How to nurture and improve mental health during pregnancy

Pregnancy affects heads as well as bodies. Sally J Hall looks into the advice available.

4 min read

How to nurture and improve mental health during pregnancy

Pregnancy affects heads as well as bodies. Sally J Hall looks into the advice available.

4 min read

It’s supposed to be a rose-tinted time of anticipation but for many pregnant women, anxiety and depression can take over. Guilty for having these feelings, they often fail to seek help.

Maternal mental health - Why aren’t I happy?

Pregnancy triggers a surge of progesterone, which can increase feelings of stress. Add to this other stresses you are under (changing relationships, juggling work, worries about birth, feeling out of control) and it’s no surprise many women struggle with maternal mental health.

It took 10 months to get pregnant. I was very disappointed. I expected all the things that you see in magazines. I wasn’t glowing, my skin was bad, I felt uncomfortable with my body, and my mood was so low that I realised eventually that I was very depressed. I felt guilty that I was supposed to be happy, but I was wondering whether it was worth it.
Suzy, mum of two



Mental health and pregnancy - what to look out for

While many of us are aware of postnatal depression, you may not know that antenatal depression, OCD (obsessive compulsive disorder) and pregnancy anxiety affect as many as one in five women.

The NCT says that signs of pregnancy depression or anxiety can happen at any point. Look out for:

  • Worrying about giving birth and being a mum

  • Having little energy, not sleeping well

  • Having little interest either yourself, your pregnancy, or both

  • Feeling detached, or being emotional, sad or angry

  • Having crippling anxiety

  • Not interested in sex

  • Not able to concentrate

  • A sense of hopelessness about the future

The mental health charity MIND offers help and support. They suggest you try:

  • Talking therapy, including cognitive behavioural therapy (CBT) and interpersonal therapy

  • Medication, likely to be a pregnancy-safe antidepressant

  • A combination of the two

In very severe cases, your doctor may recommend electroconvulsive therapy (ECT), which may be offered shortly after birth. If you, or those around you, are worried that you’re having mental health problems, speak to your doctor as soon as possible. They are best placed to help you access support that is available.

Consultant in maternal medicine and obstetrics, Roshni Patel, works at the Chelsea & Westminster Hospital in London. She says: “Initially, we need to listen to a woman’s worries and find out what’s going on in her head. For example, a woman may begin by saying that labour scares her, but when you dig a little you find a specific worry, such as tearing or induction. We need to identify each fear and go through them. My job is to be reassuring and totally honest, to listen to women and engage with them.”

“Some women need more care, and we refer them. For some, CBT and counselling are helpful, some respond well to psychotherapy and some need medication. We explain risks and benefits so that women can make their own, informed choices and medication ensures breastfeeding is possible.”

“Some women have endured trauma in a previous pregnancy or labour and while we can’t change that, we can examine what happened before, and offer them tools to move forward.”


Self-help techniques for mental health

Julianne Boutaleb Consultant Perinatal Psychologist and Director of Parenthood in Mind, offers these techniques:

  • It’s normal to feel overwhelmed; becoming a mother is a huge shift in emotions, relationships and identity

  • Many of us are not used to feeling so vulnerable and dependent. Allow yourself to feel your feelings

  • Speak to someone who gets it; a trusted friend or therapist specialising in perinatal issues

  • Use distraction; getting engrossed in an activity such as sewing, gardening or decorating helps mitigate overwhelming emotions

  • Use positive affirmations, such as “I am doing all I can to look after myself and my baby”

  • Gentle physical exercise such as swimming, walking or yoga are good ways of releasing stress hormones

  • Look into grounding and breathing exercises. Headspace and The Positive Birth Movement have easily accessed online packages

  • Ask family and friends to check in with you if you’re anxious about a scan or appointment in pregnancy

  • Don’t dismiss anxieties about the birth; if you had a difficult previous birth, let your midwife know so they can discuss birth options with you

  • If your feelings are linked to previous pregnancy loss, seek help from the Miscarriage Association or Tommy’s

  • If you feel your levels of anxiety or depression are getting worse, please speak to your doctor or midwife, or contact a helpful organisation.


Where to find support for mental health during pregnancy

There’s help out there for anxiety and depression during pregnancy, from medication to support groups and talking therapies.

Action on Postpartum Psychosis (APP) - App-network.org

Anxiety UK - Anxietyuk.org.uk

Maternal OCD - Maternalocd.org

MIND - Mind.org.uk

NCT - Nct.org.uk

NHS - https://www.nhs.uk/pregnancy/keeping-well/mental-health/

OCD Action - Ocdaction.org.uk

PANDAS Foundation - Pandasfoundation.org.uk

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