Prenatal mental health can significantly affect the unborn child and its future development. According to research, women experiencing depression or anxiety before or during pregnancy may be at greater risk of having a baby with cognitive, social, and behavioural problems later in life. It highlights the importance of perinatal mental health support for both parents during and after pregnancy (von Hinke, et al., 2022).
Postpartum Mood and Anxiety Disorder (PMAD) is one of the most common types of mental health disorders in pregnancy in the United States. These disorders include postpartum depression (PPD), a type of major depressive disorder, and postpartum anxiety disorder (PPA). These mood disorders can occur anytime during pregnancy or after delivery.
How prevalent is anxiety or depression among pregnant women?
According to Postpartum Support International, about 15% to 23% of women worldwide experience anxiety during pregnancy, while 15% deal with anxiety after childbirth. Depression through pregnancy is estimated to affect 10% of women, and 15% face postpartum depression. The burden is greater for women who are experiencing poverty or are teen parents.
How do you recognize PPD and PPA?
- persistent feelings of anxiety
- irritability and anger
- changes in sleep patterns
- crying spells
- feeling guilty and worthless
- feeling sad, down or depressed almost every day
- hopeless or feel like a failure
- loss of interest in doing things that they used to enjoy
- trouble falling asleep or sleeping too much
- little energy, feeling tired all the time
Perinatal emotional well-being is crucial as it has many impacts on an expecting birthing person’s physical health, besides psychological and interpersonal stresses she could experience throughout her pregnancy journey. Research has shown that when pregnant persons are given proper prenatal psychological support through counselling therapy, there are fewer instances of depression in mothers who receive treatment versus those who do not.
Who are in the high-risk groups?
There are several risk factors that can put a woman at an increased risk of developing Perinatal Mood and Anxiety Disorders (PMAD). Some factors include:
- previous diagnosis of anxiety or depression
- history of trauma or abuse
- having a stressful life event, for example, a breakdown of the relationship, marital conflicts, recent death, job loss
- previous miscarriage or stillbirth
- the unexpected birth outcome, having a child with special needs
- single parent
- social isolation, new immigrants, lack of social support
💡 When a parent has PMAD, it will also impact the baby’s growth both physically and psychologically. Physically, babies born to mothers with perinatal mental health disorders are more likely to have low birth weight, be born prematurely, or have negative developmental outcomes. Psychologically, these babies will also have a higher risk of developing psychopathology themselves later in life.
The early years of life are suggested to be a key developmental phase in intergenerational psychopathology transmission. Available evidence supports the idea that early exposure to parental psychopathology, during pregnancy and the first postpartum year, may be related to a child’s psychological functioning beyond the postpartum period, up to adulthood years (Aktar et al., 2019)
What can be done?
Aktar et al. (2019) continued that early intervention is the key to breaking the chain of intergenerational transmission of psychopathology to the offspring. Interventions include prenatal psychological support using various types of therapies – group or individual counselling with a trained therapist or Registered Nurse Psychotherapist. In addition, parenting classes provide educational tools to help expectant parents prepare for parenthood, and psychosocial interventions help specifically around maternal mental health. These strategies put into place by health care professionals aim to create an environment conducive to optimal prenatal experiences, which will ultimately benefit parents’ emotional state during pregnancy, and improve infant health outcomes afterward.
Prenatal services that address parental mental well-being have been found to minimize developmental deficits, e.g., preterm birth, low birth weight, and poor motor skills, in infants who did not get adequate nurturing in-utero. Accessing professional resources can reduce adverse childbirth outcomes linked closely with psychological issues surrounding conceiving & birthing among all partners involved in the process. Furthermore, providing support such as nutritional education, promoting healthy lifestyles, facilitating access to medical care if necessary, and much more should become priority objectives amongst healthcare providers offering expert advice to soon-to-be parents. Hence, no gaps are left open when it comes to supporting parents throughout the entire pregnancy till the moment they greet their new bundle of joy into the world!
In conclusion, perinatal psychological support is an invaluable resource for parents, helping them better understand their mental health during the prenatal period and beyond. Counselling can provide insights to parents into better managing their emotional well-being and their babies. With the right prenatal psychological support, parents can feel more secure and empowered throughout the process of childbirth, setting them up for successful parenting in the future.
- Aktar, E., Qu, J., Lawrence, P., Tollenaar, M., Elzinga, B., & Bögels, S. (2019). Fetal and Infant Outcomes in the Offspring of Parents With Perinatal Mental Disorders: Earliest Influences. Frontiers In Psychiatry, 10. doi: 10.3389/fpsyt.2019.00391
- Hoffman, C., Dunn, D., & Njoroge, W. (2017). Impact of Postpartum Illness Upon Infant Development. Current Psychiatry Rep, Nov 6;19(12):100. doiL 10.1007/s11920-017-0857-8
- von Hinke, S., Rice, N., & Tominey, E. (2022). Mental health around pregnancy and child development from early childhood to adolescence. Labour Economics, 78, 102245. doi: 10.1016/j.labeco.2022.102245
About the Author
Amy Li is a CAPPA Certified Childbirth Educator, New Parent Educator, Postpartum Doula, HUG Your Baby teacher, and a Registered Nurse. She completed her RN training in London, England, and received her nursing degree and Cognitive Behaviour Therapy Advanced Certificate in Toronto. In the past 18 years, Amy devoted her career in supporting high-risk families through their prenatal, postpartum, and parenting journeys, and providing counselling to women with postpartum depression. As a life-long learner, Amy has explored different modalities in teaching childbirth classes to suit a diverse community, including the Lamaze method and as a prenatal educator at a teaching hospital, and she is thrilled to share her experience with others.
As a Faculty of Childbirth Educators, Amy aspires to promote and strengthen the well-being of our future generation. She sees that children are our future, and pregnancy gives us a golden opportunity to foster a secure attachment between caregivers and babies. Amy is adamant that all families should be equipped with evidence-based knowledge and have the right to make the best informed-decisions for themselves. Childbirth educators play a critical role in laying a solid foundation for positive maternal and infant health trajectories.
Her mission is to pass on her wealth of knowledge and expertise to her students so that they will continue this valuable mission to empower families throughout their gratifying birth and parenting journeys. She is committed to giving children the best beginning for a great start in life and ultimately making a positive impact on our next generation that benefits all.