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Prenatal Depression and Anxiety

Everyone can feel anxious or down at times, even during pregnancy. Most of the time, these feelings go away on their own after a few days. If you have ongoing feelings of depression or anxiety that last for more than two weeks, it's time to get help.

Feeling sad or anxious all the time can get in the way of a healthy pregnancy. You may feel ashamed or embarrassed that you don't feel happy or joyful during pregnancy. You are not a bad person or parent for having these feelings.

If you have anxiety or depression during pregnancy, you're not alone. One in five pregnant people will have a mental health issue during or after pregnancy. That's according to the American College of Obstetricians and Gynecologists (ACOG).

If you feel this way, you don't need to tough it out or hope it gets better. Prenatal depression and anxiety can get worse if left untreated and lead to other mental health issues, including postpartum depression (PPD). UPMC offers prenatal care and services to treat and manage your mental health during pregnancy.

What are Prenatal Depression and Anxiety?

Prenatal depression and anxiety are the most common mental health conditions that happen during pregnancy. Postpartum depression (PPD) is depression that happens after pregnancy.

Mental health conditions are the leading cause of pregnancy-related deaths, according to the Centers for Disease Control and Prevention. Prenatal anxiety and depression don't go away on their own. You need treatment to get better.

How common are prenatal anxiety and depression?

Anxiety is the most common mental health condition among adults. It affects pregnant people the same: About one in five will have anxiety during pregnancy or postpartum, according to ACOG.

About one in 10 pregnant people have depression during pregnancy, according to ACOG.

What Causes Anxiety and Depression During Pregnancy?

Doctors are not sure exactly why anxiety gets worse during pregnancy. Different people can develop anxiety and depression during pregnancy for different reasons. Your genes and hormone level changes that impact emotions and mood can play a role.

Studies have shown that people with postpartum depression have changes in brain connections and activity on MRI scans. Doctors don't yet know what these changes mean.

It's common to have both anxiety and depression during pregnancy. Having anxiety also increases your risk of developing prenatal and postpartum depression.

What increases your risk of prenatal anxiety and depression?

Many things can add to or increase your risk of anxiety or depression during pregnancy. These are called risk factors.

Prenatal anxiety and depression risk factors include:

  • Extreme or ongoing stress.
  • Exposure to violence, including domestic or intimate-partner violence, sexual violence, or gender-based violence.
  • History of anxiety or depression, whether personal or family history.
  • Lack of social support or poor relationships.
  • Lower education.
  • Migration.
  • Poverty, lower income, or economic hardship, including having Medicaid insurance.
  • Single parent status.
  • Smoking.
  • You are stopping your medication for anxiety or depression.
  • Surviving emergency and conflict situations, including natural disasters.
  • Unintended pregnancy.

What Are the Symptoms of Prenatal Anxiety and Depression?

Anxiety and depression during pregnancy and after can keep you from taking care of yourself and your baby. Getting help starts with recognizing the symptoms of prenatal anxiety and depression.

What does prenatal anxiety feel like?

Whether you are having your first baby or your fourth, you may have concerns about pregnancy, delivery, or even parenthood. When these feelings last or don't go away, they can affect how you think, feel, and act.

Your anxiety can also turn into a phobia, a fear of certain situations or things. You may avoid certain situations, such as leaving your house, getting your blood drawn, or going to your prenatal visits.  

Symptoms of anxiety during pregnancy include:

  • Constant fear, worry, or feelings of doom, such as not being a good mother or something going wrong with the pregnancy, delivery, or your baby.
  • Difficulty concentrating.
  • Feeling irritable, tense, restless, or on edge.
  • Trouble sleeping, such as falling asleep or staying asleep.
  • Unexplained physical symptoms, such as headaches, nausea, muscle aches, or stomach pain.
  • A panic attack, which includes sudden dizziness, sweating, a racing heart, or chest pain.

What does prenatal depression feel like?

Even though only 10% of pregnant people are diagnosed with prenatal depression, a larger percentage have depressive symptoms. Studies have estimated that 25% to 30% of pregnant people have depressive symptoms during pregnancy. Depressive symptoms often get worse during the 3rd trimester of pregnancy.

Symptoms of depression in pregnancy include:

  • Aches and pains that don't have a known cause or don't get better with treatment.
  • Changes in appetite, such as overeating or loss of appetite.
  • She was crying often.
  • Decreased interest in wanting to be a parent or feeling disconnected from your pregnancy.
  • Feelings of guilt, hopelessness, worthlessness, or helplessness.
  • I was feeling overwhelmed.
  • Lasting sadness or "empty" mood.
  • Loss of energy or feeling tired all the time.
  • Loss of interest in things you once enjoyed.
  • Problems falling asleep or sleeping too much.
  • Problems concentrating, remembering things, or making decisions.
  • Restlessness and irritability.
  • Thoughts of harming yourself or your baby.
  • Thoughts of suicide or suicide attempts.
  • I am withdrawing from family and friends.

When and where to get help for a mental health crisis?

