Perinatal mental health: the full picture from pregnancy to the first year

Mental health · Updated July 2026 · All articles

Around 1 in 5 women experience a mental health problem during pregnancy or in the year after birth. That is a large number, and yet perinatal mental health is still underdiagnosed and under-supported in many parts of the world. This article is a plain-language overview of the full spectrum of conditions, how screening works, and how to find the right support.

What perinatal means

Perinatal refers to the period around birth: from conception through to the end of the first postnatal year. Perinatal mental health, therefore, covers mental health conditions that arise or significantly worsen during pregnancy or within the first twelve months after the baby is born.

This is a broader window than many people realise. Mental health difficulties in pregnancy are just as real and just as deserving of support as those in the postnatal period, but they are less commonly discussed and sometimes missed entirely.

The spectrum of conditions

Perinatal mental health is not one thing. It covers a wide range of experiences with very different presentations, causes, and treatment needs.

Baby blues: Very common in the first few days after birth (up to 80% of new mothers), characterised by tearfulness, mood swings, and anxiety. Usually resolves on its own within two weeks and does not require treatment, though it does need recognition and kindness.

Postnatal depression (PND): Affects around 10 to 15% of mothers. More persistent and intense than baby blues, involving low mood, loss of interest, anxiety, and sometimes intrusive thoughts. Very treatable with talking therapy and/or medication.

Postnatal anxiety: Often experienced alongside PND but can occur on its own. May involve constant worry, physical symptoms of anxiety, panic attacks, or hypervigilance around the baby. Also very treatable.

PTSD after birth: Around 4% of mothers meet diagnostic criteria for PTSD following a traumatic birth. Symptoms include flashbacks, nightmares, avoidance, and hypervigilance. EMDR and trauma-focused CBT are the most evidence-based treatments.

Postnatal OCD: Characterised by intrusive thoughts (often involving harm coming to the baby) and compulsive behaviours to neutralise them. Underdiagnosed because parents are often too frightened to disclose the thoughts. Very responsive to CBT.

Postpartum psychosis: Rare (1-2 per 1000 births) but a medical emergency. Sudden onset, usually in the first two weeks after birth. Involves confusion, hallucinations, delusions, and extreme mood changes. Requires immediate medical attention and responds well to treatment.

Perinatal bipolar disorder: Existing bipolar disorder can be significantly affected by the hormonal and sleep changes of pregnancy and the postnatal period. Careful management before, during, and after pregnancy is important.

Mental health in pregnancy

Pregnancy is often portrayed as a uniformly happy time, but for many people it brings anxiety, low mood, and significant worry alongside the excitement. Depression and anxiety during pregnancy are at least as common as postnatal depression, and they are risk factors for postnatal difficulties too.

Treating mental health difficulties during pregnancy is safe, effective, and beneficial for both mother and baby. Untreated antenatal depression and anxiety are associated with poorer outcomes for both, so seeking help during pregnancy is just as important as seeking it after birth.

How screening works

In the UK, midwives and health visitors use the Edinburgh Postnatal Depression Scale (EPDS), a ten-question self-report questionnaire, to screen for depression and anxiety at several points during pregnancy and postnatally. They may also use the PHQ-9 (Patient Health Questionnaire) and the GAD-7 (Generalised Anxiety Disorder scale).

These are screening tools, not diagnostic tools. A high score means a conversation, not a label. If your score suggests you might be struggling, your midwife or GP will follow up to understand what is actually going on and what would help most.

It is worth knowing that screening is only as useful as your honest answers. If you are holding back on the questionnaire because you are worried about the consequences, please know that the aim of the people asking is to support you, not to judge you.

Barriers to asking for help

Many people who are struggling with perinatal mental health do not come forward for a range of understandable reasons. These include fear of being seen as an unfit mother, shame about not feeling the way you feel you are supposed to feel, a belief that the symptoms are not serious enough to bother anyone with, not knowing what support is available, and cultural or family pressure to cope silently.

None of these barriers are unreasonable, and none of them should be in your way. The people you would speak to (GPs, midwives, health visitors) have seen this many times before. They want to help. There is no good outcome from struggling alone.

What support is available

The support available varies depending on where you live, but includes:

• GP referral to talking therapies: CBT, IPT, counselling, and other approaches via NHS IAPT (Improving Access to Psychological Therapies) services, which you can also self-refer to in most areas
• Specialist perinatal mental health teams: Multidisciplinary NHS teams with specific expertise in pregnancy and the postnatal period; not available everywhere but coverage is expanding
• Mother and baby units: Residential inpatient facilities for mothers experiencing severe perinatal mental illness, designed to keep mother and baby together
• Medication: Various antidepressants and other medications are considered safe and effective during pregnancy and while breastfeeding; a GP or psychiatrist can advise
• Peer support: Organisations including PANDAS Foundation, APNI (Association for Postnatal Illness), and PANDA (Perinatal Anxiety and Depression Australia) offer peer support and information

Pregnancy as both a trigger and an opportunity

Pregnancy and the postnatal period are times of heightened vulnerability to mental health difficulties. But they can also be a time when people are more open to support than they might otherwise be, and when the healthcare system is more actively present in their lives. Many people who have never engaged with mental health support before find that the context of having a baby makes reaching out feel more possible.

If there is something that has been weighing on you, pregnancy or new parenthood is actually a reasonable moment to address it. You do not have to wait until you are in crisis.

Frequently asked questions

What does perinatal mean?

Perinatal refers to the period from conception through to the end of the first postnatal year. Perinatal mental health therefore covers mental health conditions that arise or worsen during pregnancy or in the first twelve months after birth.

How common are perinatal mental health problems?

Around 1 in 5 women experience a mental health problem during pregnancy or in the year after birth. This makes perinatal mental health problems among the most common complications of pregnancy and the postnatal period, yet many go undetected and unsupported.

What is the EPDS and when is it used?

The Edinburgh Postnatal Depression Scale (EPDS) is a ten-question screening tool used by midwives and health visitors to identify women who may be experiencing depression or anxiety. It is typically offered at several points during pregnancy and postnatally. It is a screening tool, not a diagnosis, and a high score prompts a follow-up conversation rather than an automatic clinical conclusion.

What is a specialist perinatal mental health team?

Specialist perinatal mental health teams are multidisciplinary NHS teams with particular expertise in supporting women during pregnancy and the first year after birth. They can provide assessment, therapy, and medication support, and they work to keep mother and baby together whenever possible. Not all areas have them, but the NHS is expanding coverage.

Can mental health problems start for the first time during pregnancy?

Yes. Pregnancy is a time of significant hormonal, physical, and emotional change, and mental health conditions can emerge for the first time during this period even in people with no previous history. It is also a time when existing conditions can be significantly affected, either improving or worsening.

Why do people often not ask for help with perinatal mental health?

Common barriers include fear of being seen as an unfit mother, shame, a belief that their symptoms are not serious enough, not knowing what support is available, and cultural pressure to appear to be coping. All of these are understandable and none of them are good reasons to go without support. The people around you want to help.

This article is for general information only. If you are struggling with your mental health, please speak to your GP, midwife, or health visitor. In a crisis, contact Samaritans on 116 123 (UK) or your local emergency services.