Maternal Mental Health | OB-GYN

OB-GYN

Maternal Mental Health

We take a team approach to caring for pregnant and postpartum women who experience depression, anxiety, and other maternal mental health conditions. Together, we’re here for you.

Medically reviewed by Brenna Rizan, M.S.W. on March 05, 2024.

Mother sitting on the ground looking lovingly at her baby sleeping.

What Are Maternal Mental Health Conditions?

Managing mental health conditions requires a team approach to care. At UC Davis Health, our OB-GYNs and psychiatry team work together to provide the treatments and support you need. U.S. News & World Report consistently ranks our OB-GYN program among the top 25 in the country.

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What Are Maternal Mental Health Conditions?

Pregnancy and new motherhood are profound life transitions that can affect you physically and emotionally. Sometimes these changes impact your mental health.

Maternal mental health conditions may occur anytime during the perinatal period, including pregnancy (prenatal) and up to a year after childbirth (postpartum). This is the most common complication to pregnancy and affects up to 1 in 5 women, regardless of race, culture, or income.

Types of maternal mental health conditions include:

  • Prenatal and postpartum depression
  • Generalized anxiety disorder
  • Obsessive-compulsive disorder (OCD)
  • Birth-related post-traumatic stress disorder (PTSD)
  • Bipolar disorder
  • Postpartum psychosis
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Symptoms of Maternal Mental Health Conditions

Symptoms vary depending on the type of maternal mental health disorder you have. We talk with you about what you are experiencing to pinpoint what’s wrong. While it may feel difficult to talk about your symptoms, we’re here to listen with compassion and support.

Common Symptoms

Maternal mental health conditions may cause: 

  • Feeling sad, down, or having little interest in things you used to enjoy.
  • Feeling angry or irritated about things that did not previously bother you.
  • Feeling excessive guilt or worry, often blaming yourself when things do not go as planned or feeling that you have let yourself or your family down.
  • Having scary thoughts of harming yourself or your baby.
  • Sleep or appetite problems that are not related to pregnancy symptoms or the baby.
  • Feeling that you are going through the motions of parenting or not bonding with your baby.
  • Difficulty concentrating or completing tasks and feeling constantly overwhelmed.

Severe Symptoms

Severe symptoms of maternal mental health conditions may include:

  • Having thoughts of harming yourself or your children.
  • Having the idea that your baby is not really yours, is out to get you, or is bad or evil.
  • Seeing or hearing things that others do not.
  • Extreme and uncharacteristic restlessness, irritability or anger.
  • Feeling you function normally on less than 4 hours of sleep.
  • Behaving in extreme, reckless, and uncharacteristic ways. This could be excessively spending when you can’t afford to, hypersexuality, or feeling invincible.
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Causes of Maternal Mental Health Conditions

There are many reasons why you may be experiencing changes to your mental health. In fact, every new mom is at risk. Half of people who experience a maternal mental health condition have no prior history of a mental health concern.

Hormonal change is the most common cause of maternal mental health conditions. Our endocrine system is made of glands that make and release hormones. Hormones are chemicals in our body that help regulate may systems including mood, metabolism, and fertility.

While hormonal changes are expected and needed in pregnancy, not everyone responds to these changes the same. You may be more sensitive to hormonal changes if you experience increased mood symptoms during menstruation or have been diagnosed with premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD).

Sometimes hormonal changes related to pregnancy can cause a chemical imbalance. When our endocrine system is not functioning properly, we can experience medical conditions such as mood disorders, infertility, thyroid dysfunction, and diabetes.

Postpartum is a sudden drop in estrogen and progesterone hormones after childbirth, which can cause depression and other mental health conditions. Many women will experience this as the baby blues.

The baby blues are not a maternal mental health condition, but a way to describe this expected hormonal shift that leaves women feeling that they’re on a rollercoaster of emotions. These feelings are not persistent. You are still able to care for yourself and your baby. You still enjoy your new role as a parent and feel a sense that this is temporary, and you will be back to yourself in no time. Symptoms like these generally go away after a few weeks.

Postpartum hormonal changes become a sign of a maternal mental health condition when a mother feels emotionally overwhelmed most of the day for at least 4 days a week. Symptoms often do not improve with the support of family and friends.

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Maternal Mental Health Conditions Risk Factors

There are some factors that can increase your risk for maternal mental health conditions, including:

History of Mental Health Conditions

If you have a pre-existing mental health issue, your symptoms may worsen during pregnancy or after childbirth. You could also develop a different disorder entirely. Also, how you feel in one stage of pregnancy may change in another stage. A family history of mental health disorders can also increase your risk.

