Perinatal Mental Health



Your reproductive journey is highly unique. While all of us wish for an uneventful, beautiful pregnancy journey, the reality is that this journey is often complicated in various ways, which may include difficulty in conception, pregnancy loss, and mental health issues during and after pregnancy. The important thing to remember is that you are not alone. Stress and emotional difficulties during a woman’s reproductive experiences are very common; in fact, postpartum depression is the most common complication of childbirth.

Support during these times is essential for all individuals and families. Often times, people benefit from professional support, whether that is through group therapy, individual therapy, psychiatric care or a combination of these. Most importantly, it is essential to find support from providers who are experienced and respectful of your emotions and decisions.

Psychiatrist Dr. Iyer has a special interest in perinatal mental health difficulties and advocates for raising awareness and decreasing stigma around all mental health issues, particularly those around women’s’ mental health. She frequently writes and speaks on topics pertaining to maternal mental health, including at the annual Postpartum Support International Conference. In her practice, she has worked with hundreds of individuals and families who have struggled with mental health difficulties around pregnancy, post partum, infertility and pregnancy loss. She offers a kind, respectful and gentle approach to all women and families in need of support throughout any aspect of their reproductive journeys.

Fortunately, emotional wellness during these times can be achieved with the right support and approaches. While medications can be helpful in some circumstances, there are several non-medication approaches that are also highly effective. The good news is that treatment – which often times does not require psychotropic medications – is safe and rapidly effective, meaning that you could be feeling better quite soon!


Wellness in Pregnancy

Emotional wellness during pregnancy can be complex on many levels. We are socialized to believe that this is meant to be the happiest time in our lives and that such happiness should come to us naturally and easily. But the reality is that reproductive-related issues can lead us to feel anxious, depressed, psychotic or even paranoid – and many women describe feeling uncomfortable with the discrepancy between how they actually feel and how they believe they should feel.

While some women experience emotional difficulty for the first time during pregnancy, many other women say their symptoms existed even before the pregnancy started. There are several biological and social factors, such as a lack of emotional support, history of depression or marital problems, which could contribute to the onset of these symptoms.

Symptoms of depression and anxiety may include:

  • Feeling sad, depressed, and/or crying a lot
  • Intense anxiety; rumination, obsessions
  • Loss of interest in usual activities
  • Feelings of guilt, worthlessness or incompetence, especially with new infant
  • Lack of energy and irritability
  • Appetite changes
  • Poor concentration / focus
  • Suicidal thoughts

While it is expected that many women could have changes in their emotions during their pregnancies, sometimes self-care and a solid support network may be sufficient to help you navigate this. However, you may consider seeking professional support:

  • once these emotions persist for weeks or worsen in severity
  • start to impair your functioning
  • lead to thoughts to harm self or baby

The medical literature shows that untreated psychiatric symptoms during pregnancy are not conducive to the wellness of the mother or the baby. Untreated symptoms could also last into the postpartum period, resulting in conditions like postpartum depression.


Postpartum Wellness

Postpartum blues are quite common, experienced by as many as 85% of postpartum women, and characterized by irritability and mood changes shortly after birth. Fortunately, these symptoms can resolve fairly quickly.

On the other hand, postpartum depression is characterized by a more severe cluster of symptoms that can occur even months after birth. The severity of these symptoms can seriously impact a postpartum mother, her infant and the rest of the family.

Postpartum anxiety may be characterized by excessive worry, panic and irrational fears that can be debilitating to a postpartum mother. These experiences could impact her wellbeing or ability to care for/bond with her baby.

While postpartum depression has gained increasing recognition as one of the most common complications of childbirth, there are various other postpartum complications that are also noted to be equally debilitating. These include postpartum OCD, bipolar disorder, PTSD and psychosis, all of which are treatable conditions.


Pregnancy Loss

The loss of a pregnancy can be a traumatic, shocking event for a woman and her family. Women who experience it can feel isolated from others. The grief around loss can feel overwhelming and can be characterized by multiple conflicted emotions, including sadness, anger and guilt. This loss can add strain to a marriage and can be especially difficult for families.

When there has been a pregnancy loss, it is crucial for a woman and her partner to seek out emotional support. While many may seek comfort from their friends, families and places of worship, professional support can be highly beneficial in helping navigate through grief.



The road to pregnancy can be a difficult and emotional one, particularly for those who are experiencing infertility. Over 10% of couples of reproductive age will experience infertility. The infertility journey can be emotionally draining for many women. It can also be particularly difficult for a couple, where the emotional highs and lows of infertility treatments can be taxing on the relationship.

Professional support during infertility treatment can be helpful in managing the high levels of stress, anxiety and emotions that may occur during these treatments.


Further Resources

If you are looking for additional online resources, please click the following links:

Postpartum Support International:

MGH Center for Women’s Mental Health:


** If you are having thoughts of harming yourself or your child, please call 911 or go to the local emergency department immediately.


Photo credit: Sewcream / Bigstockphoto

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