Managing Before and During Pregnancy
How and When Mental Health Challenges Began
The people we interviewed talked about how their mental health issues began either before or during their pregnancy. Each person’s story was unique, with differences in symptoms and in how these symptoms first appeared. You can find more details about the type of symptoms experienced by these women on the topic page about the onset of symptoms. Many people also explained how their personal situations and choices influenced their mental health, sometimes for the better and sometimes for the worse. Decisions about using medication, especially before and during pregnancy, were key considerations during this period.
Previous Experiences with Mental Health and Pregnancy
For several people, mental health issues were a part of their lives even before pregnancy. These past experiences made them more aware of potential symptoms and helped them take steps to prepare for likely or possible problems. However, not everyone was aware of the risks of new or newly diagnosed mental health issues during and after pregnancy. Some people mentioned that they had never heard of postpartum depression or other mental health challenges associated with pregnancy. Several people who were already on medication for mental health issues had to make decisions about ongoing treatment, including stopping certain medications, changing them, or reducing the dosage. Additionally, several people faced difficulties maintaining their mental health care routine during and after pregnancy due to several factors.
Just before pregnancy, Krysta felt great after having suffered from anxiety most of her life, but then her anxiety started to come back.
Transcript
So I had suffered with anxiety most of my life but prior to pregnancy I had done therapy so I was feeling really great for, I don’t know, maybe a year or two. So no anxiety symptoms or depression. Once I got pregnant anxiety started to come back. It got […]
After being fired at work while pregnant, Susan suffered from situational depression and was surprised when it continued after the birth of her daughter.
Transcript
And so when I was four months pregnant, I was fired from my job and I went from being a full-time career woman to being at home, having one income, being pregnant, not knowing what was coming next and just being terrified of everything that was to come. I started […]
Experiencing Mental Health Problems During Pregnancy
Several people described a certain moment when they suddenly started to feel anxious or were ‘having a bad feeling’ at different stages of their pregnancy.
At 8 months pregnant, Christine noticed a change from feeling 'good nervous' to 'anxious nervous.'
Transcript
It was close to the end of my pregnancy with my son. And it was maybe a month before I was due. And it just sort of happened very gradually where I started feeling just anxious about having a baby. And I noticed it was more at night, during the […]
At the same time, there were also people who felt that they had a perfect pregnancy and/or delivery but started feeling unwell as soon as the baby was born, or in the months after.
Erin2 loved being pregnant, but birth completely derailed everything.
Transcript
No, and that’s the crazy part. So when I was pregnancy I felt great. Like I loved being pregnant. I felt very womanly. I felt like very feminine. I loved the way my body was like making this life. Like I felt great, and I felt prepared, I felt ready […]
Factors Affecting Women’s Mental Health
Many pregnancy–related experiences and choices had an impact on women’s mental health. These included having gone through stressful times while undergoing fertility treatments, previous miscarriages, fear for the pregnancy, delivery or a miscarriage, and anxieties around new situations. Physical issues, financial stress and other high-impact situations such as the loss of a loved one and problems at work during this period were also described as having an impact on participants’ mental health. Yet several people also described a more sudden onset of feeling more anxious.
Tara cried a lot right before giving birth as she was facing fears around her changing relationship, weight changes and the delivery.
Transcript
I was really scared to give birth. If someone had asked me kind of what I was hoping for at that time the days before giving birth, I would have asked, like, if I could be put under as in, like, general anaesthetic and then you take out the baby, […]
Having gone through two miscarriages Michelle1 felt anxious about her ability to carry a baby full term.
Transcript
Well, so there were all these, in retrospect, there were all these factors that were happening during my pregnancy and red flags that popped up that would have been warning signs I guess for post partum depression and anxiety, things that would increase my likelihood of having it. But of […]
Louise's health took a turn for the worse when she barely ate and slept and spent most of her days in the car where she felt best.
Transcript
Ah! Ok, bien la dépression comment que ça a sorti, ça, je vous dirais, c’est… Bien quand je suis arrivée ici, j’ai discuté avec la psychologue et tout, comment ça se passait. Bien là, j’avais troubles anxieux généralisés. Un trouble phobique, pas phobique… phobie sociale! J’ai tout un peu… J’ai […]
Worries around Emma's role as a mom and other people's expectations grew into intrusive thinking that she didn't want to be here anymore.
Transcript
So I started noticing when I was pregnant with my daughter, she’s my firstborn. I was about seven months pregnant, and I just kind of started realizing I was having feelings that didn’t feel normal, just really anxious and tense all the time, worrying about things like my bond, my […]
Mental health was also affected by the important and stressful decisions required around medication use, including about whether to start or stop certain medications or to reduce the dose. But people also described how their usual medications or new ones, did help them to cope with the pregnancy. You can read more about this in our topic page about medication and treatment approaches.
The first fear Hope experienced when she heard she was pregnant was that she then had to get off her medications.