Difficult Pregnancy or Childbirth

A high-risk pregnancy or complicated childbirth may lead to anxiety, depression and PTSD. This risk may increase if you or your baby has health problems requiring extended hospitalization (NICU) or extensive care coordination.

Lack of Support

The months before and after your baby’s arrival can be a vulnerable period. Lack of support from your family and friends may cause isolation, worsen sleep deprivation, and increase the challenges of balancing the demands of everyday life. This can lead to depression or other problems. Relationship instability, financial difficulties, housing insecurity, food insecurity, employment challenges, and other social drivers of health can also worsen your mental health.

High Stress Parenting

Certain high-stress parenting situations can increase your risk for maternal mental health conditions. These include being under the age of 20 when becoming pregnant, birthing multiple babies, being a single parent or being in an active military family.

Big Life Changes

Life changes can cause stress. Increased stress in pregnancy and postpartum is known to increase your risk for maternal mental health conditions. If you can avoid big life changes, it is recommended that you do so. This includes moving or changing jobs.

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Diagnosing Maternal Mental Health Conditions

Our OB-GYNs routinely screen for signs of maternal mental health disorders during pregnancy and after childbirth. They may make an initial diagnosis based on your verbal or written answers to screening tests.  You can be referred to a UC Davis Health psychiatrist or connected with a behavioral health provider to complete a more thorough assessment and develop a care plan.

You never need a referral to engage in behavioral health services through your insurance company or health plan. Patients are always welcome to contact their insurance company or health plan directly to establish care.

Maternal Mental Health Disorder Treatments

Treatments for maternal mental health disorders depend on your condition. Many women benefit from a combination of therapies.

You may receive joint care from your OB-GYN, psychiatrist, therapist or other mental health professional. These experts work together to protect the health of you and your baby during and after pregnancy.

Support Groups

Support groups can be peer led or clinician led. Peer support groups help people to know that they’re not alone in their experience. They can help provide empathy, guidance, and hope, and many are free. Clinician-led support groups often follow the same group of people over a period of time. They typically follow specific topic areas designed to improve mental health through guided sharing and support.

Counseling

Psychotherapy, or talk therapy, can help change your thought processes and provide you with coping strategies. Not all therapists are trained in maternal mental health conditions. In California, all health plans and insurers are required to have specific supports for maternal mental health. Ask you health plan or insurer what their program consists of and how to connect to care.

Medications

Antidepressants, anti-anxiety drugs and other medications can ease symptoms. We also offer the first FDA-approved IV medication for postpartum depression. Research shows that in most cases, the risk associated with taking a medication to improve your mental health carries the same risk as continuing to experience symptoms of a maternal mental health condition. In addition, not properly treating your symptoms can severely impact your functioning and negatively affect other areas of your life. Your care team makes sure the medications are safe to take while you are pregnant or breastfeeding.

Hospitalization

Severe symptoms of a maternal mental health condition often cannot be treated in an outpatient setting. This is because the symptoms can pose a significant risk to the life of the mother and their family. If you or a loved one is experiencing severe symptoms please contact 9-8-8 or go to the nearest emergency room for evaluation.

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Preventing Maternal Mental Health Conditions

Because all pregnant or postpartum women are at risk of developing a maternal mental health condition, there is no known way to prevent the conditions. However, there are several ways that you can reduce your risk of a maternal mental health condition. Here are some ways to reduce your risk:

  • Educate yourself about the warning signs of maternal mental health conditions.
  • Participate in maternal mental health screening.
  • Build a village of support. This includes asking for and accepting help with childcare, house cleaning, meals, and other tasks.
  • If you have a diagnosed mental health condition, make sure your obstetrician knows and it is well managed. Medications can lose their effectiveness during pregnancy because you’re making more blood.
  • Be honest if you’re experiencing any challenges that are impacting your mental health.
  • Join a group for new parents. Your local family resource center or First 5 Commission can help you find one.
  • Develop a postpartum support plan. Consider resources like Postpartum Support International.

Who does it affect?

1 in 5Women experience a mental health disorder during or after pregnancy

Mental health treatments

3 in 4Women don’t get treatment for maternal mental health disorders

Sources: Maternal Mental Health Leadership Alliance: Improving Maternal Mental Health Care in the United States

Maternal Mental Health Leadership Alliance: Improving Maternal Mental Health Care in the United States

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