Mental Health Before Pregnancy

By evaluating your mental health risk factors, you can plan for appropriate care. Here are some steps to consider:

Consider your family history of mental health conditions. Having a family member with mental health issues, especially perinatal mood and anxiety disorders, can increase your risk of experiencing a mental health issue. Genetics and upbringing in an environment where mental illness was present may contribute to this elevated risk.

Learn more about your risk factors and what you can do to reduce your chances of developing these conditions from blogs from the Massachusetts General Hospital (MGH) Center for Women’s Mental Health website:

• “Risk Factors for Postpartum Depression: Family History of Psychiatric Illness”
• “Family History of Psychiatric Illness, Even in Male Relatives, Increases Risk for Postpartum Depression”
• “Perinatal Depression is a Heritable Illness”

Reflect on mental health challenges you’ve experienced. These might be:

• Major life stresses, trauma, or hormonal shifts can make you more susceptible during the pregnancy/postpartum periods.
• Personal or family history of depression, anxiety, bipolar disorder, or OCD are important risk factors to consider.
• Severe PMS or challenging premenstrual symptoms can also increase the risk for perinatal mood complications.

Get the care you need. If you have risk factors for mental health conditions, don’t wait for symptoms such as changes in mood, sleep, or behavior to show before seeking help and support.

• Reach out early to your health care provider or a mental health professional so you can take proactive steps to safeguard your mental health during this transition.
• Share your mental health history openly with your health care and perinatal care team.
• Explore treatment and support options to manage any issues.
• Identify potential concerns ahead of time so you can create a plan and support system.

The journey to conceive can be filled with highs and lows. When fertility challenges arise, you may experience a wide range of emotions. You don’t need to carry these alone.

Seek assistance.

• Search for online and in-person groups dedicated to infertility or pregnancy loss that can offer a sense of community and comfort through shared experiences.
• Connect with communities who understand what you’re going through.
• Find out if fertility clinics offer peer-led or other support groups.
• Consider counseling to provide guidance and coping strategies to empower you during this challenging time. Psychology Today offers a directory of counselors specializing in fertility issues.

Understand medication side effects. It’s important to be mindful of the potential mood changes that can accompany fertility medications, particularly those used in in vitro fertilization (IVF) hormone treatments.

• Keep track of your emotional well-being while taking medication, and don’t hesitate to reach out to your care team for additional support.
• Consider taking a step back to prioritize your mental health if you need a break from intensive fertility treatment. Remember, your mental health is just as important as your physical health.

Treatment for mental health conditions varies but can include a combination of therapy and medication. You may encounter misconceptions about taking medications during pregnancy, so it’s important to review your current psychiatric medications with both your mental health and health care provider and create a maintenance plan specifically tailored to pregnancy. Here are some things to consider:

Learn more about your medications. Some medications carry varying levels of risks during pregnancy.

• Discuss dosing adjustments or alternatives with both your mental health and general health care provider to find out how to balance your needs and your future baby’s healthy development. There are options, even if some changes are temporarily required.
• To learn more, check out the CDC’s medicine and pregnancy webpage.

Create an integrated care team. An integrated care team would include your perinatal medical provider and mental health provider communicating and working together.

• Make sure, with your consent, that there is open communication between your providers so they can coordinate any therapies or medications you need.
• Read more about the “Collaborative Care” model from the American Psychiatric Association.

Find a perinatal mental health specialist.

• Ask your perinatal medical provider or primary care physician if they have relationships with perinatal psychiatrists who understand your unique needs.
• Search for reproductive psychiatry specialists covered by your insurance plan.
• Check out Postpartum Support International’s directory that can connect you with mental health professionals in your area.

In NAMI’s Community & Culture section, you’ll learn that our culture, beliefs, sexual identity, values, race, and language all affect how we perceive and experience mental health conditions. You have a right to integrated physical and mental health care from a compassionate, understanding team. Having a perinatal health care provider that you trust can ultimately support your mental health. Parents deserve equal health treatment across all populations, particularly for those who are underrepresented. Here are some things you can do:

Be aware of bias and discrimination.

• It’s important for health care systems and health care providers to work towards eliminating bias, discrimination, and stereotypes that can negatively affect your medical experience.
• Make sure you feel safe and respected in a stigma-free environment that addresses all barriers, including racism, sexism, ableism, and LGBTQI discrimination.

Find health care providers who make you feel heard, understood, and empowered.

• Look for providers who actively listen, validate your experiences, make efforts to understand your individual needs and concerns — and are part of practices or facilities committed to diversity and inclusion initiatives.

Advocate for yourself.

• Take time to find out about your perinatal health and available treatment options, so you can ask informed questions.
• Check out reputable websites, such as the MGH Center for Women’s Health website, to gather information.
• Openly communicate your concerns and expectations to your provider, and don’t hesitate to ask questions about your care.
• If you feel your perinatal health care needs aren’t being met, it’s okay to seek other medical opinions and find a different provider that works for you.

Connect with online groups.

• Look for ones that assist underrepresented communities in accessing compassionate perinatal services and emotional support.
• Search online for a local group you can attend in-person or find one you can access remotely to provide emotional support, provider recommendations, and shared experiences.
• Ask friends and community or religious leaders if they know of any organizations or groups offering help.
• Here are two resources to check out:
  • Compass Perinatal Peer Support
  • Postpartum Support International online support meetings

Get more information from these resources: For more on advocating for yourself and finding inclusive care, check out these resources from leading health organizations:

• NAMI’s Identity and Cultural Dimensions: Describes the barriers that might be experienced in different cultures.
• The American Medical Association’s website: Provides resources on cultural competence and minority health.
• American Public Health Association website: Offers information on health disparities and minority health.
• Every Mother Counts: A global organization that promotes taking action for equity in maternal care.
• National Council of Asian Pacific Islander Physicians: Focuses on Asian American and Pacific Islander health issues and advocates for cultural competence in healthcare.
• National Hispanic Medical Association: Advocates for Hispanic health professionals and addresses health issues impacting Hispanic/Latinx populations.
• National Medical Association: Represents African American physicians and addresses health disparities affecting the Black/African ancestry community.

Preparing for pregnancy involves not only physical readiness but also emotional preparedness. Here are some strategies:

Build your support system.

• Surround yourself with caring friends, relatives, or communities who provide nonjudgmental understanding.
• Identify a point person or two you can lean on especially during pregnancy for moral support.
• Discuss any fears or concerns about pregnancy and postpartum periods with your health care provider early on. Open communication allows them to provide reassurance and guidance tailored to you.
• Consider therapy or support groups.

Practice self-care. Self-care and stress management are key to maintaining emotional wellness before pregnancy.

• Make space to nurture your sense of peace and happiness, like pursuing creative outlets, soaking up the outdoors, or quieting your mind through meditation and mindfulness.
• Establish some self-care routines now before pregnancy when it may be harder.

Be informed. From managing anxiety to postpartum depression coping strategies, information is empowering.

• Look for resources for your unique challenges and pregnancy experience, such as support groups, online forums, and educational material on perinatal mental health. Here are some ideas to get you started:
  • American Hospital Association
  • Maternal Mental Health Leadership Alliance
  • Maternal Mental Health NOW
  • MGH Center for Women’s Mental Health
  • MotherToBaby
  • Newborn & Parenting Support
  • Postpartum Support International