Pregnancy and mental health

Pregnancy is the period from conception to birth where a fetus is formed inside a woman’s uterus and transforms into an infant. It is generally detected after a missed menstrual cycle. A pregnancy is often planned but at times is unplanned and the expecting woman chooses to continue with it. The complete period of carrying the baby is called gestational period which is of a duration of about 40 weeks or a little over 9 months. It is generally divided into three segments called trimesters, the first trimester lasting between week 1 to week 12 of pregnancy, the second trimester between week 13 to week 28 and the final trimester between week 29 to week 40.

It is extremely common for expecting women to undergo a plethora of emotions but the regulation of these emotions is of utmost importance. Maternal mental health and its influence on infant development begin right from the time of conception.

The perinatal period dually consisting of prenatal/antenatal (prior birth) and postnatal (post birth) phases of life is crucial, both for the mother and her baby. Antenatal mental health problems especially can be an antecedent for underlying mental health problems in not only the mother but also the baby.

Although pregnancy is often considered as a time of emotional well-being, studies of the recent past has found out that up to 20% of women suffer from mood or anxiety disorders during their pregnancy (according to NCBI). Particularly vulnerable are those mothers with histories of psychiatric illness who unfortunately choose to (or have to) discontinue medications during pregnancy often leading to withdrawal symptoms. Such cases become particularly risky as the prescribed medication might cause immense fetal damage while on the other hand discontinuing it would be of significant threat to the mother. Also, when left ignored or untreated certain disorders such as ADHD, major depression and schizophrenia can be passed on to the child.

Furthermore, healthy expecting women who take little to no precautions during the gestational period, bring danger to them as well as their child’s life. Exposure of teratogens such as alcohol, smoking, drugs and certain under the counter drugs may have serious and lifelong impact on the mother as they cause neonatal withdrawal, while it may leave the infant with abnormalities such as mental retardation, cleft palate and several Central Nervous System disorders. Unfortunately, the intakes of drugs medically prescribed for the betterment of the mother and to avoid transmission of abnormalities to the fetus might also be absorbed by the placenta and negatively affect the fetus. Such drugs being anticonvulsants (to control epilepsy), anticoagulants (to treat blood clots), ibuprofen, etc. can lead to prolonged delivery and heart defects in the baby.

Feeling stressed is normal during pregnancy but stress related hormones can affect a woman’s immune system and cause premature birth. This often leads to depression which can occur before, during or after the pregnancy and around 1 in 7 women are treated for the same, sometime between the year before the pregnancy and the year after the pregnancy (March of Dimes, 2015). Women who were previously subjected to depression are more likely to experience it again during pregnancy. Prenatal/antepartum depression (depression during pregnancy) often occurs due to overt physical changes as well as hormonal changes which are often regarded as normal but also need medical supervision. Childbirth can trigger a variety of emotions ranging from happiness to stress and at times, even depression which eventually fades. But at times, first time expecting mothers experience a severe and prolonged type of depression called postpartum depression. This is generally overcome in due course of time and medical assistance but otherwise, post partum depression is succeeded by an extreme mood disorder called postpartum psychosis (which is usually rare.)

Although postpartum depression is linked with women, new fathers sometimes also suffer from depression after the birth of their young one. Even though they are overwhelmed with joy and excitement, they begin to feel their responsibilities increase.  Post partum depression in fathers, also referred to as paternal post partum depression is often seen in young fathers, men with a history with depression and those men with financial insecurity and instability struggling to provide for their family. Paternal post partum depression is seen to have a similar impact on the mental health of the father and the child’s development as maternal post partum depression has.

Planning a baby is always exciting but also demanding. Confusion is normal, but those who choose to continue with an unplanned pregnancy go through immense stress and mixed emotions than those with planned pregnancies. However, in both cases, it is equally important to look after the mental health and take required precautions for the well being of the mother as well as the child. Pregnancy is always associated with physiological and psychological changes. Preoccupation and obsession with these changes often result in potent danger to the mother as well as her baby.

To avoid any negative effect or impact on the new parents, would be parents now a days choose to attend prenatal work shops or pregnancy classes (taken around month 6 or 7 or anytime before labor.) Also called antenatal classes, they help educate parents about prenatal care, health care, medications, prenatal assessment, stages of labor and birthing techniques. At present, apart from vaginal birth and caesarean section, several parents have been opting for another type of prepared birth called the Lamaze Method (developed by French obstetrician- Ferdinand Lamaze) in which training, education and instructions are detailed and intense. It especially involves a special breathing technique to control pushing in the final stages of labor. However, constant emotional and psychological support needs to be exchanged between the partners and by close relatives of the expecting parents. The complete consent of the mother needs to be involved in the continuation of the pregnancy in order to develop a healthy pregnancy without detrimental or damaging psychological conditions to the mother and the child.