I often hear patients tell me that they want to stop taking medications during pregnancy. Or, they may want to put off starting a medication when they are pregnant. This is because they worry about how it could impact the baby. These are valid concerns. However, I think the importance of a mother’s mental health is often overlooked.
Instructions are overwhelming for new mothers. For example, we are told what to eat, what not to eat, how to think, how to sleep, what music to listen to, how to work, how to work out, and more. On top of that, we are expected to be an embodiment of maternal instinct and expertise. How is all of this pressure possible without causing stress for a mom? In short, it’s not. Over 80% of women experience some form of anxiety or depressive symptoms during the antepartum and postpartum period.
Untreated Mental Health is a Risk
Mothers were viewed simply as a vessel for carrying a baby for too long. As a result, prescribers had to determine medications based on “pregnancy risk categories”. This is no longer the case, as we are becoming more aware of the negative impacts of undertreating mental illness, or not treating at all. The number one most common complication at birth is not congenital defects, infections, or medication withdrawal. Untreated mental health needs are.
This is why we hear terms like “risks versus benefits”. But what does that mean exactly? For example, if a mother’s anxiety goes untreated throughout her entire pregnancy, she is likely releasing high amounts of cortisol. Also known as the stress hormone. In turn, this affects her baby. Potential complications include prematurity and low birth weight. This would be an example of how the risk of not treating severe anxiety would be higher than the benefit of not utilizing medications while pregnant.
What to Watch For
So, how do you know when something is wrong? Symptoms to be looking for during or after pregnancy include:
- Lack of interest in baby
- Anger and irritability
- Feelings of guilt, hopelessness, helplessness
- Sleep disturbances
- Loss of appetite
- Increased sadness
- Thoughts of self-harm or harming baby
- Loss of interest in things you used to enjoy
Additionally, there are some risk factors that might be a good indicator of possible symptoms. These risk factors include:
- Personal history or family history of depression, anxiety, or postpartum depression
- External stressors, financial, marital, social, occupational
- Physical health conditions such as thyroid disorder and diabetes
- Lack of support
- Complications at birth such as requiring a NICU stay
If you are concerned you may be suffering from antepartum or postpartum anxiety or depression, inform your obstetrician immediately. They may want to evaluate medical concerns that may contribute to low mood such as iron and thyroid issues. During this time, it is also highly recommended to establish care with a therapist. In therapy you can begin discussing symptoms, concerns, and goals of treatment. If you end up deciding that you are comfortable with medication management, or you have further questions, set up an appointment. We can provide an evaluation to go over any other concerns you may have. Medication Management is provided by mental health nurse practitioners who have specialized training in psychiatric medications.
Friendly reminder that what’s best for YOUR mental health is what’s best for YOUR BABY’S health.