According to the American Congress of Obstetricians and Gynecologists, about one out of every five or six women will experience symptoms of depression during pregnancy. We diagnose prenatal depression when a women experiences two weeks or more of persistent sadness, loss of interest in enjoyable activities, significant changes in sleep or appetite, feelings of guilt or worthlessness, or repeated thoughts of death or self-harm. Women with a personal or family history of depression are at higher risk. Other risk factors include relationship problems, stressful life events, and pregnancy-related issues, such as earlier age of pregnancy, greater number of children, infertility treatments, medical complications, and previous pregnancy loss.
Untreated depression during pregnancy is unhealthy for mother and baby. A woman who is depressed may not take adequate care of herself, leading to poor nutrition, drinking, smoking, and suicidal behavior. Risks for the baby include premature birth, low birth weight, and developmental problems. Women who experience depression in pregnancy are also at risk for depression after delivery, or postpartum depression, and that may interfere with bonding behavior between mother and baby.
Effective treatment for depression is important to mother and baby. Good self care (exercise, a healthy diet, regular sleep) is always important. For women with mild or moderate depression, support groups and individual or group psychotherapy, especially cognitive behavioral therapy, may be enough. Women who experience more severe depression sometimes take antidepressant medication. A decision to take medication must balance the possible benefits and risks. All antidepressants cross the placenta and get into the baby’s blood stream. There is not enough information to say that any antidepressants are completely safe, and some antidepressants may be linked to physical malformations, heart problems, pulmonary hypertension, and low birth weight. Talk with your prenatal care and mental health providers about risks and benefits of specific antidepressants, and remember that new information about safety of antidepressants in pregnancy is always becoming available.