The Baby Blues: Moving the Conversation Forward to Include Prenatal Depression
Meet prenatal depression, postpartum’s ugly cousin.
We’ve all likely heard of postpartum depression, or the period following the birth of a child during which mothers sometimes experience the clinical symptoms of severe depression. Celebrities Chrissy Teigen, Drew Barrymore, and Gwyneth Paltrow have shared their personal journeys with postpartum, describing their own encounters with its depressive episodes as “scary” and “painfully debilitating.”¹ Recently, increasing cases of postpartum depression have helped launch the disorder into the public arena, with the Center for Disease Control (CDC) estimating that it affects approximately 1 in 9 women- with localized prevalence rates reaching as high as 1 in 5.²
This increase in attention has enabled women to begin seeking and securing the mental health services that are so desperately needed after some of life’s most significant (and unforgettable) events, including the birth of a child. However, with the focus centered primarily on the type of depression that occurs after birth, we tend to overlook the reality that prenatal depression- depression during pregnancy- also poses a significant health risk to women.
Growing a baby is difficult work; rapid fluctuations in the levels of estrogen and progesterone can contribute to serious changes in a woman’s brain, mind, and body³. Mood swings, weight gain, and limited physical activity can all play a role in the development of prenatal depression, and women who experienced anxiety and depression prior to pregnancy are also more likely to experience it again over the course of pregnancy⁴.
Perhaps more overwhelming than the physical and emotional changes, however, is society’s persistent underlying belief that mothers-to-be should be radiant with joy over the arrival of their child, focusing on nothing other than maintaining and enjoying a healthy pregnancy.
This is a tragically naive view of motherhood that reflects the more simpler times of years gone by; today, mothers work outside of the home- sometimes up until their very due date- and care for their families, all in the course of a day. Financial struggles remain a plague on those who do not receive paid maternity leave from their jobs, while growing costs associated with living and healthcare threaten the average American’s ability to save money. These everyday realities all loom in the background, posing serious and frequently hidden stressors to the mother-to-be.⁵
Pair these common worries with the nausea and fatigue that often accompany the early to mid-stages of pregnancy, and prenatal depression almost seems like a certainty.
I was fortunate during my own pregnancy to work with practitioners who were well-versed on the threat of prenatal depression. After reviewing my medical chart during my first trimester, a midwife asked me if I was experiencing any symptoms of the anxiety and depression that often plagued me during the other, more hormonal times of the month. I was taken aback by her observation, as the possibility of experiencing these issues again during pregnancy had failed to cross my mind. Wasn’t childbearing supposed to be fun and attractive? (Think: Katherine Heigl’s character in “Knocked Up”.) Certainly, I was expecting some tears, but nothing akin to the week-long mood swings I experienced on a monthly basis prior to getting pregnant! Never could I have imagined that- after my initial joy had passed- I would recall the time that I had almost drowned as a child, and relate it to my adult journey towards becoming a mother for the first time.
As I progressed through my first and into my second trimester, I realized just how fortunate I was to be able to have a professional to talk to about these problems. The symptoms of depression came and went- never sticking around long enough to pose an actual problem- but the threat of them was constantly there; in fact, the third trimester proved to the worst among them all, with crying episodes happening at least once or twice a week and an overall loss in motivation occurring daily. My practitioner advised me that services were available to address these issues, and together we devised a plan to identify the most common of my depressive symptoms for my “support team” in case those closest to me began to see something troubling that I could no longer observe in myself. Knowing that it was acceptable to acknowledge pregnancy can be difficult and that sometimes, it is alternatively terrifying and overwhelming was incredibly helpful in those moments when the tears just wouldn’t stop coming.
Unfortunately, my experience is not every mother-to-be’s experience. Other women I’ve spoken to about prenatal depression have shared that such a possibility was never discussed and- in the event that they attempted to relay their concerns to medical professionals- were simply told to “enjoy” their pregnancy experience rather than decry it. These anecdotes of mothers who have been failed by the system simply prove the need to continue moving the conversation forward to include prenatal depression in all its horrifying glory, including its symptoms and risk factors. Doing so will almost certainly benefit mothers and their children everywhere, and perhaps remove at least one cause of worry and concern from their list of many.
: Haley Overland & Jessica Spera. (2019). 16 celebrities who struggled with postpartum depression. https://www.todaysparent.com/blogs/trending/
: Center for Disease Control (CDC). (2019). Depression among women. https://www.cdc.gov/reproductivehealth/depression/index.htm
: Healthline. (2017). What bodily changes can you expect during pregnancy? https://www.healthline.com/health/pregnancy/bodily-changes-during
: Juli Fraga. (2016). Prenatal depression may be the most severe form of maternal depression. https://www.washingtonpost.com/news/to-your-health/wp/2016/08/29/prenatal-depression-may-be-the-most-severe-form-of-maternal-depression/