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7) Bookshelf NBK582663
7) Bookshelf NBK582663
This sheet is about having depression in a pregnancy or while breastfeeding. This information should not take the place
of medical care and advice from your healthcare provider.
What is depression?
Depression is a serious medical illness that can have different causes. It can change how someone feels, thinks, and acts.
The most common symptoms of depression are long-lasting and strong feelings of sadness and not being able to feel
pleasure or happiness. Other symptoms include anxiety, irritability, trouble concentrating, fatigue (feeling very tired), and
thoughts of death or self-harm. Physical symptoms of depression can include increased heart rate, loss of appetite,
stomach pain, and headaches.
Pregnancy may trigger the development of depression in some people. This may be due to changes in hormone levels
during pregnancy and the stress that comes with this major life event. Treatment for depression can include counseling,
psychotherapy, and / or medications.
I have depression and I am planning on getting pregnant. Is there anything I need to know?
Talk to your healthcare providers about your plans to get pregnant so they can review your current health and treatments.
Sometimes, changes in treatment may be recommended before or during pregnancy.
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complications for the person who is pregnant and their baby. If the person who is pregnant has depression, they may also
have changes in their sleeping or eating patterns.
Does having depression in pregnancy affect future behavior or learning for the child?
Some studies have shown untreated depression in pregnancy may negatively affect a child’s behavior or development.
I do not want to take my medication for depression during my pregnancy. My healthcare provider said this could be
worse for my baby and me. Is this true?
Studies have found that people who are pregnant with depression and their babies typically have better outcomes if they
receive treatment compared to having untreated depression.
Stopping your medication could lead to a return of your symptoms of depression (relapse). One study found that those
who stopped their medications for major depression had a 5 times greater risk of relapse during pregnancy compared to
those who stayed on their medications. Restarting the antidepressant medication lowered the chance of a relapse, but it
did not completely prevent the relapse in all cases. A relapse of depression during pregnancy could increase the risk of
pregnancy complications.
It is important to talk with your healthcare providers before making any changes to how you take your medication. Your
healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness
during pregnancy. Consider your personal feelings, the severity of your symptoms, any past hospitalizations, how quickly
symptoms have returned in the past if you have ever gone off medication, and how quickly you respond when you
restart medications.
If you decide to stop your antidepressant medication, your healthcare provider may suggest that you slowly lower your
dose before you stop completely. This is to help prevent possible withdrawal symptoms that some people experience
when they suddenly stop taking antidepressants. It is not known what effects, if any, withdrawal could have on a
pregnancy.
I feel so sad and have so little energy that I am having trouble going to my prenatal care appointments. Can this affect
my baby?
Regular prenatal appointments can help to improve outcomes for you and your baby. It is not uncommon for people with
depression to not feel motivated or have the energy to participate in parts of their day-to-day life, including going to your
appointments. Studies have found that people with mental health conditions, including depression, go to less than half of
their prenatal care appointments. Studies have also shown higher rates of preterm births and deaths in the newborn period
in the babies of those who did not have appropriate prenatal care.
Do people with depression during pregnancy have a higher chance of having postpartum depression or mood
disorders?
One of the most serious effects of not treating depression during pregnancy is the increased chance for postpartum
depression (PPD). PPD is depression following childbirth. While the general population risk for PPD is approximately 5-
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15%, a number of studies have shown higher rates of PPD among individuals who were depressed during their pregnancy.
Reports have suggested that PPD may make it harder for a person to take care of and bond with the baby. This might
have a negative effect on the baby’s development and behavior.
Some people may struggle with depression while breastfeeding. Find people who are supportive such as family, friends,
your healthcare provider, or a lactation consultant. Ask for help if you have any concerns or trouble with nursing. You can
contact a MotherToBaby specialist to discuss your treatment while breastfeeding. Be sure to talk to your healthcare
provider about all of your breastfeeding questions.
If a male has depression, could it affect fertility (ability to get partner pregnant) or increase the chance of birth
defects?
Some reports have found depression in males can decrease the chance of conceiving a pregnancy. Depression and
anxiety in male patients have been shown to lower semen volume and sperm density. Some studies have found that 2%
to 9% of males can experience depression during a partner’s pregnancy. Emotional well-being is important, not only for
a person’s health, but also for the health and support of their partner and children. Anyone who has symptoms of
depression should seek appropriate care. In general, exposures that fathers or sperm donors have are unlikely to
increase the risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at
https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.
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Selected References:
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• Bennett HA, et al. 2004. Depression during Pregnancy. Clin Drug Invest; 24 (3): 157-179.
• Bennett HA, et al. 2004. Prevalence of Depression during Pregnancy: Systematic Review. Obstet Gynecol; 103: 698-
709
• Berard A, et al. 2017. Antidepressant use during pregnancy and the risk of major congenital malformation in a
cohort of depressed pregnant women: an updated analysis of the Quebec Pregnancy Cohort. BMJ Open 7:e013372.
• Bonari L et al. 2004. Perinatal Risks of Untreated Depression during Pregnancy. Can J Psychiatry; 49:726-735.
• Burt VK & Stein K. 2002. Epidemiology of Depression throughout the female life cycle. J Clin Psych; 63 (suppl 7): 9-
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• Centers for Disease Control and Prevention. 2018. Depression Among Women of Reproductive Age:
https://www.cdc.gov/reproductivehealth/Depression/
• Chisolm MS, Payne JL. 2016. Management of psychotropic drugs during pregnancy. BMJ; 532:h5918.
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Schizophrenia and Major Affective Disorders. Am J Psychiatry; 162: 79-91.
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