Pregnancy & Depression: Antepartum & Postpartum

Table of Contents

Amongst physical and lifestyle changes, pregnancy can alter a mother’s mental health. Research shows that depression could be the most prevalent issue that women face during and after pregnancy. As many as 1 in 8 mothers face depression during or after their pregnancy2.

In mild cases, this could detract from the mother experiencing their newborn. In more severe cases, depression can lead to serious health consequences for the baby and the mother.

The maternal consequences of depression can include physical health, psychological health, relationship, and risky behaviors. The infant consequences can include physical health, sleep and motor function, cognitive, language, emotional, social, and behavioral development. In addition, the mother and child relationship can include difficulties with bonding, breastfeeding, and the maternal role.

Pregnancy & Depression: During & After

Perinatal depression refers to the common mood disorder that occurs during or after pregnancy. It can be categorized into two different forms depending on when they occur: antepartum and postpartum.

Antepartum or prenatal depression occurs during pregnancy. This kind of depression is most likely to occur during the third trimester compared to any other time14.

Postpartum depression occurs after giving birth. This type of depression typically begins within the first month after a mother gives birth, but its onset can vary up to one year. What makes postpartum depression different than “baby blues” is that it is long-lasting and affects a mother’s ability to function normally.

Within 1 to 2 days after the birth of a child, 75% of women experience the baby blues16. Baby blues may look like short crying spurts, dysregulated sleep, and emotional instability. This reaction is completely normal and typically resolves within 10 days.

Symptoms of Antepartum Depression

Symptoms of antepartum depression can range from mild to severe on a case-by-case basis. In general, they occur for longer than 2 weeks and impact a mother’s day-to-day activities. A mother experiencing antepartum depression during pregnancy may experience the following symptoms1:

These symptoms are all varying types and degrees of stress on the mother. If high stress persists through the pregnancy, it could lead to premature birth or low-birthweight11.

Risk Factors of Antepartum Depression

In the healthcare profession, risk factors are details that increase the risk of developing a condition. Risk factors do not dictate whether a mother will experience antepartum depression. Rather, they serve as a tool to help identify which mothers may need mental health support throughout pregnancy.

The rapid change of lifestyle and social engagement involved with pregnancy is a risk factor for mental health issues19. Along with hormonal changes, irregular sleep patterns can increase the risk of developing antepartum depression. These two changes may account for why this disorder is more common to occur in the third trimester.

Most researchers argue that both sleep deprivation and hormonal changes are two key factors to look at. During and after pregnancy a woman’s reproductive hormones fluctuate dramatically including estrogen, progesterone, oxytocin, cortisol, and thyroid18. These hormone fluctuations can contribute to depression during and after pregnancy.

The risk factors of antepartum depression include but aren’t limited to:

There are also risk factors associated with socioeconomic disparities such as poverty, unstable housing, and a lack of secure health insurance. Currently, it’s undetermined whether age, race, and ethnicity could be risk factors.

Symptoms of Postpartum Depression

Antepartum and postpartum symptoms are similar and as such, each list could apply to each condition. The main differentiating factors between these forms of depression are when the depression occurs and how it affects the baby. A mother experiencing postpartum depression may experience one or more of the following symptoms13:

After the baby is born, depression can no longer affect its birth time or weight like it can in antepartum depression. However, having a depressed mother for a sustained period could alter the child’s brain structures15.

Aside from obvious physical health risks to the baby, there can also be negative mental health effects for them. This can stem from the mother’s inability to bond with the child. A lack of connection can lead to the child having long-term mental health problems later in life20.

Risk Factors of Postpartum Depression

The risk factors of ante- and postpartum depression are similar because both are forms of depression. The risk factors of postpartum depression serve as a reference point for mothers and medical professionals to be alert for depression.

For depression that occurs after childbirth, risk factors may include6:

If medical professionals are aware of risk factors early in the pregnancy, they can watch the mother and offer treatment when necessary.

The First Step Towards Treatment

The first step in getting treatment is to talk about your experiences with a medical professional. Mental health issues are as normal as physical health issues. As such, they deserve attention and respect.

One study showed that two-fifths of people with mental health issues don’t talk about them with doctors3. This is largely due to the potential fear of consequences and stigmas. However, the only way to get treatment is to first talk with a doctor or mental health professional so that they can diagnose the problem.

