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Trying to conceive, pregnancy, and mental health

Both the stress of trying to conceive a baby and pregnancy can affect a woman's mental health. You may feel sad, scared, or not in control of your life either when you are trying hard to conceive or when you are pregnant. You may worry about the costs associated with assisted reproduction and/or pregnancy. You may worry about the new responsibilities that come with being a parent.

Don't keep these feelings to yourself. Get help if you feel depressed, anxious, or overwhelmed! Preventing or treating depression helps both you and your child, and may also lower your child's risk of developing depression or other health problems later.

Infertility and mental health

Infertility means not being able to get pregnant after one year of trying (or after trying for 6 months if a woman is 35 or older). Women who can get pregnant but are unable to stay pregnant may also be infertile. Infertility affects 10 to 15 percent of couples.

Women who want a child but have not yet conceived often experience the following:

  • Anger
  • Depression
  • Anxiety
  • Marital problems
  • Sexual dysfunction
  • Social isolation
  • Low self-esteem

Researchers are not sure if mental health can affect fertility, although it is clear that infertility can affect mental health. It's possible, though, that high levels of depression, anxiety, and stress can affect the hormones that regulate ovulation. This could make it difficult for a woman to become pregnant.

Treatment

Couples with infertility have many treatments available to help them conceive. Most of these treatments cost a lot of money and may not be covered by health insurance. While many couples who seek infertility treatment are already stressed, the process and cost of assisted reproduction itself can also cause anxiety, depression, and stress. If you are trying fertility treatments and they are not working, you may be at risk for further depression and self-esteem problems. Try to keep a positive attitude, and be sure to talk to your doctor about getting help if you feel you need it. A number of research studies show that women who are distressed have lower pregnancy rates among women trying infertility treatments.

Talk therapy, either one-on-one or in a group, can lower stress and mood symptoms. Women who had talk therapy during their infertility treatments were more likely to get pregnant than those who did not.

Researchers are still learning whether drugs like antidepressants can help infertile women. Many women don't want to take medications during infertility treatments because they are afraid it may affect the outcome of a pregnancy. However, there is no data that shows that commonly used antidepressants affect a woman's chances of becoming pregnant.

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Pregnancy and mental health

Depression is a common problem during and after pregnancy. When you are pregnant or after you have a baby, you may be depressed and not know it. Some normal changes during and after pregnancy can cause symptoms similar to those of depression. How long symptoms last, and how often they occur, is different for each patient.

Symptoms of depression include:

  • Feeling restless or moody
  • Feeling sad, hopeless, and overwhelmed
  • Crying a lot
  • Having no energy or motivation
  • Eating too little or too much
  • Sleeping too little or too much
  • Having trouble focusing or making decisions
  • Having memory problems
  • Feeling worthless and guilty
  • Losing interest or pleasure in activities you used to enjoy
  • Withdrawing from friends and family
  • Having headaches, aches and pains, or stomach problems that don't go away
  • Having suicidal thoughts

Your doctor can figure out if your symptoms are caused by depression or something else.

Certain factors may increase your risk of depression during and after pregnancy:

  • A personal history of depression or another mental illness
  • A family history of depression or another mental illness
  • A lack of support from family and friends
  • Anxiety or negative feelings about the pregnancy
  • Problems with a previous pregnancy or birth
  • Marriage or money problems
  • Stressful life events
  • Young age
  • Substance abuse

Women who are depressed during pregnancy have a greater risk of depression after giving birth. It's important to know that if you take medicine for depression, stopping your medicine when you become pregnant can cause your depression to come back. Do not stop any prescribed medicines without first talking to your doctor. Not using medicine that you need may be harmful to you or your baby.

Postpartum depression

After giving birth, about 85 percent of women have some kind of upset mood. For most women, this doesn't last long. But 10 to 15 percent of women will feel seriously depressed or anxious. Postpartum mental health conditions are divided into three categories:

  1. Postpartum blues
  2. Postpartum depression
  3. Postpartum psychosis

Postpartum blues are felt by 50 to 85 percent of women after delivery. It's a normal experience after childbirth. Women with the blues feel tearful, irritable, and anxious for up to two weeks after giving birth. These feelings go away on their own and don't require any treatment.

Postpartum depression can start at any point after giving birth but may start as late as three months after delivery. Some women notice their depression started during their pregnancy. The symptoms of postpartum depression are noted above. There are a number of things that may cause postpartum depression, including:

  • Hormonal changes
  • Marital dissatisfaction
  • Poor social support for the new mother
  • Stressful life events around the time of the birth (such as a premature baby)

Postpartum psychosis is the most severe kind of mental health illness that follows pregnancy. It is rare and happens only in 1 or 2 women for every 1000 that give birth. It starts suddenly and symptoms can start within 48 to 72 hours after childbirth. Most women with postpartum psychosis show symptoms within two weeks of giving birth. These include:

  • Fast-changing depressed or excited mood (similar to bipolar disorder)
  • Restlessness
  • Irritability
  • Insomnia
  • Confusion
  • Disorganized behavior
  • Delusions
  • Hearing voices that tell the mother to hurt herself or the baby

A woman is at risk for suicide or for harming her baby if she has postpartum psychosis. It's important to tell a doctor right away if you or someone you know is feeling this way.

If you are having symptoms of depression during or after pregnancy, call your doctor if:

  • Your baby blues don't go away after two weeks
  • Symptoms of depression get more and more intense
  • Symptoms of depression begin any time after delivery, even many months later
  • It is hard for you to perform tasks at work or at home
  • You cannot care for yourself or your baby
  • You have thoughts of harming yourself or your baby

Your doctor can ask you questions to test for depression. Your doctor can also refer you to a mental health professional who specializes in treating depression.

Some women don't tell anyone about their symptoms. They feel embarrassed, ashamed, or guilty about feeling depressed when they are supposed to be happy. They worry they will be viewed as unfit parents.

Any woman may become depressed during pregnancy or after having a baby. It doesn't mean you are a bad or "not together" mom. You and your baby don't have to suffer. There is help.

Treatment

The two common types of treatment for pregnancy-related or postpartum depression are:

  • Talk therapy. This involves talking to a therapist, psychologist, or social worker to learn to change how depression makes you think, feel, and act.
  • Medicine. Your doctor can prescribe an antidepressant medicine. These medicines can help relieve symptoms of depression.

Learn more about taking medications during pregnancy.

These treatment methods can be used alone or together. If you are depressed, your depression can affect your baby. Getting treatment is important for you and your baby. Talk with your doctor about the benefits and risks of taking medicine to treat depression when you are pregnant or breastfeeding.

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More information on trying to conceive, pregnancy, and mental health

Read more from womenshealth.gov

  • Depression During and After Pregnancy Fact Sheet — This fact sheet discusses depression during and after pregnancy, what might cause it, symptoms you may experience, and how it is treated. It also explains how untreated depression can negatively affect your life.
    http://www.womenshealth.gov/publications/our-publications/fact-sheet/depression-pregnancy.cfm
  • Infertility Fact Sheet — This fact sheet provides information on infertility, including its causes, ways to test for it, treatments, and an overview of other options for having a baby.
    http://www.womenshealth.gov/publications/our-publications/fact-sheet/infertility.cfm

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Content last updated March 29, 2010.

Resources last updated March 29, 2010.

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