Parenthood and mental health, part 1: Pregnancy and childbirth

Reviewed by Robert P. Bogenberger, Ph.D.

Pregnancy, childbirth, and parenting a newborn are rewarding as well as exhausting. The nine months of pregnancy and first year of your child’s life can feel like a whirlwind. Change affects nearly every aspect of your life, including your identity, body, relationships, finances, and expectations at both work and home. It’s no wonder pregnancy, childbirth, and parenthood can affect your mental health.

Like any major life transition, parenthood can involve common mental health struggles that are usually temporary and resolve on their own. However, some mental health conditions associated with pregnancy and parenthood may require professional help.

Do only biological mothers struggle with pregnancy and parenthood?

Parenthood can cause or intensify mental health problems for all types of parents, not just people who give birth.

Mental health is important for mothers, fathers, biological parents, stepparents, adoptive parents, foster parents, surrogate mothers, and other types of guardians. It’s important for all types of families and households: those with single parents, heterosexual parents, same-sex parents, gender-nonconforming parents, and more.

In this article, we’ll sometimes use terms like “mother” and “maternal” to refer to the parent who experiences pregnancy and gives birth to a child. However, we recognize and affirm that not all people who give birth identify as mothers or women, and not all mothers give birth to their children.

Whether you consider yourself a mother, father, parent, or guardian, what’s most important is that you prioritize your mental health so you, your child, and your family can flourish.

Pregnancy: Prenatal mental health challenges

Pregnancy can be a joy and a wonder, as well as a source of stress and anxiety. It may bring a range of emotions. You may face prenatal mental health challenges, which can be complicated by your health, your pregnancy’s circumstances, your family history, and other societal factors.

Health and pregnancy

Your health can affect your pregnancy—and vice versa—in a number of ways:

  • History of mental illness: If you’ve struggled with your mental health before pregnancy, you may be likelier to struggle with it during pregnancy and after birth. Your risk may also be greater if any mothers or grandmothers in your family had mental health challenges during their pregnancies.
  • Disability: If you have a disability, discrimination and lack of accessible care may make it difficult to get the physical and mental health care you need.
  • Nutrition: If you’re unable to access proper nutrition, it may impact your physical and mental health during pregnancy. Your child’s health may be affected also.
  • Difficult pregnancy: Some pregnancies are more difficult than others. Morning sickness, chronic pain, long-term bed rest, and other prenatal challenges can affect your physical and mental health.

Unwanted or unexpected pregnancy

Your stress can increase dramatically if your pregnancy is unwanted or unexpected. Deciding whether to see the pregnancy to term, deciding whether to raise a child if your pregnancy is brought to term, and dealing with outside pressure to decide one way or another brings stress that can be harmful and traumatizing, especially if you’re a minor.

Having negative, complicated, or conflicting feelings about your pregnancy can contribute to or cause:

If you’re pregnant and in crisis or thinking about ending your life, help is available now. Call the National Suicide Prevention Hotline at 1-800-273-TALK (8255) for free, confidential help 24/7. You can also chat online or text HOME to 741741 to speak with a crisis counselor.

High-risk or “miracle” pregnancy

On the other end of the spectrum, you may feel added stress or anxiety because you desperately want to carry a high-risk pregnancy to term. Pressure can intensify further if you’ve experienced the trauma of infertility, miscarriage, stillbirth, or the loss of an infant or child.

Societal factors

Life’s injustices and inequalities don’t disappear when you become pregnant. Societal factors that can affect your pregnancy include:

  • Socioeconomic class: If you’re working class or poor, it may be hard to access the health care you need.
  • Gender norms: Cultural expectations around gender may pressure you to conceive, carry a pregnancy to term, or be a “perfect” parent.
  • Lack of family support: If you feel alone in your pregnancy due to a lack of support from your family or partner, you may struggle more with your mental health.
  • Work stress: The United States is the only developed nation to not guarantee paid maternity leave for new mothers. While some may take up to 12 weeks of unpaid maternity leave, they may not be able to afford it, or they may face retaliation or discrimination when returning to work.1 Pregnancy may increase your stress if you’re already unemployed or underemployed.

Childbirth and perinatal mental health challenges

“Perinatal” refers to the time period shortly before and after childbirth. It covers both prenatal and postpartum mental health challenges. Common sources of concern during this period include:

  • Childbirth: The process of giving birth may be intimidating or frightening if this is your first delivery or if you’ve previously had a negative childbirth experience. Anxiety around labor and delivery may worsen as your due date draws closer.
  • Maternal mortality: The US has the worst maternal mortality rate of any developed nation.2 Black mothers in particular face an elevated risk due to systemic racism in the US healthcare system.
  • Traumatic births: Giving birth can be physically, mentally, and emotionally traumatic for you, your partner, and loved ones witnessing the birth. It can also be traumatic if your child has health complications or concerns.
  • Grief: You may experience heightened anxiety if you’re at increased risk for the loss of your child or the loss of your own health, including your reproductive capabilities. If any of these potential losses occur, grief will follow.
  • Feeding difficulties: It’s common for babies to experience feeding problems, by breast or bottle. This can cause anxiety or shame, particularly if your baby has reflux, has trouble gaining weight, or has trouble breastfeeding.
  • Babies with additional considerations: Taking care of a newborn is exhausting in its own right. This can be further complicated if your baby shows signs of colic, if your child is born prematurely, or if you’re caring for multiples.
  • The fourth trimester: The first 12 weeks following childbirth are often referred to as “the fourth trimester.” Your body goes through almost as many changes as it did during pregnancy. Parents have to adjust to a new routine of feeding and caring for their baby 24/7 as they battle sleep loss, hormonal changes, and other physical and mental health challenges.

Get help now

If you’re pregnant or a new parent and are having symptoms of anxiety, depression, or any of the mental health conditions discussed here, help is available now:

  • Find a therapist: Browse our provider directory to find a counselor near you.
  • Medication: Your doctor may decide that therapy and medication together are your best treatment option. You may be prescribed medication even while you’re pregnant. It’s important to follow your doctor’s treatment plan as prescribed.
  • Support groups: Pregnancy and parenthood can be isolating experiences. Joining a support group is often helpful, especially for new parents.

Read Part 2 of this article to learn about postpartum mental health challenges and discover ways to support parents from pregnancy through a child’s first years.