Antepartum & Postpartum Depression Diagnosis

These mental health conditions are not diagnosed with physical tests. However, a doctor may want to run tests to be sure that another illness is not causing symptoms.

Hypothyroidism, for example, often looks similar to perinatal depression. To diagnose, the doctor will also want to rule out birth control side effects, bipolar disorder, and postpartum psychosis.

From there, they are likely to use one or more questionnaires. The most common test is the Edinburgh Postnatal Depression Scale (EPDS)12. With honest reflection, you will answer 10 questions that reflect your experiences over the past 7 days.

A similar diagnostic tool is the Patient Health Questionnaire (PHQ-9). This survey can be used as a diagnostic tool for major depressive disorder and asks about your experiences over the past two weeks.

These diagnostic tools require honest self-reports. You may also be asked to complete a survey upon each doctor’s visit after identifying depression as an issue. After completing the diagnostic tools, you and your doctor may choose a treatment option that best suits your needs.

Treatment Methods

While the timeframe and effects of depression can be overwhelming, there is hope for all mothers in receiving treatment. Treatment and recovery time can vary depending on the severity of the depression and individual needs. Treatment for antepartum and postpartum depression is vital for both the health of the mother and the baby. 

Proper treatment based on individual needs and severity of depression can result in a reduction of symptoms and an overall increase in the quality of life. A doctor or mental health professional can help mothers choose the best course of treatment. Perinatal depression treatment is typically treated in a similar way to other types of depression. 


Self-care isn’t a substitute for receiving actual treatment but can help with some symptoms of depression and have a positive effect on mental health. Exercise can reduce postpartum depression symptoms by improving quality of life and reducing fatigue10. Physical activity should be consulted by a doctor to understand the level of activity that is recommended.

There’s also a lot of research on the interconnectedness of gut health and its effect on mental state7. Making healthy choices when depressed can be difficult, but eating nutrient-rich foods can help. The more whole foods consumed during and after pregnancy, the better off the baby and mother will be.


Psychotherapy is an overarching term for practices that fall within the category of “talk therapy”. Two main types of psychotherapy are found to be effective for antepartum and postpartum depression. Both types of therapy are non-invasive and medication-free.

  • Cognitive-behavioral therapy (CBT) – helps identify and change harmful thoughts and behaviors. Research shows that CBT is effective in improving antepartum and postpartum depression symptoms8. It also reduces the number of mothers experiencing this condition.
  • Interpersonal therapy (IPT) – focuses on relationships with others. IPT is an empirically validated approach that improves mental health by using the techniques of communication analysis and role-playing17.


Often, doctors prescribe antidepressants to patients suffering from depression. There are differenƒt categories of antidepressants, such as selective serotonin reuptake inhibitors (SSRIs). Each type works with the body’s neurochemistry in specific ways, making some of them safer for pregnant women than others.

It’s not uncommon to take medicine while carrying your baby. In fact, 70% of mothers take at least one medication throughout their pregnancy5. Some medications transfer through breastmilk, so it’s important to understand the risks of any medicine taken.

While it seems like a straightforward treatment, antidepressants do not work for everyone. Antidepressants can come with a long list of side effects including headache, dry mouth, fatigue, dizziness, sexual issues, drowsiness, insomnia, and weight-related issues4.

Transcranial Magnetic Stimulation (TMS)

Transcranial magnetic stimulation (TMS) is an FDA-approved non-invasive treatment option for depression. During TMS treatment, a magnetic coil is placed on the top of the head and electromagnetic frequencies are used to target specific areas of the brain. In patients with depression, the prefrontal cortex is targeted because the neurotransmitters located there are known to be lower in people with depression.

TMS treatment involves 19-37-minute sessions 5 days per week for 4-6 weeks. Unlike medications and antidepressants, there are minimal side effects to the mother and baby. So far, research proves TMS to be a low-risk treatment during pregnancy9.

Receive Treatment

If you or a loved one are struggling with depression during or after pregnancy, know that this is a common and treatable condition. Experts believe there are multiple methods of treatment for individuals struggling with antepartum and postpartum depression. Discuss treatment options with a doctor or mental health professional and decide what is best for you.

