Pregnancy & Birth

Why we need to start talking about antenatal depression

Becoming pregnant can open the floodgates for feelings of anxiety, stress and fear in some women - and it's important women get the help and support they need.

"From the day I found out I was pregnant, I felt like a failure because I didn't have that excitement that everybody says you'll have," says 22-year-old Lauren. "All these negative emotions came over me – fear, panic, shock, and massive amounts of anxiety. It was horrendous."
It wasn't until after her 20-week scan that Lauren, from the UK, was diagnosed with antenatal depression (AND), a condition that affects around one in 10 women during pregnancy, however it's believed this number is as high as one in eight women in New Zealand.
Women suffering from antenatal depression can struggle to take care of their own health, and this can slow the growth of their unborn baby, increase the risk of a premature birth and delay the child's motor and emotional development. Women who suffer from AND are also more likely to experience depression after their child is born.
Postnatal depression, which kicks in after the birth of your baby, affects a similar number of women as AND, but is probably better known and more widely talked about.
"For some women I think it seems more logical that you might struggle after you've had a baby, when you're juggling looking after the newborn and looking after yourself," says Sophie King, a UK midwife.
"But I think antenatal depression is not so talked about among pregnant women because people presume you should be happy and excited that you're having a baby, not feeling low. You can feel both!" she adds.
Lauren continues, "When you first find out you're pregnant, you're always worried about the likelihood of miscarriage and whatnot, but with antenatal depression everything seemed to be 10 times worse.
"It was stopping me getting out of bed, it was making me miserable, I didn't really want to be around people, and initially I couldn't even get excited about being pregnant."
Lauren's experience is fairly typical of antenatal, or prenatal, depression. Symptoms can include feeling down, restless, lethargic or irritable, a loss of interest or enjoyment in your normal activities, trouble sleeping, and isolating yourself from other people.
"It's no different from the depression you can experience at any time in your life," explains UK maternal mental health expert Dr Alaine Gregoire.
"The only thing that is critically different, obviously, is the timing. Pregnancy is a really important time in the lives of women and families, and it's actually quite easy to slip into being very unwell without even really clicking that you're no longer yourself."
For 27-year-old Rachel, it was a miscarriage scare that kickstarted antenatal depression during her second pregnancy.
"At around five or six weeks I was convinced I was having a miscarriage, and I think that had a lasting effect on me," she says.
"I've had mental health issues before, including PND with my first baby, but during my second pregnancy was the first time I'd ever had to take time off work with it," she adds.
"My first pregnancy wasn't planned, and there was a lot of shame around it, so having a planned pregnancy this time around – and with far less stress going on in my life – I left like I should be enjoying it," Rachel says.
"I did, to some extent, but there was this cloud of depression always hovering."
Annie, who's 33, was delighted to find out she was pregnant, having previously undergone major treatment for breast cancer. For her, though, antenatal depression and anxiety kicked in after she developed Hyperemesis Gravidarum, a severe form of morning sickness.
"I wanted to go to baby fairs, have baby showers, and enjoy being pregnant, but I just felt too low. I didn't make any plans, and cancelled anything I'd already arranged," she says.
"I hated antenatal groups because I felt too ashamed to talk about how rubbish everything seemed. I felt like I owed it to my unborn baby and myself to get it together and enjoy my pregnancy."
For women who are struggling with AND, your midwife and/or your GP can connect you with support services and mental health professionals who can help. If you don't feel listened to, it's important you reach out to someone you trust to help you get the support you need.
"My GP and midwife were amazing – I had extra visits with the midwife and a GP whose door was always open to me, but I had to fight to stay off medication because I didn't want to do anything that could put the baby's health at risk," Rachel says.
However, Lauren didn't feel supported: "The attitude – from my GP, midwife, and friends and family – was very much: 'Don't worry, you'll get over it. As soon as you hold the baby you'll be fine'. But I really, really wasn't."
Like many women, Lauren found that her AND developed into postnatal depression and continued to affect her after the birth. When her baby was just three months old, Lauren attempted suicide.
"After that, social services basically told me to buck my ideas up, because I would probably lose the baby if I did anything like that again," she says. "I had some support from the doctor, in terms of therapy, but otherwise I very much had to support myself."
For her, it was connecting with a maternal depression support network that made all the difference. "It sounds so silly and so simple, but talking about it really does make you start to feel better," she says.
"I downplayed it a lot, but I really, really wish I'd spoken about it earlier and things could have got better, because I don't have any good memories of being pregnant. I literally felt the worst I've ever felt when I was pregnant," she adds.
Likewise, Annie says the best advice she could give to other women struggling is: "Be aware of your feelings and try not to dismiss them. Even if you keep them to yourself, you can still have a happy pregnancy. Don't feel guilty about being miserable."
She adds: "Mental health can be commonly dismissed as 'hormones', which is a dangerous presumption. Talk to your doctor, your midwife, and your obstetrician. You are not the only one. Your body and mind deserve equal treatment."

Where to get help for antenatal or postnatal depression

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