Depression, Anxiety During Pregnancy Are Underreported

Less than 20 percent of pregnant women diagnosed with depression previously reported symptoms to their doctor.

A federal task force recently recommended that pregnant women be screened for depression because it’s common, yet they don’t tend to report it.

One study estimated that 1 in 7 women develop depression during pregnancy or during the first 12 months after delivery. Yet, most women with depression don’t report symptoms to their doctors.

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The reasons vary, but include pregnant women’s inability to recognize symptoms or differentiate them from symptoms related to the pregnancy itself.

Part of the urgency behind the task force recommendation is the “devastating” effect untreated depression can have on you and your family, according to the American College of Obstetricians and Gynecologists (ACOG).

“Among the common causes of maternal mortality, suicide exceeds both hemorrhage and hypertensive disorders,” ACOG President Mark S. DeFrancesco, MD, said in a statement. “Clearly, it is essential that perinatal depression be recognized as a serious medical condition with long-term implications for the mother and for her family.”

Additionally, studies have found that depression during pregnancy can increase the risk of problems during delivery, and lead to low birth weights and premature babies.

“Depression during pregnancy is (also) known to be associated with harmful prenatal health consequences, such as poor nutrition, poor prenatal medical care, risk of suicide, and harmful health behaviors (e.g., smoking and alcohol or other substances),” according to the Agency for Healthcare Research and Quality.

Perinatal depression often goes unrecognized because health professionals may see changes in “sleep, appetite, and libido” as part of normal pregnancy and postpartum changes, ACOG says. “In addition to clinicians not recognizing such symptoms, women may be reluctant to report changes in their mood,” the organization adds.

Pregnant women and new mothers have reported fear of being judged over depression and the social stigma attached to it in general. You’re also led to believe you should be happy over having a baby, which may add to your reluctance over talking about feeling down.  

The task force appeal to have all pregnant women screened, at least within a year after birth, is part of a wider-ranging recommendation for screening of all adults for depression.

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The independent panel of experts didn’t review depression in pregnant and postpartum women previously, and there were no prior recommendations for screening them.

The addition of the recommendation specific to pregnant women bolsters standing ACOG guidelines for depression screening and the well-woman visit, DeFrancesco said. The ACOG calls for routine depression screening for all women at least once during the perinatal period.

“(The) ACOG’s committee opinion also adds that women at high risk of depression – for example, with a history of depression or anxiety – warrant especially close monitoring by their physicians,” he said.

In 2014, an article by the American Psychological Association said perinatal depression was not being “well addressed,” and it called for the education of pregnant women on how common depression and anxiety actually is.

“(Depression) is under-identified, and even when identified, often inadequately treated,” the authors wrote. “Among the almost four million women who give birth annually in the United States at least 13 percent experience a major depressive disorder, with many more having significant symptoms that compromise their ability to care for themselves and their families.”

You won’t necessarily become depressed or have more than an expected level of anxiety over having a baby, but you will benefit from knowing that it could happen, and that it is common.

That knowledge is especially important if you have a history of depression or had depression during a first pregnancy and are expecting another child, making you more susceptible.

Experts urge you to come forth with mood changes you have during pregnancy. It’s not all sunshine and rainbows, they say, and you don’t have to pretend to feel that way.

“Because perinatal depression is a health problem, it is not the fault of any woman,” a federal self-help booklet makes crystal clear.