Supporting your Perinatal Mental Health and Wellbeing

Pregnancy, childbirth, and parenting bring dramatic changes to your life - and your emotional health.

While it can be an exciting and joyful time, the changes that accompany the perinatal period can also leave you feeling sad, guilty, overwhelmed, irritable, or unable to relax and enjoy your developing relationship with your baby and family. 

  • You may feel more tired than usual yet unable to get a good night’s sleep.
  • You may be uninterested in eating. 
  • You may feel like you get angry or annoyed more easily.
  • You may have trouble thinking clearly and making decisions. 
  • You may find your heart racing with anxiety for reasons you don’t completely understand.
  • You may even experience flashbacks or nightmares about traumatic experiences you've had.

All these reactions are normal, but they might also be symptoms of a temporary and treatable set of conditions called Perinatal Mood an Anxiety Disorders (PMADs). Learn more about the signs and symptoms of perinatal mood disorders.

How are PMADs Recognized

Many of us already deal with depression, anxiety, or mood disorders. It's estimated that 1 in 6 people has a mental health condition. These conditions are treatable and manageable. 

For some people the perinatal period will be the first time they experience these symptoms. For others, it will be a time when they pay special attention to the way their diagnosis manifests.

The screening tool that is used most commonly for identifying Perinatal Mood and Anxiety Disorders (PMADs) i the Edinburgh Postnatal Depression Scale (EPDS).

Print a copy of the EPDSSee more information on the Edinburgh here

Then learn about the 3-Question EPDS. Print a copy of the EPDS-3.

Take a Screening for Common Perinatal Mood and Anxiety Disorders

The National Perinatal Association has partnered with Mental Health America to bring you their useful, quick, and easy screening tools.

These short, confidential questionnaires can help you identify what you are feeling and to determine whether you might benefit from a range of positive interventions that have helped others.

A positive score on a screening questionnaire does not mean you have a specific diagnosis. It just gives an idea of whether you have any of the feelings associated with the various conditions.

Because, mental health conditions like:

      • depression
      • anxiety disorders
      • and post-traumatic stress disorder (PTSD) 

are common and normal. 

They are not a sign of weakness. In fact, understanding your mental health needs and addressing them is a sign of strength and resiliency.

Use these Mental Health Screening Tools provided by our partner Mental Health America.

How to use these results:

  • If you're pregnant ask your doctor, midwife, or other health care provider how to recognize and manage the feelings you're experiencing. Not only should they provide reassurance and emotional support, they should help get you connected to the people and programs that can help you navigate complicated feelings.
  • If your baby is still in the hospital nursery, NICU (Neonatal Intensive Care Unit), or PICU (Pediatric Intensive Care Unit), we recommend discussing results of your screening test with the the unit's social worker or psychologist, or even the neonatologist or chaplain. Any of these professionals should be able to help you and direct you to further resources in your baby’s hospital or in your community.
  • If your baby is already at home, you can contact your OB/GYN provider, your family doctor, or your child’s pediatrician. Again, they can refer you to local resources.

The Importance of Identifying these Conditions for NICU Parents

We know that the prevalence of perinatal mood or anxiety disorders is higher for NICU parents than other parents, due to the stressful experiences that are a normal part of having a baby who needs intensive care. 

The feelings you're having are understandable, temporary, and treatable.

Sometimes these conditions become apparent only AFTER your baby has been discharged from the NICU; in fact, you may not notice these disturbing feelings until years after your baby has come home with you. 

It is important that your uncomfortable feelings be recognized and treated, because being depressed, anxious or overly stressed can interfere with your developing relationship with your baby or other members of your family. You owe it to yourself, your baby, and your family to get help if you need it. 

You can feel better.

REMEMBER: If you are having any of these feelings, it's ok. It's normal. What you are feeling is temporary and treatable. And YOU ARE NOT ALONE. With help and support, you will feel better. Many of us have felt the way you might be feeling now.

 Here are some things that help:

Take a Break:  Sometimes the emotions associated with Perinatal Mood and Anxiety Disorders might feel like more than you can handle. If they do, give yourself permission to take a "time out." Go for a walk. Take a shower. Take a nap. Ask for help with the kids. If you need to, it's ok to put your baby down in a safe place and walk away for a few minutes. 

Make a Plan: Even if you haven't had any of these feelings yet, think about what you would do if you did. Who would you tell? Where would you go? What would you need? Then, if you ever feel overwhelmed, you will be prepared. Stop, pay attention, and go to your plan.

Don't Go It Alone: Pregnancy, parenting, or a NICU stay can be incredibly isolating. Sometimes you can go days without thinking about anything other than your pregnancy and baby. Other times, it feels like you haven't had an adult conversation is weeks. Make time to talk to a trusted provider, partner, or friend - even if it's just a quick call, email, or text. Because when you're feeling bad, it's easy to feel like no one notices or cares. But that's not true. People care about you. If you are worried about telling someone you know about how you feel, there is still help. Calling a postpartum depression or suicide hotline and talking to someone you don't know - but who understands - can be a lifeline. It allows you to talk through your feelings and get helpful feedback.

The Warmline messages are returned every day of the week. You are welcome to leave a confidential message any time, and one of the warmline volunteers will return your call as soon as possible. If you are not able to talk when the volunteer calls you, you can arrange another time to connect. The volunteer will give you information, encouragement, and names of resources near you.
    • NEW! Text the Warmline — 503-894-9453

    • CRISIS TEXT LINE: Text HOME to 741741 from anywhere in the USA, anytime, about any type of crisis.
Call for yourself or someone you care about; free and confidential; network of more than 140 crisis centers nationwide; available 24/7

A Special Note about Perinatal Substance Use Disorders

Substance use is common among women of reproductive age, but it can also be problematic. So it's important to talk about it and ask questions.

Screening, Brief Interventions, and Referral to Treatment (SBIRT) is a comprehensive, integrated, public health approach to the delivery of early intervention and treatment services for persons with substance use disorders, as well as those who are at risk of developing these disorders.

The SAMHSA SBIRT page includes curricula, online resources, and publications designed to help implement SBIRT initiatives. 

See NPA's resources on perinatal substance use, including our position statement on Perinatal Substance UseSee sample SBIRT questions.

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