can happen to people who have never experienced it before. We have people coming to us who say they have planned a pregnancy for a long time but then they don't feel the excitement they think they should, and then they feel guilty and depressed about that."

She again stresses that women must speak to their GP, midwives or obstetricians about medication.

"People can speak to their midwives about how they are feeling or their GP and treatment if needed can be put into place during pregnancy, and if anything happens after the birth as well," says Rachael.

But she says as always, resources are limited. "I think more needs to be done," she says. "The issue at the moment is there is just not the money there. The NHS do the best they can with the resources they have been given but unfortunately there just isn't enough there to treat people. With antenatal mental health there's almost the attitude 'it's only nine months, so we'll deal with it later'."

But pregnancy is the very beginning of a mother's relationship with her child; if only more effort was put into laying solid foundations during this crucial time, it might save a lot of heartache later on.

Grace suffered from depression during pregnancy; it was an unexpected pregnancy and her partner abandoned her. "Throughout my pregnancy I felt lost, abandoned, unsupported and incredibly confused," she says.

"How could my life have changed so much in so little time? How was I to be a good mother, when I didn't feel ready? Why didn't he want me?"

This led to problems after the birth too – she couldn't bond with her daughter at all at first. "I had to be prompted to pick her up; I had no desire to hold her. Then upon being discharged from hospital I couldn't even travel in the same vehicle as my daughter.

"This was not what I had envisaged happening when I had babies. I wanted that rush of love and the feeling of completeness that so many people had spoken about."

Eventually she received help – antidepressants, along with support through the local post-natal depression charity Bluebell, and she now has a great relationship with her daughter and hope for the future.

"Depression can happen to anyone and it is important to talk openly about one's feelings so that someone can help," she says. "People are not meant to do it all alone; we need each other."

Useful contacts for advice and support:

The Samaritans: 08457 90 90 90 (UK)

Bluebell: 0773 8628 842

Family Lives: 0808 800 2222

Family Links: 01865 401800

Pandas Foundation: 0843 2898 401