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Maternal mental health matters

Why Maternal Mental Health Matters: Caring for Your Mind During Pregnancy and Beyond

Elaine Candeloro, DNP, APRN, FNP-C, CNM

Pregnancy is one of the most profound transformations a person can experience. In less than a year, your body, hormones, relationships, career, finances, identity, and daily routines can change dramatically. While much of the focus during pregnancy is on physical health, your emotional well-being is just as important, and the two are deeply connected.

Pregnancy Changes Everything

Every pregnancy is unique, and every person experiences this transition differently. Some pregnancies are carefully planned, while others come as a surprise. Regardless of how your journey begins, becoming responsible for another life can bring excitement, uncertainty, joy, fear, and everything in between.

Pregnancy also has a way of bringing unresolved emotions to the surface. Previous trauma, pregnancy loss, difficult childhood experiences, relationship challenges, or past abuse may become more noticeable during this time. Hormonal changes can amplify emotions, while physical discomfort, financial concerns, career decisions, and changing family dynamics add additional stress. Friends, family members, coworkers, and even strangers may offer unsolicited advice or comment on your body, birth plans, or parenting decisions.

If something feels emotionally triggering during pregnancy or childbirth, tell your healthcare provider. We want to know. Understanding your concerns allows us to help create a safer, more supportive experience.

It's also important to remember that emotional symptoms can sometimes be caused—or worsened—by physical conditions such as thyroid disorders, anemia, vitamin deficiencies, chronic pain, sleep deprivation, or pregnancy complications. If you are struggling, don't assume you simply have to "push through."

Pregnancy Is Predictably Unpredictable

One of the most challenging aspects of pregnancy is that no two experiences are exactly alike.

If possible, schedule a preconception visit before becoming pregnant. This provides an opportunity to discuss your

medical history, medications, mental health, nutrition, and answer any questions before pregnancy begins.

Once pregnant:

  • Establish prenatal care early.
  • Attend childbirth education classes.
  • Learn about breastfeeding, newborn care, and postpartum recovery.
  • The books “Birth Vibes” by Jen Hamilton and “Nobody Told Me About That: The First 6 Weeks” by Ginger Breedlove are excellent resources for navigating what to expect during delivery and postpartum. 
  • You cannot prepare for every surprise—but education helps replace fear with confidence.

Caring for Yourself

Eating nutritious foods, staying physically active, prioritizing sleep, and staying hydrated are some of the many things you can do to support the health of yourself and your baby.

In addition to attending to your physical wellbeing, nurture your spirit.

Continue activities that bring you joy. Spend time with supportive people. Read books, enjoy hobbies, listen to music, take walks, laugh often, and make time for rest.

Sometimes We Don't Recognize Our Own Mental Health Symptoms

Mental health concerns are not always obvious to the person experiencing them. You can expect that your healthcare provider will frequently ask about your mental health, and sometimes offer a screening tool to ask specific questions.

It's also helpful to perform your own "mental inventory" every so often.

Ask yourself:

  • Am I enjoying things I used to enjoy?
  • Am I sleeping when I have the opportunity?
  • Do I feel constantly overwhelmed?
  • Am I worrying more than I can control?
  • Have I become someone I don't recognize?

Discuss these questions with your partner or someone you trust. They may notice changes before you do.

Signs of Anxiety

While occasional worry is completely normal, anxiety becomes a concern when it interferes with daily life.

Symptoms may include:

  • Racing heart or palpitations
  • Constant worry or feelings of dread
  • Difficulty concentrating
  • Insomnia despite feeling exhausted
  • Obsessive planning, list-making, or researching
  • Feeling an overwhelming need to control every detail
  • Becoming "stuck" or unable to make decisions
  • Physical symptoms such as nausea, shaking, chest tightness, or shortness of breath
  • Intrusive thoughts that feel upsetting or difficult to dismiss

Intrusive thoughts are surprisingly common after having a baby. They do not mean you want to harm your baby. However, if these thoughts become frequent, distressing, or difficult to manage, please tell your healthcare provider.

Effective treatment is available.

Signs of Depression

Depression during pregnancy and after birth is common and treatable.

