Q&A: Mental Health Screenings During and After Pregnancy

Stephanie Specht's picture
By Stephanie Specht on February 3, 2016

The U.S. Preventive Services Task Force has recommended that women be screened for depression during pregnancy and after delivery. Recent studies have shown that mental illness during and after pregnancy is much more common than was previously thought. In fact, many of the cases that are considered to be post partum depression often started during the woman’s pregnancy. 

The Task Force estimates that about 1 in 10 women suffer depression during pregnancy or in the first 12 months after delivery. Yet, fewer than 20 percent of women ever even seek help. If left untreated, depression and other mood disorders can hurt the well-being of the child. 

We sat down with Jennifer C. Wells, M.D., a psychiatrist at Carilion Clinic who specializes in a woman’s mental health during and after pregnancy, to find out why the new guidelines are so important.

Living: Why is screening for mental health issues during pregnancy and after birth so important?

Dr. Wells: During pregnancy and the first year after delivery is a critical time for not only one but for two individuals. If that crucial bonding time is disrupted or even destroyed, the effects can be harmful to the baby and the mother in the short- and long-term. Not having that bond can affect how the child grows and learns, and we are finding that the child is more prone to suffer from mental health issues in the future.   

Living: Why are women more vulnerable to mental health issues during this time period?

Dr. Wells: Pregnancy changes everything in your life. Your hormones are surging during pregnancy and directly after birth they plummet, so it is a time of tremendous change both emotionally and physiologically. And it also can change your relationship with your spouse and your family, as well as your finances. It is a stressful time for every woman, but if you are already predisposed to mental illness or anxiety, a change as great as this can certainly put you at greater risk for depression or other mental disorders.

Living: Why are women apprehensive to seek help?

Dr. Wells: There is still a lot of stigma around mental illness. When you are pregnant, it is supposed to be a time of wonder and joy, so if a woman does not feel like that then she often feels scared and ashamed. It can be hard for women to tell people that they don’t feel attached to their baby. In our society, it is not accepted that you would feel anything less than pure joy during this time in your life. It is just not accepted that you can be sick. 

Living: Is it safe to take antidepressants during pregnancy?

Dr. Wells: All medications have risks and benefits. There has been some recent attention on certain antidepressants and pregnancy, but the general consensus is that they are safe to take during and after pregnancy. I counsel my patients on any risks they may take during pregnancy, and generally, the risk is either very low or virtually nonexistent, depending on drug. Every woman has to weigh pros and cons, talk to her doctor and figure out what is the best option for her.

Living: What should a woman do if she thinks she is depressed during pregnancy or after birth?

Dr. Wells: Tell someone! Tell your doctor, your spouse, someone in your family or a friend. Just don’t be afraid to tell someone and get the help you need.  

If you are afraid to talk to someone you know, there are many support groups that you can reach out to for help. Postpartum Support International is one organization with extensive nationwide resources to link women up with providers, experts and support groups in their area.

Carilion Clinic has a special mental health hotline called CONNECT that is another wonderful resource. CONNECT is a confidential, 24-hour emergency evaluation and referral service that is available at no cost to members of our community. CONNECT is staffed by psychiatric nurses and clinical social workers who are trained to help people connect to the psychiatric and behavioral medicine support they need to function well.