The perinatal period includes: Preconception; Pregnancy; The first months after birth. Throughout this period, women suffer significant transformations, challenges and changes are multiple and not always simple to deal with or overcome. Knowing how to recognize the signs and when to seek professional help can make difference. And this both to the physical and mental health of the woman and her child and to the well-being of the couple and their growing family. Therefore, having mental health professionals in health teams that follow up women who want to become mothers is desirable and increasingly common. All phases are important The months before conception – the periconceptional period – are crucial for reproductive health. There are emotional factors that play an important role in fertility and may interfere with the ability to get pregnant . In turn, the difficulty in achieving a desired and planned pregnancy for physical reasons negatively affects the couple emotional stability. From a biological point of view, pregnancy and postpartum expose the mother to several hormonal changes that have an impact on the brain and can influence the regulation of emotional processing. Postpartum hormonal changes and the perception of the baby emotional signals can also influence the mother cognitive and emotional processing, making her more vulnerable to anxiety and depression . Depression and anxiety It is estimated that during pregnancy, depression symptoms have a prevalence of 7%-25%. In the postpartum period, its prevalence is 10%-20%. Depression in pregnancy are associated with: Greater risk of obstetric complications; Difficulties in bonding and baby development. Postpartum depression is associated with: Changes in the mother’s behavior; Interference in mother-child interaction; Problems in the child cognitive and socio-emotional development. Anxiety disorders have been less studied in the perinatal period, despite their estimated prevalence of 20%. High levels of maternal anxiety during pregnancy are associated with: Obstetric complications; Premature birth; Low baby weight at birth; Emotional and behavioral problems in childhood and adolescence. In the postpartum period, maternal anxiety has been associated with: Increased use of health services; Reduction of the breastfeeding period, especially in primiparous women (first birth). It is important to highlight that there is a high rate of comorbidity between anxiety and depression, both for the general population and for pregnant women. Furthermore, anxiety symptoms are a risk factor for the development of postpartum depressive symptoms. The importance of the support network One of the factors that affects the risk of presenting symptoms of anxiety and/or depression during the perinatal period is the kind of support that the mother receives during this phase and the capacity of her social network to provide both the necessary emotional support and support in practical day-to-day issues. During pregnancy, higher levels of social support are associated with reduced anxiety , a greater perception of control and lower rates of postpartum depression. Seek for professional help Seeking care from mental health professionals is the path that women who need support in this area should follow. There are several possible approaches to supporting women at any stage . Psychological support , with sessions it is possible to talk openly about concerns, emotional or other issues, with a clinical psychologist. This can help finding ways to manage different feelings and emotions and implement strategies that provide relief from the complaints. Psychopharmacological approach , to be considered whenever necessary, as there are currently safe medications for pregnant and breastfeeding women, and which can be very effective in treating depression, anxiety, sleep disorders, among other problems. As in all situations, also for mental health, receiving adequate information from a psychiatrist and being able to make informed and conscious decisions are crucial elements to achieve positive results. In most cases, success results from a combination of different strategies, which are tailored and adapted to each specific case, and implemented in collaboration with the maternal health team that follows each woman. Author : Rita Navarro In the Hospital da Luz network you can find psychiatrists and psychologists dedicated to perinatal mental health. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