Written testimony
We also have a history of thyroid issues on my paternal side and maternal side and because of what I’ll talk about later in my second birth postpartum, I really believe there’s a huge link between thyroid health and mental health challenges, and that get highlighted in the postpartum period, especially when it comes to breastfeeding. So, I do have a minor form of major depression that has been treated over time with Celexa for a few years, and then just like, I got off of that, because it just made me feel numb and dead inside and no sex drive and tired and stuff, and just modified my lifestyle. And then because of issues in reproduction in my family, my husband has azoospermia, so we need a donor to have our babies.
And that brings into my story, you know, a different type of reality with child bearing, because it is not easy to have technology ruling your reproductive life and the losses that come with that on a professional level, on a personal level, on a relationship level. I had a lot of stress, different I would say than regular people that go to bed and oops they get pregnant or go to bed and, oh it worked, okay. Or even go to bed and try for six months or a year with their partner and then it works or it doesn’t work, I have to have a completely different relationship with getting pregnant. So, I was saying, I already lost my thought. I was saying that a little bit – so, right. And so, I went through, after my first was born with our donor, who is an ID open donor that my daughter will have access to at the age of 18 if she wants. I had a series of, you know, terrible years with miscarriage and it just never worked again and it was very, very, very, very difficult, I still get emotional talking about it, wow.
So in 2014, I was not well, I really didn’t feel well. And so, I went back on medication, but I did not want to go on the SSRI, because they, I don’t want to gain weight, I don’t want to feel like have zero sex drive, my relationship I think, you know, marriage and work and all that, I mean, we need to have some type of drive sometimes. And so, my doctor suggested Wellbutrin, which is an NDRI I believe, so it works on dopamine not serotonin, and you know, it gives you a little punch of energy and is good, so that worked for me. And then it stopped working for me and we added in Concerta, which is used for ADHD, but it can also compliment an antidepressant for, it’s antidepressant effects on the dopamine system, and it changed my life. Like literally I got on top of my career and kind of it helped me focus and meditate, and I was able to kind of process a lot of my loss through the reproductive issues with failed IVF and failed insemination and miscarriage.
And just change my focus, felt really good, was advancing in my career, we had one sample left at the fertility clinic, and you know, what are you going to do with that, because I really wanted to close the door after seven years of kind of thinking about a number two. I was feeling really good, we were feeling really good, and I said you know, maybe we should just try again, just one last time and then close the book. And it probably won’t work and I’ve got my life in order, I’m done with this, I’m going to go ahead, going back to school, changing my career, we’re good, we moved everything. And you know, called the fertility clinic, and because I hadn’t been there since 2014, since my failed IVF. I decided never to go back into one of those buildings again, because they’re absolutely horrendous when you actually don’t get pregnant.
I made an appointment and they could only see me, this was in June, they could only see me for my first consult in December, I was totally cool with that, not in any rush and anyway. Didn’t even know if I was going to go to the appointment in December, decided to go, then you know, are we going to go back for the actual ultrasound and the whole day one, three, blah, blah, blah and for instance we decided to, my doctor said, you know what, you should just try insemination and not IVF. And anyway, I got pregnant, so. That was a big shock and my first fear was, am I going to have to get off of my meds, because they really helped me a lot. And so, I talked to my doctor, who I trust fully, and she said; no, stay on them, you know, we’ll revisit this later, but right now, stay on them, and she’ll send me to a specialist to verify that they were not safe, but you know, to talk about it.
And so, I talked to the specialist and definitely Wellbutrin, like I can stay on that during the pregnancy, there’s less data about Concerta, she asked me to call Mother Risk, and talk to a consultant there. And basically, I came to the conclusion on my own that I am going to stay on the Concerta, because it just, you know, I just didn’t want to risk getting back into the same place as I was in 2014, it wasn’t very pretty.
Finding the right medication was an important factor for many in feeling better; women also described other helpful measures to cope with their mental health problems during pregnancy. You can read more about this topic page about coping with perinatal mental health.
After mental health issues with her first pregnancy, Michelle2 was proactive during the next pregnancy.
Transcript
And so then as years went on we got pregnant again and I had a few like, doctors say to me like that’s a very slippery slope. Like we’ll have to watch you like crazy. Like this’ll probably happen again. Oh and then I’d – like for this to happen […]
To cope with her anxiety, Sophia thought it might help if she told herself that she was not pregnant.
Transcript
Non, non! L’accouchement ça a été merveilleux. Mon Dieu, ça a pris 3 heures. (rires) Mais c’est qu’après on aurait dit que durant toute ma grossesse, je m’étais comme un peu coupée de mes émotions par rapport à ce qui s’en venait parce que c’était tellement difficile pour moi d’envisager l’avenir […]
Not wanting to return to her eating disorder while pregnant, Erin1 and her doctor found ways to deal with the weight gain.
Transcript
Interviewer: So did you – did you share with your doctor, you know, the way you were feeling because of the changes in your body? Like, did she know about the eating disorder? Absolutely. She knew about my eating disorder. I’d been very open with her. In fact, we were […]
During her second pregnancy, Erin was closely monitored due to complications in her first pregnancy and mental health problems.
Transcript
It was a bit – it was very hopeful going into it. But like I said, it was a difficult pregnancy right from the beginning, because of the extreme nausea and vomiting. But I was going to this very, I guess, very intense obstetrical program that treats women with all […]