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 might be feeling down.
  • You may feel more tired than usual, yet unable to sleep.
  • You might be less interested in eating. 
  • You may get angry and annoyed more easily.
  • You might have trouble thinking clearly and making decisions. 
  • You may worry or get anxious for reasons you don’t completely understand.
  • You may even experience flashbacks or nightmares about past traumatic events.

All these reactions are normal, but they might also be symptoms of a temporary and treatable set of conditions called Perinatal Mood and Anxiety Disorders (PMADs).

Learn more about the signs and symptoms of perinatal mood disorders from Healthy New Moms, a program of Mental Health America's Maryland chapter.

WHAT to EXPECT: 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.

How are PMADs Recognized

Many of us already cope with depression, anxiety, or mood disorders. It's estimated that 1 in 6 people has a mental health condition. Fortunately, 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 extra special attention to the way their diagnosis manifests.

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

Print a copy of the EPDSThen see more information on the Edinburgh here

You may also want to 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 determine whether you might benefit from a range of interventions that have helped others.

A positive score on a screening questionnaire does not mean you have a specific diagnosis. It just gives you an idea of whether or not 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 Perinatal Mood and Anxiety Disorders . Not only should they provide reassurance and emotional support, they should help you get connected to the people and programs that can help you navigate complicated feelings.
    • If your baby is still in the hospital, NICU (Neonatal Intensive Care Unit), or PICU (Pediatric Intensive Care Unit), we recommend sharing the results of your screening test with the unit's social worker or psychologist, or even the neonatologist or chaplain. Any of these professionals should be able to help. They can offer you services at the hospital or direct you to resources in your community.
    • If your baby is already at home, you can contact your OB/GYN, your midwife, your doula, your family doctor, or your child’s pediatrician. They can refer you to local resources and follow up with you to make sure you were successful getting connected.
    • Sometimes talking to someone who has "walked in your shoes" can help. Perinatal Mood and Anxiety Disorders are common, but people don't always talk about them. Sometimes they're worried about how other people will react. However, we recommend that you share what you're feeling and reach out for support. There are many peer-to-peer organizations, programs, and support groups that were started because people wanted to help others like them and to let people know that they are not alone. 

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 symptoms become apparent only AFTER your baby has been discharged from the NICU. In fact, you may not recognize 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 feeling depressed, anxious, or distressed can interfere with your relationship with your baby or other members of your family. You owe it to yourself, your baby, and your family to get the help you need.

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 else. Sometimes, it feels like you've gone weeks without having a conversation another adult. Try to stay connected to the outside world. 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. Talking to a trained listener allows you to share your feelings and get helpful feedback without worrying that what your sharing will upset or burden them. That's what they are there for. They want to help you feel better and stay healthy.


  • 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 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 people with substance use disorders, as well as those who are at risk of developing these disorders.

The SAMHSA SBIRT page has 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.


Kristy Love, Executive Director

P.O. Box 392 Lonedell, MO 63060

© 2020 National Perinatal Association

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