Maternal Mental Health Treatment During Pregnancy: Why It Matters
- Mary Cunningham
- 7 days ago
- 5 min read
Pregnancy is often imagined to be a joyful time, but approximately 1 in 10 women finds that pregnancy brings anxiety, depression, and emotional overwhelm or even exacerbates pre-existing mental health conditions. Many women are hesitant to treat mental health conditions during pregnancy due to uncertainty about how medications might affect their infant. 1 While that
concern is valid, the reality is that untreated mental health conditions during pregnancy can affect both the mother and the fetus. It is important to know that caring for your mental health during pregnancy is just as important as other health measures that you might take for your baby’s growth and development. The good news is that there are low-risk, evidence-based options, including medication, therapy, and holistic supports, to help improve your mental health without guilt or fear that treatment might harm your baby.
How does an untreated mental health condition affect your baby?
Recent research is beginning to make the connection between maternal mood disorders during pregnancy and fetal outcomes. While the exact mechanisms linking the two remain unclear, it seems evident that certain conditions and exposures during pregnancy are associated with epigenetic changes in the fetus. Put simply, what the mother experiences during pregnancy can switch fetal genes on or off, making her baby more likely to experience certain health and growth outcomes. For example, when depression goes untreated during pregnancy, the baby may have a greater chance of being born early, with low birth weight, or slowed growth before birth. 1
Mothers with perinatal mood disorders, specifically in the antepartum period, tend to have children who are more susceptible to mental health concerns than others. Maternal depression during pregnancy has been connected to higher odds of depression, regardless of the mother’s mood postpartum, indicating an intrauterine influence on mood rather than the infant’s postpartum environment or genetic makeup. Similarly, excessive maternal cortisol from stress or depression in pregnancy has been tied to children’s altered stress responses and greater anxiety traits. Another study of mothers with higher levels of anxiety/depression in the third trimester was associated with higher levels of DNA methylation on a gene that encodes the human
glucocorticoid receptor, which affects how the body responds to cortisol. What this means on a functional level is that their infants’ stress response is more likely to be heightened, which can increase the child’s risk for anxiety and depression later in life. 2
It is critical to mention this: while prenatal exposure to a maternal mood disorder does increase a child’s tendency toward a disorder, it does not guarantee that a child will develop one. One systematic review of multiple research studies noted that while epigenetic changes have been
noted in the children of mothers with anxiety or depression during pregnancy, the likelihood is only somewhat increased. Additionally, that likelihood was noted to be inconsistent across different studies. 3,4
The bottom line is that multiple factors can contribute to the development of anxiety and depression, and no mother should ever feel responsible if their child eventually has symptoms of those disorders. However, it is important for pregnant mothers or those desiring to become pregnant to understand that leaving mental health conditions untreated has the potential to change their child’s trajectory.
How does an untreated mental health disorder affect your pregnancy?
Untreated mental health disorders during pregnancy can affect mothers far beyond the initial nine months they carry a child, including risks to both mental and physical health. Mental health risks include a higher chance of postpartum depression and suicidality after delivery. High-risk
behaviors such as smoking, substance abuse, and poor nutrition are more common in pregnant women with mood disorders. Pregnancy complications such as preeclampsia and premature delivery are more likely to occur, as well. The negative outcomes that can result from untreated mood disorders may affect the dynamics of the family unit, continuing to impact the newborn
past the first few months of life and into childhood. 5
What treatment options are available during pregnancy?
Providers and patients should work together to find a treatment that takes both maternal stabilization and neonatal health into account. Providers trained in caring for women with mood disorders during pregnancy will consider a range of factors when recommending treatments, such as maternal age, gestational age, and potential drug interactions. While no treatment option is risk-free, the benefits of treatment often outweigh the risks.
Many providers will first offer a safe psychotropic medication as the primary treatment for mood disorders during pregnancy. As an increasing amount of data related to medication used during pregnancy is collected and analyzed, encouraging findings are emerging about the safety and effectiveness of these medications. For example, one recent study found that medication risks are
less significant than the complications associated with lack of treatment. 6 Studies have also shown that SSRIs, a group of commonly used antidepressants, do not increase the risk of conditions such as ADHD, autism, behavioral and speech disorders, and intellectual disabilities. 1 Additionally, they may provide some protective effects in reducing the number of preterm births and cesarean sections. 7 While some infants born to mothers on psychiatric medications
may experience poor neonatal adaptation, including temporary respiratory, gastrointestinal, and neuromuscular issues, these effects are generally self-limiting, often resolving within a few hours to about a week after birth.
Although medication therapy is often considered first-line treatment for addressing mood disorders during pregnancy, psychotherapy is another evidence-based option that has been shown to be an effective intervention. Therapy can help mothers learn how to build emotional regulation
skills, strengthen motivation, challenge negative thought patterns, and improve cognitive flexibility. 8 These tools can support not only mental health, but also physical well-being and overall quality of life. Cognitive-behavioral therapy and interpersonal therapy are two methods that have shown good results during pregnancy and are considered gold-standard interventions to treat anxiety and depression during pregnancy. Data indicate that psychotherapy has a medium
effect on improving depression. Thus, for women who prefer to avoid medication or want to add another layer of support, psychotherapy can be a meaningful and effective part of their care plan.
For women who prefer to explore additional treatment options, there are several complementary and alternative approaches that may help support mood during pregnancy. Supportive strategies beyond medication and psychotherapy, such as regular exercise, mindfulness, yoga, bright light
therapy, acupuncture, massage, and certain supplements like omega-3 fatty acids or folate, may also be helpful for some patients. 9 These approaches can be valuable additions to care, but they should be discussed with a qualified clinician to ensure they are appropriate and safe for both mother and baby.
What should you know before making treatment decisions?
Overall, research continues to shed light on how untreated mental health concerns can affect a baby during pregnancy, and it reinforces an important truth: there is no one-size-fits-all approach to care. Every treatment option comes with potential risks and benefits, which is why having a provider who listens, collaborates, and helps guide you through those choices can make such a
difference. With the right support, mothers can feel empowered to make informed decisions that protect both their own well-being and their baby’s health. Knowledge truly is power, and every mother deserves compassionate care, education, and the confidence to choose the path that feels right for her.
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