Self-care and mental health
Depression—feeling sad, empty, or “down”—and anxiety—feeling nervous, worried, and/or scared—are serious medical conditions that involve the brain and may occur during pregnancy or after birth. Depression and anxiety may get in the way of doing everyday activities, like taking care of yourself and your baby. They are treatable, which is why it’s important to get help.
People with depression or anxiety around pregnancy feel:
- Extremely sad or angry without warning
- Foggy or have trouble completing tasks
- “Robotic,” like you are just going through the motions
- Very anxious around the baby and your other children
- Guilty and like you are failing at motherhood
- Unusually irritable or angry
- Little interest in things you used to enjoy
- Scary, upsetting thoughts that don’t go away
Depression and anxiety during pregnancy or after birth can happen to anyone. However, several factors make some people more likely than others to experience one or both of these conditions. These risk factors include:
- A history of depression or anxiety, either during pregnancy or at other times Family history of depression or anxiety
- A difficult pregnancy or birth experience
- Giving birth to twins or other multiples
- Experiencing problems in your relationship with your partner
- Experiencing financial problems
- Receiving little or no support from family or friends to help you care for your baby Unplanned pregnancy
Yes—these medical conditions can affect your baby, but not directly. Early bonding is important for your baby’s development and becoming close to your baby is a big part of that bonding. When you have depression or anxiety during pregnancy or after birth, it can be hard to become close to your baby. You may not be able to respond to what your baby needs.
And, if there are older children in the house, they may be missing your support as well.
Yes, there are treatments, and they can help you feel better. Treatment can reduce your symptoms or make them go away completely. Many treatment options are available for depression or anxiety during pregnancy or after birth. There is no single treatment that works for everyone. Your provider may ask you a set of questions, called a screening, to learn more about what you are feeling. Together, you can find the treatment that is right for you.
- Connect with others. Look for a group in your community or online. These groups may give you the chance to learn from others who are going through or have gone through the same thing and to share your own feelings.
- Make time for yourself. Do something for you, like getting out of the house, or taking a hot bath without interruption. If you can, have your partner, a family member, or babysitter watch the baby regularly and go visit a friend or run an errand.
- Do something you enjoy. Whether it is listening to music, reading a book, or watching a favorite movie, take a bit of time each day to do something you enjoy.
- Be realistic. You don’t have to do everything. You don’t have to have the “perfect” home. Just do what you can and leave the rest.
- Ask for help. Don’t be afraid to ask for help from family and friends, whether it’s caring for the baby or doing household chores.
- Rest when the baby rests. Sleep is just as important for you as it is for the baby. Sleep when the baby sleeps, during naps and at night.
- Be with others. Seek out other adults, like family and friends, who can provide comfort and company. Regularly create a special time for you and your partner or for you and a friend to be together.
Pregnancy loss
If you are pregnant and you lose the baby before 20 weeks, it is called a miscarriage. Most miscarriages happen before 12 weeks. This is the end of the first trimester. Many happen before you even know you are pregnant. In the past, a woman who miscarried many times might never know why it happened. Today, more and more women are finding out the causes of their recurrent (repeated) pregnancy loss.
Repeated pregnancy loss is when you have 3 or more miscarriages in a row. This usually happens in the first trimester or early second trimester. Miscarriages are common. You have a 15% to 20% chance of your pregnancy ending in miscarriage.
If you have lost 1 pregnancy, don’t worry. Your chances of carrying the next pregnancy to full term stay about the same as if you had never had a pregnancy loss. The chance of having a pregnancy loss again after 2 pregnancy losses grows with each loss. The risk for repeated pregnancy loss goes up with age. If you are age 40 or older with previous repeated pregnancy loss, you have a much higher risk compared with younger women.
There are many different reasons for pregnancy loss. Ask your healthcare provider about these possible reasons:
- Genetic problems. Problems with the genes or chromosomes of the baby are the most common reason for a first pregnancy loss. This often happens all of a sudden, by chance, in the embryo. This is usually less often the cause for women with repeated pregnancy loss.
- Problems with the uterus. Problems with the uterus can cause both first and second trimester pregnancy losses. Problems you are born with (congenital) include double uterus or uterine septum. Other problems are uterine polyps, fibroids, and scar tissue inside the uterine cavity.
- Cervical insufficiency. This is sometimes called incompetent cervix. If you have cervical insufficiency, you will lose the pregnancy around 20 weeks. This problem can be treated with a stitch to help hold the cervix closed or progesterone supplementation.
- Being exposed to certain chemicals. If you or your partner is exposed to certain chemicals, it could cause pregnancy loss. Some chemicals that may be linked to it include: anesthetic gases (nitrous oxide), pesticides, formaldehyde, benzene, ethylene oxide, arsenic, lead, mercury, and cadmium. You and your partner should talk with your healthcare provider about any chemicals in the workplace.
- Endocrine problems. Some endocrine problems have been linked to pregnancy loss. These include diabetes (that is not controlled), severe thyroid problems, or luteal phase defect.
- Smoking, drinking, and drug use. Smoking, drinking, and illegal drug use can cause repeated pregnancy loss. You should not smoke. You should also avoid alcohol and drugs during pregnancy.
- Immune problem. An immune problem called antiphospholipid syndrome causes repeated pregnancy loss in some women. This problem can be treated with low-dose aspirin and heparin.
Testing and treatment usually isn’t done until after the third miscarriage in a row. However, it can be done after a second miscarriage if you are age 35 or older. A lot of the testing and treatment is controversial. Also, the reasons that treatments work are not well understood.
Getting pregnant again
It is likely that you will go on to have a healthy baby even if you’ve suffered repeated pregnancy loss. Informative and caring counseling also seem to play a big role.
These things can raise your chance of having a healthy and successful pregnancy:
- Having a healthy lifestyle
- Taking a folic acid supplement
- Quitting smoking
- Controlling your weight
- Drinking little or no alcohol
- Reducing the amount of caffeine in your diet
Source: Pregnancy loss
Early treatment is important for you, your baby and the rest of your family.
The sooner you start, the more quickly you will start to feel better. If you need help finding a behavioral health provider near you, go to MagellanAssist.com and use the provider search tool or call 1-800-424-1764.
