National Pregnancy Week highlights the importance of mental health during pregnancy

As joyous as pregnancy is often portrayed to be, for many women, it morphs into a time characterised by fear, sadness, anxiety, and emotional distress. During National Pregnancy Week, from February 3 to 7, the South African Society of Psychiatrists (SASOP) is advocating for a greater awareness of mental health issues among expectant mothers, particularly the importance of recognising and treating depression and anxiety during this critical period.

Statistical evidence reveals a concerning reality: in South Africa, between 16% and 50% of pregnant women are estimated to experience depression or anxiety, with approximately one in ten at high risk of suicide. These conditions, while common, can lead to severe consequences if left unaddressed. SASOP emphasises that untreated perinatal mental illness not only endangers the well-being of mothers, but also has far-reaching implications for families and society at large.

“Mental illness during pregnancy is real, widespread and treatable,” says Dr Jessica Stanbridge, a psychiatrist and member of SASOP. “Ignoring symptoms or stopping medication without guidance can place both mother and baby at risk.” Her insights underline the importance of mental health care, which can lead to life-saving interventions and mitigate long-term harm.

The findings indicate that untreated depression and anxiety can significantly increase the risk of various complications, including:

• Premature birth and low birth weight
• Poor growth and development of the baby
• Challenges in bonding with the baby post-birth
• Severe postnatal depression and potential relapse
• Increased risk of self-harm or suicide in the mother
• In rare but tragic instances, harm to or loss of the baby (infanticide)

Dr Stanbridge reassures that “these outcomes are not inevitable”. With the appropriate support and treatment, many of these risks can be largely prevented. However, many pregnant women grapple with fears about taking medication and potential harm to their foetus. SASOP addresses these concerns by highlighting the necessity of individualised medical advice.

“Current evidence shows that most antidepressants, including SSRIs, are generally safe during pregnancy when carefully prescribed and monitored,” she explains. “The risks of medication must always be weighed against the very real dangers of untreated depression and anxiety.” For women presenting moderate to severe symptoms, treatments often include medication, counselling, and social support, all geared towards ensuring emotional stability and nurturing a healthy environment for both mother and child.

While mood fluctuations are commonly experienced in pregnancy, persistent or severe symptoms warrant immediate professional help. Women should seek assistance if they are facing:

• Ongoing sadness, numbness, or hopelessness
• Constant worry, panic attacks, or overwhelming fear
• Extreme fatigue, sleep issues, or changes in appetite
• Feelings of incapacity to cope or function
• Thoughts of self-harm or harming their baby

“Pregnant women deserve compassion, understanding, and access to evidence-based care,” says Dr Stanbridge. “Medication is not a failure. It is often one of the tools that allows a mother to stay well and keep her baby safe.”

For those experiencing emotional distress or contemplating ceasing psychiatric medication during pregnancy, SASOP encourages immediate consultation with doctors, midwives, or mental health professionals. Early support avenues — whether through therapy, social networks, or medication — can be lifesaving and provide invaluable protection for families.

For assistance, individuals can contact the South African Depression and Anxiety Group (SADAG) through their 24-hour helplines at 0800 567 567 or 0800 456 789. SMS support is accessible at 31393.

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