If you have severe symptoms of prenatal anxiety or depression or postpartum depression, contact your health care provider immediately.

You can also contact Postpartum Support International (PSI) coordinators. PSI provides support, encouragement, and information about perinatal mood and anxiety disorders, including postpartum depression. Contact 1-800-944-4773 for local help.

IF YOU BELIEVE YOU MAY HARM YOURSELF OR YOUR BABY, CALL 911 or CALL OR TEXT 988 SUICIDE & CRISIS LIFELINE.

How Does UPMC Care for Prenatal Anxiety and Depression?

Mental health stigma can make you feel ashamed or alone. We understand what you are going through. Your pregnancy care team can help you manage prenatal mental health issues, but only if you let us know how you are feeling.

Who is on your pregnancy mental health team?  

Treatment for prenatal anxiety and depression during pregnancy is part of UPMC's Behavioral Health Services for Women. Your pregnancy support team can help meet your physical and emotional needs.

Your care team may include:

  • An ob-gyn.
  • A certified nurse-midwife (CNM).
  • A doula. Doulas are specially trained labor and pregnancy support people who provide non-medical comfort and care before, during, and after pregnancy. Research finds using a doula can decrease your risk of postpartum depression.
  • A psychiatrist.
  • A psychologist.
  • A social worker.

What treatment does UPMC offer for prenatal anxiety?

If your anxiety is ongoing, treatment can help you get control of your fear and worry. To treat anxiety during pregnancy, doctors often recommend psychotherapy.

Types of therapy for prenatal anxiety include:

  • Cognitive behavioral therapy (CBT) — Doctors consider CBT the gold standard of care for psychotherapy. CBT teaches you different ways of thinking and reacting to situations so you feel less anxiety and fear.
  • Exposure therapy — If your anxiety causes you to avoid situations or activities, your therapist may recommend exposure therapy. It's a type of CBT that focuses on confronting your fears to help control them.
  • Acceptance and commitment therapy — This newer therapy uses strategies such as goal setting and mindfulness to reduce anxiety.

If therapy alone does not help to control your anxiety symptoms, your pregnancy care team may recommend medication.

According to ACOG, anxiety during pregnancy can also increase your baby's risk of:

  • Low birth weight.
  • Preterm birth.
  • Problems with behavior later in life.

What treatment does UPMC offer for prenatal depression?

Treatment for prenatal depression often includes psychotherapy, medications, or a combination of both. UPMC's maternal fetal medicine experts know which medications for depression are safe to take during pregnancy and breastfeeding.

Untreated depression during pregnancy increases your risk for:

  • Developing PPD after pregnancy, which can make it hard for you to bond with your baby.
  • Developing substance use problems, including smoking, drinking alcohol, or taking harmful drugs.
  • Not taking care of yourself during pregnancy, such as not eating or sleeping well and not going to prenatal visits.
  • Thinking about harming yourself or your baby, and suicide attempts, though rare.

Depression during pregnancy also increases your baby's risk of:

  • Preterm birth.
  • Low birthweight or being small for gestational age — they don't weigh what they should at birth.
  • Mental health conditions and learning and behavior problems later in life.
  • Being more irritable, less active, and less attentive than babies whose mothers did not have depression during pregnancy. They also have fewer facial expressions.

How can I relieve pregnancy anxiety and prenatal depression?

If you have anxiety and depression during pregnancy, you need treatment to help you feel better and prevent the symptoms from getting worse. You can also do things to protect your mood and mental health during pregnancy.

These can help boost your mood and relieve worry and stress:

  • Avoid drinking too much caffeine — Coffee, tea, or soft drinks can increase anxiety.
  • Eat a healthful diet —Your pregnancy care team can offer nutritional advice. The USDA's MyPlate guidelines also provide advice on what to eat during and after pregnancy.  
  • Get regular physical activity — Pregnant people should get 150 minutes of moderate-intensity aerobic activity each week, such as brisk walking. Your ob-gyn, CNM, or doula can tell you what activities are safe during pregnancy.
  • Get enough quality sleep — For overall health, adults need at least seven hours of sleep each night. For better sleep, avoid caffeine in the evening and turn off electronic devices and screens at least 30 minutes before bed.
  • Keep a journal — Writing down your feelings can help you process them.
  • Practice deep breathing exercises — Deep breathing can help calm your body. For guided exercises, try apps for meditation or relaxation.
  • Get out of the house — Spend time doing things you love or with loved ones.

Why Choose UPMC for Prenatal Mental Health and Pregnancy Care?

At UPMC, we understand your mental health and well-being matter as much as your physical health during and after pregnancy. We offer holistic health care, including:

Comprehensive pregnancy care

At UPMC, mental health care is part of pregnancy care. We screen all pregnant people for perinatal depression and anxiety. You will get these mental health screenings at each appointment.

Support services during and after pregnancy

Pregnancy and bringing a baby home can feel overwhelming and challenge you both physically and emotionally. UPMC offers several support groups for new parents.


Last reviewed by a UPMC medical professional on 2024-09-05.