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Key takeaways

• Pregnancy brings emotional changes; you can talk to your midwife or doctor about your feelings.
• Do not stop mental health medication without speaking to a doctor first.
• Work with your healthcare team to create a personalised treatment and support plan.
• Plan ahead for your mental well-being for the time after birth (the postnatal period).

Understanding mental health during pregnancy

Pregnancy is a time of significant physical and emotional change. Changes to your hormones and body, and symptoms such as nausea and difficulty sleeping can all affect your mood.

It is normal to experience some emotional ups and downs during pregnancy. However, if you feel low a lot of the time or are struggling with your mental well-being, it is important to speak to your midwife or doctor.

Common worries and new conditions

Many women experience worries during pregnancy, such as about how you will cope or if you will be a good parent. Concerns about labour, giving birth, or feeling alone are also common.

Sometimes, mental health issues can appear for the first time during pregnancy. These can include depression or anxiety, such as panic or obsessive-compulsive disorder. An extreme fear of giving birth (tokophobia) can also occur.

It can be helpful to share how you are feeling with someone you trust, and if you think things are not right, speak to your midwife and ask for help. Getting early help and support is helpful if you have a mental health condition.

Creating your treatment and support plan

If you are pregnant and have a mental health condition, creating a treatment and support plan is important. Do not stop taking any medication for your mental health without speaking to a doctor first. Stopping suddenly could cause withdrawal symptoms or make your mental health symptoms worse.

Discussing medication options during pregnancy

Your doctor will explain your treatment options to help you decide what is best for you. They will discuss the benefits and risks of taking medication during pregnancy, and potential effects if you do not have any treatment.

Treatment options may include starting new medication, continuing your current one, adjusting the dose or switching to a different medication. Your doctor may recommend a medicine that has a better safety profile in pregnancy or is less likely to cause side effects. They will monitor you regularly and review your treatment if needed.

Many mental health medications are used during pregnancy. The decision to use medication is based on balancing the potential benefits and risks for both you and your baby.

Different types of medication can be used depending on your symptoms and diagnosis. These may include antidepressants, medicines used to manage severe anxiety and panic (anxiolytics) and those used to treat serious mental health conditions such as bipolar disorder or schizophrenia (antipsychotics).

Treatments without medication

Other treatments can be used instead of or alongside medication. These include talking therapies or guided self-help. Your doctor will discuss these options with you.

Personal support networks

Building a personal support network can make a positive difference. Share your feelings with trusted family members or friends and accept offers of help with practical tasks, such as cooking or shopping. You may also find it helpful to create an emotional support plan with your partner or close friends.

Peer support groups provide a space to share experiences and connect with others in similar situations. These groups can be local or online and are often supported by peer workers with lived experience of mental health challenges. Specialist charity helplines, text services, and online platforms can also offer confidential emotional support.

Preparing for the postnatal period

Planning ahead for the time after birth is very important for people with a mental health condition during pregnancy. If you are considered at high risk of postpartum psychosis, a rare but serious mental health condition that can occur after birth, you should be offered specialist care and additional support.

Creating a postnatal wellness plan

Around 32 weeks of pregnancy, you should have a pre-birth planning meeting. This meeting includes you, your partner or family members (if you wish), and all healthcare professionals involved in your care. It helps ensure everyone is aware of your needs and any risks, and agrees on a plan for care after birth.

You should receive a written copy of your care plan. This explains how you and your family can access support quickly if you become unwell. It may also include strategies to reduce the risk of relapse and outline the early warning signs that your mental health may be deteriorating.

Support after birth

In the first few weeks after your baby is born, you will have regular contact with healthcare professionals, which may include a midwife and health visitor. If you have had a mental health condition during pregnancy you may also be supported by a perinatal mental health team.

If you experienced a mental health problem during pregnancy you should be followed up regularly in the early postnatal period. This helps ensure you receive appropriate support for your recovery, and for caring for yourself and your baby.

Talking to peers who have experienced similar mental health conditions can also be helpful. Some inpatient units and communities have peer support workers. Charities may also offer support through online chats, helplines, or in-person groups.