Pregnancy may not be a happt time for everyone
Depression and anxiety in pregnancy is not uncommon – and mental health is as important as physical health, experts tell LAUREN TAYLOR
AWARENESS of postnatal depression has thankfully grown enormously in the last decade or so, and it’s estimated that 10-15% of women experience depression after birth. But what about before the baby arrives?
The statistics are possibly higher. It’s believed one in four women suffers mental health problems in pregnancy, according to a 2018 Kings College London study, while the NHS says it’s ‘common’ to experience mental ill health for the first time in pregnancy.
Plus, if you have a history of severe mental ill health, you’re more likely to become ill during pregnancy or the year following birth than at other times in your life.
SO, WHY AREN’T WE TALKING ABOUT IT MORE?
PROFESSOR Susan Ayers from City, University of London, a psychologist specialising in perinatal mental health, says: “There’s a lack of awareness that mental health issues can arise during pregnancy – for women and men – it’s estimated around one in eight first-time fathers experience depression while their partner is pregnant, according to a survey by scientists at
McGill University Canada.
A ‘HAPPY TIME’
PREGNANCY is typically celebrated as a joyful and exciting time, so it may feel at odds that a mum-to-be is finding it difficult to cope.
“In this context, it is difficult for those with mental health issues to talk about it and seek help,” says Prof Ayers.
Louise Broadbridge, a midwife specialising in mental health, says: “Women’s struggles with postnatal depression are closely monitored, however it’s only in recent years that pregnancy- related anxiety and depression has come to the fore.
“It’s often assumed that pregnant women are happy, excited. Women fear that by standing up and saying, ‘I’m struggling with this’, that questions will be asked about their ability to mother.
“In addition, some women find when they do speak up, friends and family members – albeit wellmeaning – respond with, ‘It’s just because you’re pregnant’, or, ‘You’re bound to feel anxious about having a baby’. And if you feel your feelings aren’t really being listened to or validated by those closest to you, it’s easy to feel you don’t need to seek further professional help.”
DEPRESSION AND ANXIETY
OXFORD Health NHS Foundation Trust says one in seven women experience persistent symptoms of depression in pregnancy.
These include overwhelming feelings of sadness and hopelessness, loss of interest in doing things you would normally enjoy, excessive feelings of tiredness, and feeling inadequate and unable to cope.
It’s also thought around one in 10 women struggle with anxiety during pregnancy, with symptoms including difficulty relaxing, palpitations, shakiness, difficulty breathing, worrying thoughts that seem out of proportion, and fear and avoidance of situations that make you feel anxious.
Prof Ayers says: “Research suggests anxiety can be higher in the first and last trimester. Women might be anxious in the first trimester for many reasons.
“They might be worried about miscarrying, coping with sickness and other symptoms, but haven’t told work they’re pregnant and are not yet in regular contact with maternity services, so they have very little support or advice.”
It’s also possible for the root of the anxiety or depression not to be clear. In addition, tocophobia – an intense fear of pregnancy and childbirth – is believed to be more common than people may think.
“Estimates are that 14% of women are severely frightened of birth, although rates vary in different countries,” adds Prof Ayers, who says the condition can have short and long-term effects.
WHAT CHANGES IN PREGNANCY?
ON a practical level, a huge amount is changing – and about to change – when people find out they’re expecting.
“Pregnancy is a time of huge physical, psychological and social change for women, which can trigger a range of positive and negative emotions, as well as physical and psychological health issues,” says Prof Ayers.
Louise adds: “Some women are surprised that, having been healthy, they suddenly feel unwell with early pregnancy symptoms, in addition to the obvious physical changes. The knowledge that their day-to-day landscape is going to change can be exciting but daunting, and lead to anxiety and a loss of identity.
“Uncertainty regarding relationships, finances and physical health can all impact mental wellbeing too,” she continues, “not to mention the hormones flying around all over the place.”
WHAT CAN YOU DO?
AS HARD as it can feel, pregnancy mental health is a real issue and support is out there. Plus, just talking can really help.
“Pregnancy and having a baby is a time of huge change and responsibility, which can trigger occasional anxiety in many people. However, if a woman or her partner has consistent anxiety that prevents them from doing normal day-to-day activities, they should talk to a healthcare professional about it as soon as possible to get help and support,” says Prof Ayers.
Louise adds: “Some women feel embarrassed to talk about how they are feeling, having never suffered with any form of depression before, but there’s absolutely no shame in seeking help – and just saying, ‘I feel anxious’, is sometimes all that’s needed.
“One of the most important things is to be kind to yourself. Being able to relax is key to managing anxiety; starting a pregnancy yoga class or hypno-birthing course can give you some amazing breathing techniques, which will encourage you to become more settled,” she adds.
“Just something as simple as making your outward breath longer than your inward breath promotes relaxation. Most of the time, we get anxious about the unknown, so get properly informed and find a well-rated antenatal class.”
But you don’t have to listen to all of the ‘advice’ you’re bombarded with, and be wary when people share their own birth stories.
“Listening to a steady stream of birth drama can condition you to expect that your story will read the same,” says Louise – which might not always be helpful.
Most importantly, she says, talk: “Talking really does help to make you feel safer and supported.”
■ Louise Broadbridge is speaking on a mental health panel at The Baby Show Excel London, ‘A Powerful Baby Brain’ with Ali Bastian, Olivia Siegl and Dr Sarah Vohra, hosted by Neev Spencer, on February 29.
For more information, visit thebabyshow.co.uk