Clear Care Center can help you or your loved one struggling with antepartum or postpartum depression by providing TMS therapy. Get in touch with our empathetic and knowledgeable staff who can answer any questions you may have and give you an understanding of our program. TMS therapy can help manage symptoms and increase the quality of life without the use of medications.


  1. APA. (2021, December 9). Depression during pregnancy. American Pregnancy Association. Retrieved February 14, 2022, from
  2. Bauman, B. L., Ko, J. Y., Cox, S., D’Angelo, D. V., Warner, L., Folger, S., Tevendale, H. D., Coy, K. C., Harrison, L., & Barfield, W. D. (2020, May 15). Vital signs: Postpartum depressive symptoms and provider discussions about Perinatal Depression – United States, 2018. Centers for Disease Control and Prevention. Retrieved February 14, 2022, from
  3. Bell, R. A., Franks, P., Duberstein, P. R., Epstein, R. M., Feldman, M. D., Fernandez y Garcia, E., & Kravitz, R. L. (2011, September). Suffering in silence: Reasons for not disclosing depression in primary care. Annals of family medicine. Retrieved February 14, 2022, from
  4. Bjarnadottir, A. (2018, December 4). Antidepressant side effects: Types, comparison chart, and suicide risk. Healthline. Retrieved February 14, 2022, from
  5. CDC Staff. (2020, July 31). Pregnant or thinking of getting pregnant? Centers for Disease Control and Prevention. Retrieved February 14, 2022, from
  6. CDC Staff. (2020, May 14). Depression among women. Centers for Disease Control and Prevention. Retrieved February 14, 2022, from
  7. Harvard Health Publishing. (2021, April 19). The gut-brain connection. Harvard Health. Retrieved February 14, 2022, from
  8. Huang, L., Zhao, Y., Qiang, C., & Fan, B. (2018, October 15). Is cognitive behavioral therapy a better choice for women with postnatal depression? A systematic review and meta-analysis. PloS one. Retrieved February 14, 2022, from
  9. Kim, D. R., Wang, E., McGeehan, B., Snell, J., Neill Epperson, C., Sammel, M. D., O’Reardon, J. P., Iannelli, C., & Ewing, G. (2019). Randomized controlled trial of transcranial magnetic stimulation in pregnant women with major depressive disorder. Brain stimulation. Retrieved February 14, 2022, from
  10. Kołomańska-Bogucka, D., & Mazur-Bialy, A. I. (2019, September 2). Physical activity and the occurrence of postnatal depression-A systematic review. Medicina (Kaunas, Lithuania). Retrieved February 14, 2022, from
  11. March of Dimes. (2019, October). Stress and pregnancy. March of Dimes. Retrieved February 14, 2022, from
  12. NIH. (2020, December 10). Postpartum depression screening: Medlineplus medical test. MedlinePlus. Retrieved February 14, 2022, from
  13. Office on Women’s Health. (2019, May 14). Postpartum depression. Postpartum depression | Office on Women’s Health. Retrieved February 14, 2022, from
  14. Okagbue, H. I., Adamu, P. I., Bishop, S. A., Oguntunde, P. E., Opanuga, A. A., & Akhmetshin, E. M. (2019, May 14). Systematic review of prevalence of antepartum depression during the trimesters of pregnancy. Open access Macedonian journal of medical sciences. Retrieved February 14, 2022, from
  15. Sandman, C. A. (2011, November 9). Change in mother’s mental state can influence her baby’s development before and after birth. Association for Psychological Science – APS. Retrieved February 14, 2022, from
  16. Sit, D. K. Y., & Wisner, K. L. (2009, September). Identification of postpartum depression. Clinical obstetrics and gynecology. Retrieved February 14, 2022, from
  17. Stuart, S. (2012). Interpersonal psychotherapy for postpartum depression. Clinical psychology & psychotherapy. Retrieved February 14, 2022, from
  18. Trifu, S., Vladuti, A., & Popescu, A. (2019, July). The neuroendocrinological aspects of pregnancy and postpartum depression. Acta endocrinologica . Retrieved February 14, 2022, from
  19. WHO. (2018, March 30). Mental health: Strengthening our response. World Health Organization. Retrieved February 14, 2022, from
  20. Winston, R., & Chicot, R. (2016, February 24). The importance of early bonding on the long-term mental health and resilience of children. London journal of primary care. Retrieved February 14, 2022, from