Symptoms may include:

  • Persistent sadness or hopelessness
  • Changes in appetite
  • Sleeping much more—or much less—than usual
  • Loss of interest in activities you once enjoyed
  • Difficulty bonding with your baby
  • Feeling overwhelmed or emotionally numb
  • Excessive guilt or feelings of worthlessness
  • Neglecting daily responsibilities
  • Thoughts that your family would be better off without you

These symptoms are not a sign of weakness, and they are not a reflection of your ability to be a good parent.

Postpartum Psychosis: A Medical Emergency

Postpartum psychosis is rare, but it is a true medical emergency that requires immediate treatment.

Warning signs include:

  • Hearing voices or seeing things that others do not
  • Hallucinations or delusions
  • Severe confusion
  • Extreme agitation
  • Inability to sleep for prolonged periods
  • Refusing to eat or drink
  • Behavior that seems dramatically different from normal

If you or someone you love experiences these symptoms, call 911 or go to the nearest emergency department immediately.

It Takes a Village

Building a support system before your baby arrives can make the transition into parenthood much smoother.

Your village may include:

  • Your partner
  • Family members
  • Close friends
  • Childbirth education classes
  • Exercise groups for parents
  • Faith communities
  • Parent support groups
  • Story time at your local library
  • Other parents who are navigating the same season of life

If you're new to town—or the first person in your friend group to have a baby—building a village may take intention.

Here are a few local resources to help you get started:

  • FIT4MOM Denton: Fitness classes and community support for mothers before and after pregnancy.
  • Denton Public Library: Free infant and toddler story times that provide opportunities to connect with other parents.
  • MOM Co: www.themom.co Faith-based, supportive community for mothers

Social Media and the Impact on Mental Health

Social media is still relatively new, and we're continuing to learn how it affects mental health.

Ask yourself honestly:

Have you ever finished scrolling and genuinely felt better?

Algorithms quickly learn your fears and feed you more content related to them.

While social media can provide education, practical tips, and a sense of community, it can also leave parents feeling confused, fearful, guilty, or like they're never doing enough.

If you notice social media increasing your anxiety, consider replacing some screen time with trusted educational resources, books, podcasts, local classes, or conversations with healthcare professionals.

When Professional Help Is the Right Choice

If you have a personal history of anxiety, depression, bipolar disorder, obsessive-compulsive disorder, trauma, or previous postpartum depression or anxiety, don't wait until symptoms become severe.

Establish care with a mental health professional during pregnancy whenever possible.

You don't need to be in crisis to benefit from counseling. Many parents find that scheduling a dedicated mental wellness visit during pregnancy gives them tools to navigate the transition into parenthood more confidently.

Also review your insurance benefits and employer assistance programs. Many plans now include virtual counseling, making mental health care more accessible than ever.

Most importantly, know that asking for help is a sign of strength—not failure.

You Deserve Support

You are not expected to navigate pregnancy or parenthood perfectly.

Some days will feel joyful. Others may feel overwhelming.

Whether you're experiencing mild anxiety, postpartum depression, intrusive thoughts, or simply feeling unlike yourself, help is available—and treatment works.

Please don't wait until you're in crisis. Talk with your obstetric provider, primary care provider, therapist, or another trusted healthcare professional.

Taking care of your mental health is one of the most important things you can do for yourself, your baby, and your growing family.

Local Maternal Mental Health Resources

  • Denton County Public Health – LINKS Program: Free care coordination that connects residents with mental health services, counseling, crisis resources, and community support.
  • University Behavioral Health Denton – Lotus Program for Women: Specialized inpatient and outpatient mental health care for women experiencing pregnancy-related or postpartum mood disorders.
  • Denton County MHMR Center (My Health My Resources): Behavioral health services, crisis intervention, counseling, and psychiatric care.

National Resources

If you need support, you are not alone.

  • Postpartum Support International (PSI) – www.postpartum.net
  • National Maternal Mental Health Hotline
    • 1-833-TLC-MAMA (1-833-852-6262)
    • Available 24 hours a day in English and Spanish.
  • 988 Suicide & Crisis Lifeline
    • Call or text 988 anytime for immediate mental health support.
  • SAMHSA National Helpline
    • 1-800-662-HELP (4357)
    • Free, confidential treatment referral service available 24/7.National Resources