1. Pregnancy
  2. Pregnancy health
  3. Emotional health

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Depression During Pregnancy: 4 Questions Answered by the Expert

Kathryn Abel, Professor of Psychological Medicine, answers four of the most common questions on mental health disorder and its influence on a mother-to-be and baby's health.

#1 Are there any gynaecological conditions that are attributed to mental health disorders? 

There is a number of things that are more likely to happen in mothers with mental illness. For example, polycystic ovarian syndrome and infertility are more common in women with mental illness. 

Women with mental illness, such as depression or schizophrenia, are more likely to have obstetric problems such as more premature babies, and babies whose growth over pregnancy is not optimal. 

And there are more likely to be other complications: the baby may be a little flatter at birth with a low Apgar score which is a test of how well the baby is breathing, if they are floppy, etc. Babies of mothers with depression tend to have slightly lower Apgar scores, but they recover quickly. 

Unfortunately, it does remain the case that women with more severe mental illness during pregnancy are more likely to lose a baby. 

It may be that women with the most severe depression are also those at greatest risk of miscarriage - suggesting that teenage moms, mothers who take drugs and alcohol, or a mother who has an infection is at greatest risk of losing her baby and women who have mental illnesses are also more likely to have an infection during pregnancy. 

# 2 If a woman has a history of depression, what steps should be taken by her healthcare provider if she plans a pregnancy?

If a woman has a depression history, it is vital that this is communicated to her antenatal care team and midwives. This would mean she has more antenatal monitoring of her mood and  general health. 

She should also be given plenty of supportive information, because when women become pregnant, there are so many things to think about. So she needs to be given information in a manageable way. 

It’s important that a woman is allowed to make a decision with her doctor and family, and then she can make a decision that is right for her, rather than a decision that is based on a dataset from a large population.

With respect to taking antidepressants, it’s clearly important that women are helped to make a decision for themselves and to be supported to do so. Stopping antidepressants does not have to be a final decision – if things change, a mother can always go back to taking antidepressants. 

Most women, probably only about 20 percent of all the women who become depressed during pregnancy, will have a severe depression. 

So, it’s important that a woman is allowed to make a decision with her doctor and family, and then she can make a decision that is right for her, rather than a decision that is based on a dataset from a large population. 

Nutrition, support, friends, family, not drinking alcohol, not smoking, not taking drugs, taking vitamins - vitamin D, folate – all of these usual things are important to maintain a healthy pregnancy.

Many women might be taking an antidepressant before pregnancy and during the first weeks of pregnancy without even knowing they are pregnant. It’s very important that women don’t feel blame or guilt for taking medicines they need to stay well.

#3 Can you say that antidepressants are not a one-size-fits-all solution? 

Antidepressants can be prescribed to women with sever depression. 

Yet, nutrition, support, friends, family, not drinking alcohol, not smoking, not taking drugs, taking vitamins - vitamin D, folate – all of these usual things are important to maintain a healthy pregnancy. 

#4 How can nutrition and regular exercise help?

Some of the things that are associated with depression, for example, prematurity and low birth weight, can be improved by good antenatal health. 

Part of the reason that women who are in poverty, or who are teenage have a higher risk of these problems is because they are not in good overall physical health. 

When you look at a very healthy mother, who has resources perhaps is middle-class and fit with a good diet, they have very low rates of prematurity and low birth weight.

They don’t smoke, they exercise, and they have good diets. It’s not that complicated after all. 

Staying healthy during pregnancy is much the same as staying healthy at any time in life.  

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