Perinatal psychiatry: Caring for your mind and baby during pregnancy

Pregnancy and childbirth bring so many changes. Between fluctuating hormones, sleepless nights, and shifting identities, there’s so much for new parents to manage. These stressors can result in a decline in mood, depression, or anxiety. For many people, this experience is temporary and will resolve on its own. But, for others, mental health concerns during pregnancy and postpartum can be more challenging and pose risks for both the parent and the baby. 

If you’re pregnant or have recently given birth and are having some mental health challenges, know that you’re not alone. Perinatal psychiatrists and psychiatric mental health nurse practitioners (PMHNPs) specialize in supporting birth-giving parents. These providers focus on mental health and can make sure you receive an accurate diagnosis. 

When to see a perinatal psychiatrist

Many providers can help you strengthen your mental health during the prenatal period. But you may want to consider seeing a perinatal psychiatrist if you:

• Already receive psychiatric care: If you’re pregnant or trying to become pregnant, talk to your psychiatric provider early. Your provider should be able to provide education on risks and benefits of medication during this time. If you don’t feel you’re getting the guidance you need, it might be helpful to connect with someone who specializes in mental health concerns during pregnancy and postpartum.

• Got a recommendation: Your doctor, therapist, or another healthcare provider might refer you to a perinatal psychiatric provider.

• Notice a severe change in your mood, behavior, or mental health: If you or a loved one notices that your symptoms are impacting your ability to care for yourself or your baby, don’t hesitate to seek help. You could be experiencing postpartum depression, postpartum intrusive thoughts, postpartum psychosis, or another serious concern.

• Have a history of mental health challenges: If you live with mental health challenges already or have a family history of perinatal or postpartum mental health concerns, a perinatal psychiatrist can provide support.

• Experienced birth trauma: For some birth-giving parents, birth trauma can lead to post-traumatic stress disorder (PTSD). Most people with PTSD require professional support to maintain their mental health, and this can be especially true during the postpartum period.

• Are a co-parent experiencing postpartum depression: Non-birth-giving parents can experience mental health challenges during this time. Working with a perinatal psychiatric provider can help you navigate these difficulties.

How perinatal psychiatry supports parents & baby

The perinatal period is a unique time in a person’s life. Perinatal psychiatric providers focus on supporting parents and babies during this important developmental stage. They achieve this through:

• Assessment and diagnosis: The mind and body undergo vast changes during pregnancy and the postpartum period. A perinatal psychiatric provider will review the full picture of your medical and mental health and ensure an accurate diagnosis. That way, you get the right care for your needs.

• Collaborative care: Perinatal psychiatrists don’t operate in isolation. They can collaborate with your other healthcare providers to keep everyone on the same page. This is sometimes referred to as integrated care, and it’s been shown to improve the quality of care you receive.

• Medication management: There are psychiatric medications that are considered safer for birth-giving parents and babies during and after your pregnancy. You and your provider can discuss the risks and benefits of this approach in treating symptoms for both you and your baby.

Getting psychiatric support during pregnancy

Perinatal psychiatric providers receive extra training in how pregnancy and childbirth affect mental health. They’re uniquely qualified to help pregnant people and new parents keep their minds and bodies healthy during a critical life stage. 

If you need psychiatric support during pregnancy, some tips for finding the right provider for your needs include:

• Talk to your care team. You can ask your therapist, primary care provider, or OB-GYN for a referral to a perinatal psychiatric provider. Providers who work with expectant parents can connect you with these resources.

• Check with your insurance company. Your insurer may have a list of in-network psychiatrists that can help you narrow down your search. You can request this information by calling the number on the back of your insurance card or using your member portal.

• Seek out telehealth options. If you can’t find a perinatal psychiatric provider you can meet with in person, telehealth can be a great option. Look for providers with experience in perinatal or reproductive psychiatry.  

• Look into digital directories. Organizations like Postpartum Support International have mental health provider directories. If you need immediate assistance, you can contact their hotline by calling 1-800-944-4773.

Remember, this can be a very sensitive time. It's OK to seek support. Asking for help doesn’t mean that you aren’t a good parent. On the contrary, it’s a sign of strength. By looking after yourself, you can be the best possible parent to your little one. Taking good care of your mind and body can help you have a healthy pregnancy and be fully present as you bond with your new baby.

Clinican's take

When people are experiencing severe anxiety or depression during pregnancy or postpartum, it can be difficult to talk about what you’re going through. But reaching out and discussing your symptoms openly with loved ones and your OB is so important. And if your symptoms aren’t getting better, seeking a perinatal psychiatric provider can help you get the support you need.

Stephanie J Reed, MSW, MSN, PMHNP-BC

Clinical reviewer

Find care with Rula

Pregnancy and childbirth can take a toll on your mental health. For some people, the effects are temporary. However, other people experience more severe perinatal mental health concerns. Left untreated, these conditions can make it hard to care for yourself and your child. 

Fortunately, perinatal mental health conditions can be managed with support from a perinatal psychiatric provider. They can prescribe medication and refer you to other resources that can support your well-being as a new or expecting parent.

At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best. 

Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 15,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we're here to help you make progress — wherever you are on your mental health journey.