Antepartum depression: symptoms, causes, and treatment

You’ve probably heard of postpartum depression. But what about antepartum depression?

To put it simply, antepartum depression occurs during pregnancy. It’s a common problem for pregnant women, yet isn’t discussed as often. Let’s explore what causes antepartum depression and strategies to alleviate it.

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Antepartum means “before giving birth,” so by definition, antepartum depression happens during pregnancy. You may also hear it called prenatal depression. 

Antepartum depression is a common issue, affecting up to 15% of pregnant people. This may be surprising since there’s a cliche that pregnant women are glowing and happy (Chatillon, 2010). If you don’t feel that pregnancy glow, don’t worry––many women feel this way and it’s completely normal. 

How do you know if you’re just feeling low or have antepartum depression? The symptoms look similar to signs of depression but are related more to pregnancy and childbearing. 

Symptoms of antepartum depression include (Meltzer-Brody, 2011):

• Persistent feelings of sadness or emptiness

• Fatigue

• Irritability

• Loss of interest in daily activities

• Suicidal thoughts

• Obsessive worrying or thinking

You might wonder: aren’t some of these just part of being pregnant? Who doesn’t experience fatigue and irritability during pregnancy? Isn’t it okay to obsess over my new baby? Yes, but only to an extent; these feelings should come and go or get better with time. 

If you find as the weeks go by your fatigue isn’t improving, you’re obsessing over things you can’t control, and you’re experiencing a decreased quality of life, it may be antepartum depression.

The exact causes of this condition are unknown, but research is ongoing. There’s a good chance it’s influenced by the huge hormonal swings pregnant people experience––plus the mental stress and physical discomforts of pregnancy (Meltzer-Brody, 2011).

Risk factors for antepartum depression include (Lancaster, 2010):

• Stress

• Maternal history of depression or anxiety

• Lack of social support

• Unintended pregnancy

• Domestic violence

• Low socioeconomic status (like little income or limited access to health resources)

• Being single or your relationship quality is poor

These things tend to correlate with (or happen alongside) depression in pregnancy—but they don’t guarantee it. So if any of these circumstances apply to you, that doesn’t mean you’ll experience antepartum depression. 

However, if you think you’re at higher risk for depression during pregnancy, keep a close eye on how you feel and lean on loved ones for support. If you start experiencing symptoms of antepartum depression, seek medical advice to keep you and your baby safe and healthy. 

Several screening tools are used to identify whether a pregnant person is depressed, although none were developed specifically for pregnancy. These include:

• The Edinburgh Postpartum Depression Scale

• The PRIME-MD Patient Health Questionnaire

These are short surveys that ask about your recent thoughts and feelings. These answers can help a health professional identify whether you’re experiencing symptoms of depression.

Depression can feel overwhelming to deal with, but there are many options (both medical and non-medical) to help you feel more happy and stable during pregnancy.

1. Enhance your social support network

It takes a village to raise a child, but it also takes a village to support a pregnancy. It’s normal to feel unable to meet the challenges of daily life like you could before you were pregnant—so lean on your family and friends. 

Maybe it’s asking a loved one for help cooking or cleaning, or you just need someone to vent to. You can also connect with other pregnant people, healthcare providers, and local doula groups. Libraries have good resources if you’re looking for community support groups.

Antepartum depression also puts you at risk of postpartum depression, so make sure to lean on friends and family in the postpartum period too.

2. Seek counseling or therapy

Research shows that combining social and emotional support with mental health treatment—including therapy— is the most effective way to deal with antepartum depression (ACOG, 2022). 

Many types of therapy are proven to help depression during pregnancy, including (Meltzer-Brody, 2011):

• Cognitive behavioral therapy (CBT)

• Interpersonal psychotherapy

• Group therapy

• Family or couples therapy

You can do talk therapy in-person or easily do online therapy from a phone or computer at home. You may only try it once or twice or go regularly throughout pregnancy.

3. Reduce stress

Finding ways to relieve stress is vital for our overall well-being, but it’s especially important during pregnancy. 

Here are some strategies for self-care to support a healthy pregnancy in both mind and body:

• Get quality sleep: Fatigue makes everything more difficult, let alone experiencing it during pregnancy or depression. Practice good sleep hygiene and get eight or more hours of deep sleep. Using a pregnancy pillow may help make sleep more comfortable. 

• Eat a nourishing diet: Your body is doing something complicated and incredible, and it needs good fuel. Eating plenty of leafy greens, nuts, beans, eggs, fruit, and healthy fats will help get you the nutrients you need so you aren’t feeling depleted.

• Seek support at work: Ask for modified or light duty if you have a job where you’re on your feet a lot. If you need a day off and can take one, do so. 

• Triage your to-do list: Decide what tasks you absolutely must do and drop the others.

• Practice saying no: This goes back to your to-do list. Say no to anything that isn’t a high priority (or something you don’t feel like doing). Don’t feel guilty turning down extra requests at work or even from friends or family.

• Ask people to come to you: Try to make meetup locations convenient for you, rather than traveling to meet people.

• Practice coping skills: Developing healthy coping skills looks different for everyone. Some examples include mindfulness, meditation, and positive self-talk. 

If you’re in a violent domestic situation, seek support or ways out. Even though it feels scary and uncertain, your safety is the most important thing for you and your baby. Confidential support systems like the National Domestic Violence Hotline are free and available to help. 

4. Prescription drugs

If other strategies aren’t enough, medication is an option. Many prescription antidepressants are safe to take during pregnancy and help you feel more stable. It’s important to discuss the pros and cons of antidepressants during pregnancy with your healthcare provider (Chatillon, 2010). 

Pregnancy alone brings on physical and emotional challenges. Dealing with depression on top of that can be a scary and difficult prospect. It may also make you worry that antepartum depression might harm your baby somehow.

Some studies found that the condition puts infants at risk of premature birth and low birth weight. These complications are also possible from the mother not taking good care of herself due to antepartum depression (Schaffir, 2018).

Postpartum depression and delivery complications may also be concerns. If you have poor mental or physical health, it’s harder to adequately care for a newborn, especially if you’re a new mom yourself (Chatillon, 2010).

Don’t panic if you feel depressed during pregnancy—it isn’t necessarily going to affect you or your baby. One study found that birth outcomes among depressed pregnant women were on par with those who weren’t depressed (Larsson, 2004).

Many factors influence why some people have birth complications and others don’t, but antepartum depression is essential to treat regardless (Schaffir, 2018). Your mental and emotional wellness as a pregnant person and soon-to-be parent is incredibly valuable. 

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How we reviewed this article

Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

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Current version

April 26, 2022

Written by

Nancy LaChance, BSN, RN

Fact checked by

Steve Silvestro, MD

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About the medical reviewer

Steve Silvestro, MD, Ro

Dr. Steve Silvestro is a board-certified pediatrician and Associate Director, Clinical Content & Education at Ro.