Pregnancy, childbirth and caring for a newborn can be difficult and exhausting experiences. Mood swings, raging hormones, exhaustion and anxiety are normal during pregnancy and in the early days after giving birth, but for some mothers things can be more serious. As many as one in five new mothers can experience symptoms of depression just before or after giving birth, which could ultimately affect their own health and the health and development of their children. While there have long been doubts and stigma regarding the use of antidepressants during pregnancy, there is growing scientific evidence indicating it might be a safer option for mothers struggling with depression.
‘The risks posed to a foetus from antidepressants are consistently overestimated, while the risks of untreated depression are consistently underestimated because of the pervasive stigma against mental illness,’ warns specialist psychiatrist and member of the South African Society of Psychiatrists Dr Bavi Vythilingum.
Depression during pregnancy is often undiagnosed and goes untreated, which can lead to premature labour, low birth weights and developmental delays, says Vythilingum. Postnatal mental illness in mothers, which mainly occurs as depression and anxiety, also poses a risk to newborns and young children, especially during their key developmental stages ,where key elements like bonding and family relationships can be impacted.
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According to Vythilingum, women with pre-existing mental-illness diagnoses are at greater risk of depression, while circumstances like alcohol or substance abuse, a lack of social support, poverty, unwanted pregnancies, exposure to extreme stress or domestic, sexual or gender-based violence can be contributing factors.
Pregnant women or new mothers experiencing symptoms of depression – including sleeping difficulties, feelings of inadequacy, helplessness or panic, a lack of motivation, or feeling like crying for no reason – should consult their doctor, obstetrician or psychiatrist for diagnosis and to develop an individual treatment plan.
‘While these are all common symptoms of depression, women and their partners should also look out for feelings of detachment from the baby, feeling like she doesn’t love the child as she should, and thoughts of harming herself or the baby,’ says Vythilingum.
Treatment for mental-health issues during pregnancy
According to Vythilingum, psychotherapy is always the first line of treatment, along with mobilising family support, especially by the father or significant partner, and community resources such as antenatal and baby clinics.
Medication such as antidepressants could be prescribed, depending on the nature and severity of the condition, and after weighing up the risks and benefits of medication for both mother and baby.
‘Clinicians should weigh the growing evidence of detrimental and prolonged effects in children due to untreated antenatal depression and depressive symptoms during pregnancy against the known and emerging studies on the safety of in-utero exposure to antidepressants,’ she says.
Vythilingum also advises that women who fall pregnant while taking antidepressants should not stop taking the medication immediately, but should rather consult with their doctor or psychiatrist, who will determine whether the specific medication should be continued, changed or stopped.
The selective serotonin reuptake inhibitors class of antidepressants are the most well-researched and safest for use in pregnancy at relatively low risk to the unborn baby, but it’s essential that any decisions regarding your or your baby’s health should be made in consultation with the relevant psychiatrists and obstetricians.
Image: iStock
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