Background

Expecting a baby is an emotional time for anyone, but it can be particularly difficult if you experience mental health problems. Nearly one in every five pregnant women suffer from depression or anxiety. This leaflet will provide you with up to date information about antidepressants, support groups and alternative therapies.

 

Making the best choice for you and your baby

Understandably you may have some concerns about taking medication in pregnancy, but it is important to know that the benefits of taking antidepressants will far outweigh any potential risks to the baby. Women who remain well during pregnancy are less likely to have problems postnatally.

We want you to have a happy and healthy pregnancy, to feel supported in the choices you make, to receive relevant information, and to be aware of support groups in your area. We have a specialist mental health team who will give you individual advice and guidance.

Can antidepressant medication harm my baby?

The following information is based on the best evidence currently available.  Antidepressants do cross the placenta to the baby.  It is not known whether or not they increase the risk of miscarriage, preterm birth or low birth weight due to conflicting study results. Some studies show a very slight increase in the risk of Congenital Heart problems and Persistent Pulmonary Hypertension of the New-born (PPHN).  This is a very rare condition causing the baby to have breathing difficulties.  The rate of PPHN is approximately 1 in 1000 births and if you are taking antidepressants it is thought to increase to 2-3 in 1000 births, so it is still very rare and the vast majority of women taking antidepressants will have a baby with no complications.

Studies do not provide enough information to prove that antidepressants taken by a mother cause any other birth defects. 

Some babies exposed to antidepressant medication in utero may experience mild withdrawal symptoms such as jitteriness, irritability, poor feeding and sleeping.  These symptoms will gradually disappear without treatment but may last for two weeks. Mild withdrawal is not known to cause any long term problems.

Will my baby need extra monitoring?

Your baby will receive a full ‘new-born examination’ within 72 hours of birth, all babies have this.  If your baby shows signs of withdrawal your Midwife will help you to minimise the symptoms; skin to skin contact is the best way to calm and sooth a fractious baby. If you are concerned that your baby is unwell in any way, you must seek immediate medical advice.

Can I breast feed while taking antidepressants?

If you have taken antidepressants during pregnancy, you should be able to continue doing so during breastfeeding.  The amount of medication passing into breast milk is much less than the baby would be getting whilst you were pregnant. Breastfeeding in women who are taking antidepressants is   generally thought to be safe, although there are some exceptions.  It is important to discuss this with your midwife during pregnancy as breast feeding can also help to reduce the symptoms of withdrawal.

 

Are there any natural remedies for depression?

There are lots of things that you can do to help to keep mood fluctuations under control and whether or not you need medication. The following suggestions will benefit your mental and physical health during pregnancy.  It takes time and motivation to improve your health, but the long term benefits are well worth the effort.

 

Connecting with your baby

There is now evidence that a baby’s brain grows very rapidly in the last 20 weeks of pregnancy.  During this time a baby is sensitive to the sound of his surroundings and to his mother’s mood and feelings.  It is important to begin to develop a relationship with your baby from the time you feel him move inside you. This can have a positive impact on the emotional wellbeing of both you and your baby.

Taking a short time out each day to sit and think about your baby will help to raise the levels of a hormone called oxytocin, which can make you feel good.  Prolonged skin contact after your baby is born can help to calm you both and helps to maintain higher levels of oxytocin.  Continuing this connection after your baby is born can also help with the development of your baby’s brain and help your baby to develop into a more secure, happy child and adult.

 

Eat a ‘happy diet’

Eating healthily can help with mood in general but there are some foods that are serotonin enhancers, helping to raise the ‘happy’ chemical in the brain.  These foods are; oily fish and fish oil, flaxseed oil, coconut oil, eggs and sour cherries so include these foods in your diet.

Vitamin B plays an important role in the brain, producing chemicals that majorly impact on mood.  Foods rich in B vitamins are; spinach, turkey, bell peppers, cheese and oily fish.

Magnesium helps to keep chemicals in the brain stable and can be found in; bananas, spinach, almonds, cashews, pumpkin seeds, black beans and soymilk.

Avoid caffeine as although it will give you an initial boost you’re going to come crashing down; being over-caffeinated does not support the chemicals that regulate our mood.  Try camomile tea as it contains a flavonoid (naturally occurring chemical) that has relaxing properties and can aid sleep.

 

Exercise

Exercise is fundamental to mood; it releases endorphins in the brain, endorphins are what make us feel good and happy.  It does not have to be vigorous exercise; a fifteen minute walk can do wonders to lift your mood.  It can be hard to motivate yourself, especially when you are feeling low but any form of exercise brings about positive changes.

 

Mindfulness 

Becoming more aware of the present moment can help us enjoy the world around us more and understand ourselves better, mindful courses can help to streamline the abundance of thoughts and worries that we deal with on a daily basis. Mindfulness is recommended by the National Institute for Health and Care Excellence (NICE) as a way to prevent depression in people who have had three or more bouts of depression in the past.

 

Meditation

Although meditation is not a cure all, it has benefits for people suffering from depression as it involves moving from undesirable to desirable states, bringing happiness and peace. Mindful meditation is now a recommended therapy for people with depression and anxiety.

 

Online support

There are many online courses you can access;

 

Support in the community

You can contact your Midwife, Specialist Midwife or GP for advice.

First Step: 03001239122 you can refer yourself for psychological support

Mindful Meditation, to find sessions in your area telephone:  01228 319344

‘Happy Mums Foundation’ on: 07565 486745

Samaritans 116123

 

Confidentiality

‘The Trust’s vision is to keep your information safe in our hands.’ We promise to use your information fairly and legally, and in-line with local and national policies. You have a right to understand how your information is used and you can request a copy of the information we hold about you at any time.

For further information on confidentiality contact the Information Governance Team:

Information.Governance@ncic.nhs.uk | 01228 603961

Feedback

We appreciate and encourage feedback, which helps us to improve our services. If you have any comments, compliments or concerns to make about your care, please contact the Patient, Advice & Liaison Service:

pals@ncic.nhs.uk | 01228 814008 or 01946 523818

If you would like to raise a complaint regarding your care, please contact the Complaints Department:

complaints@ncic.nhs.uk | 01228 936302