Pregnancy Mental Health

Pregnancy can bring happiness, uncertainty, fear, excitement, sadness or several feelings at once. There is no emotional template you are supposed to follow. Mental health difficulties can also begin or return during pregnancy, including depression and anxiety.

If changes in your mood, thoughts or anxiety are worrying you, you can speak to your midwife, maternity unit or GP. You do not need to wait until things feel severe before asking for support.

Mental health can change during pregnancy

Pregnancy affects people differently. Some feel emotionally well throughout it. Others find particular stages difficult, and some experience a mental health problem for the first time.

The NHS says pregnancy can be stressful and that some people develop depression or anxiety for the first time while pregnant. Previous depression or anxiety can also return during pregnancy.

NICE guidance covers a wider range of mental health problems that may occur during pregnancy and after birth, including depression, anxiety disorders, eating disorders, bipolar disorder, psychosis and schizophrenia.

Having difficult feelings does not automatically mean you have a mental health condition. Pregnancy itself can involve changes in sleep, appetite, energy and emotions. A healthcare professional can assess what you are experiencing rather than expecting you to work it out alone.

Signs that your mental health may need more attention

There is a difference between having a difficult day and experiencing feelings or symptoms that persist and begin affecting everyday life.

The NHS advises speaking to a midwife or GP if you often feel low and hopeless or no longer enjoy things you previously enjoyed. Depression during pregnancy can also involve irritability, guilt, difficulty concentrating, changes in eating and negative thoughts.

Anxiety can show up in different ways too. You might find yourself worrying persistently, feeling unable to control the worry or becoming very distressed by particular thoughts or situations.

These experiences deserve to be taken seriously without trying to diagnose yourself from a checklist.

Why pregnancy can feel emotionally complicated

Pregnancy is not emotionally simple for everyone.

You may be adjusting to physical changes, appointments, uncertainty, changes at work, financial concerns or questions about what life may look like after birth. Previous pregnancy experiences or loss can also shape how you feel about a current pregnancy.

Some people feel pressure to be constantly happy or grateful. That expectation can make difficult feelings harder to admit.

You are allowed to have mixed feelings about pregnancy. Feeling anxious, overwhelmed or low does not tell anyone how much you care about your pregnancy or future baby.

Talking about how you really feel

Mental health is part of routine pregnancy care. NICE recommends that healthcare professionals consider asking about depression and anxiety at the booking appointment and during regular contacts in pregnancy.

You can also start the conversation yourself.

You might tell your midwife or GP that you have noticed a change in your mood, that anxiety is taking up a lot of your day or that you are struggling to cope. You do not need to arrive with the right terminology or know exactly what is happening.

If saying it aloud feels difficult, writing down what you have been experiencing before an appointment may help.

Being open about your mental health gives your healthcare team a clearer picture of what support might be useful.

What support is available?

The right support depends on what you are experiencing, its severity, your circumstances and your preferences.

The NHS says treatment for depression and anxiety during pregnancy can include talking therapies such as cognitive behavioural therapy. In some situations, medication may also be considered.

NICE recommends appropriate assessment when a mental health problem is suspected during pregnancy. Specialist perinatal mental health services are available for people who need more specialised support.

You may therefore receive support through your GP, maternity team, talking therapies or a specialist perinatal mental health service, depending on your needs.

Asking for help does not commit you to one particular form of treatment. Your healthcare professional can discuss the available options with you.

What if you already had a mental health condition before pregnancy?

If you had a mental health condition before becoming pregnant, tell the healthcare professionals caring for you.

Previous mental health difficulties can sometimes return during pregnancy. Some conditions also require additional planning or specialist support during pregnancy and after birth.

NICE guidance recommends considering a person’s mental health history as part of assessment and care planning. If you have previously experienced a severe mental health problem, your maternity and mental health teams can discuss what support and monitoring may be appropriate.

Pregnancy does not mean you should manage an existing condition without treatment. Your care can be reviewed around your individual circumstances.

Mental health medication during pregnancy

If you take prescribed medication for a mental health condition, finding out you are pregnant can raise understandable questions.

Do not stop prescribed medication simply because you have discovered you are pregnant without speaking to the doctor or specialist responsible for your care. The NHS advises telling them as soon as possible.

NICE guidance recognises that treatment decisions during pregnancy involve weighing the possible benefits and risks of treatment as well as the risks associated with an untreated mental health problem or stopping medication.

A healthcare professional can discuss those considerations with you based on the particular medicine, your mental health history and your pregnancy.

The same caution applies to starting medicines, herbal products or supplements for mental health symptoms. Ask a GP, pharmacist, midwife or relevant specialist before using them during pregnancy.

Everyday things that may support your wellbeing

Small routines are not substitutes for professional mental health care, but they can still form part of looking after yourself.

The NHS suggests talking about your feelings with someone you trust or a healthcare professional, making regular time for something you enjoy, eating a balanced diet and staying active where appropriate.

Antenatal classes may also offer information and opportunities to meet other people going through pregnancy.

None of these needs to become another standard you have to meet. If you are struggling with your mental health, being told to exercise more, socialise or create the perfect routine can feel impossible.

Start with what feels manageable and seek professional support when you need it.

Pregnancy after loss or a difficult experience

A new pregnancy after miscarriage, stillbirth, neonatal loss, fertility treatment or a traumatic previous pregnancy can bring emotions that are difficult to explain to other people.

You may feel hopeful and frightened at the same time. Appointments, scans or particular stages of pregnancy may carry extra emotional weight.

You do not have to minimise those feelings because you are currently pregnant. Tell your midwife or GP if anxiety, low mood, intrusive thoughts or memories are affecting you. They can discuss appropriate support and, where needed, referral to mental health services.

When to get professional advice

Speak to your maternity unit or GP if you are worried about your mental health. You do not need to wait for symptoms to become severe.

Seek prompt professional advice if you are experiencing persistent low mood, hopelessness, loss of interest in things you normally enjoy, severe or persistent anxiety, or other changes in your thoughts, feelings or behaviour that are concerning you.

The NHS advises contacting a GP immediately if a pregnant person starts hearing or seeing things that are not real, or develops strong beliefs that are not shared by others. If you cannot contact a GP, NHS 111 or an emergency department can help.

Call 999 if you think there is an immediate danger that you might harm yourself or someone else.

Mental health emergencies deserve the same urgency and care as physical emergencies. If you are unsure whether you need urgent help, contact NHS 111 or your maternity service for advice.