Recently obstetricians have become much more aware of the importance of mental health during pregnancy and after a baby comes into the world. Anxiety and depression affect at least one in five of the general population, however pregnancy is a time of particular physical and psychological stress for women. Apart from the physical and mental changes in their bodies, hormones are responsible for a number of other changes that can affect a pregnant woman’s moods and behaviour.
Sleep disturbance is a major factor in interfering with mental wellbeing and general happiness. During pregnancy, this can begin even before the baby is delivered, because simple things such as back pain can cause sleep deprivation. Getting up at night to empty your bladder or take painkillers are just two factors that can interfere with a good night’s sleep. Once your baby is delivered and during the first six weeks, sleep is also generally interrupted – and usually quite often!
There are a number of features that can trigger us as obstetricians and advocates for women’s health to be particularly vigilant about women at risk of postnatal depression and other mood disorders. If you have pre-existing anxiety or a depressive disorder, you may be at more risk of this recurring during pregnancy. And if there is a family history of these types of disorders, you may be more at risk as well.
On the positive side, there is that a lot can be done to minimise these issues. There are a number of tools that we as professionals can use to identify women at risk. One of these is the Edinburgh Postnatal Depression Scale (EPDS), and there is also an assessment sheet produced by mental health organisation, Beyond Blue.
We ask all of our pregnant patients to fill out these questionnaires. They are easy to complete and the questions are quite generic, but they can alert us to patients who may be at risk of experiencing mood disorders after birth. If we do identify a patient at risk, there are also a variety of things we can do in advance to assist, including referring our patients to a psychologist or counsellor, which can be enormously beneficial.
The most important thing to remember is that the management of mood disorders during pregnancy is an area where there have been major advances. And often it’s as simple as early detection and the formulation of a plan that means the physical and mental health of our patients and their babies is our number one priority.
Hospital midwives are very skilled at supporting women during the first few days after delivery, both with the challenges of breastfeeding and the general demands of coping with a small, very dependent newborn.
We work with a number of psychiatrists with a special interest in mood disorders during pregnancy who have been very successful with treating women with mood disorders. They also work with women at risk before symptoms appear to ensure their patients have the optimum mental health during pregnancy.
It is also reassuring to know that women are wonderful at helping one another through these types of issues. That’s why it’s so important that you have a support network around you that can make coping with the demands of early motherhood so much easier!
If you are already taking medication, you need to share the details with your general practitioner and our team as well. Some medications are safer to use during pregnancy than others, so we need to discuss this well before you fall pregnant. If we recommend any medications during pregnancy, you can also be assured that it has been safely tested over many years as being safe for pregnant women.
In terms of the treatment of anxiety or depression, non-medication management can be helpful, and this is where psychologists, psychiatrists and counsellors are so valuable. Pregnancy mood disorders are extremely well managed these days and diagnosing them early is vital. It will ensure that not only your pregnancy is enjoyable, but that you enjoy the many days, weeks and years ahead with your precious child.
If you have any questions or would like to discuss this further, book an appointment with Dr Terry Sheahan today.