Knowledge Centre

Perinatal mental health refers to a person’s emotional, psychological, and social wellbeing during pregnancy and the first year after birth.

This period often brings major physical, emotional, and life changes, and it is common for mental health to shift during this time.

Perinatal mental health includes the wellbeing of:

• Birthing parents
• Partners and non-birthing parents
• Families adjusting to a new baby

Many parents describe this time as both meaningful and overwhelming. Support can make a significant difference.

What kinds of mental health challenges can occur?

Perinatal mental health includes more than depression. Some parents may experience:

• Perinatal depression (during pregnancy or postpartum)
• Perinatal anxiety
• Obsessive–compulsive symptoms (OCD), including intrusive thoughts
• Post-traumatic stress (PTSD) related to birth related or past trauma
• Bipolar disorder
• Postpartum psychosis (rare but requires urgent care)

Some parents may also experience distressing symptoms such as:

• Persistent worry
• Irritability
• Emotional numbness
• Difficulty feeling connected to the baby

These experiences can feel frightening, but they are not uncommon and support is available.

Perinatal mental health challenges can appear during pregnancy or anytime in the first year after birth. Experiences vary from person to person, and symptoms may range from mild to more intense.

Some people may notice:

Emotional or Mood Changes

• Persistent sadness, low mood, or frequent crying
• Feeling overwhelmed, hopeless, or emotionally numb
• Irritability, anger, or strong emotional reactions that feel difficult to manage
• Losing interest in things that usually bring enjoyment
• Feeling disconnected from yourself or others

Anxiety-Related Experiences

• Ongoing or excessive worry, often about the baby’s health or safety
• Racing thoughts or difficulty relaxing
• Panic attacks (such as shortness of breath, dizziness, or chest tightness)
• Feeling tense, restless, or constantly “on edge”
• Avoiding situations such as leaving the house or accepting help

Thoughts and Cognitive Changes

• Difficulty concentrating, remembering things, or making decisions
• Strong self-criticism, guilt, or shame
• Thoughts like “I’m not a good parent” or “I should be coping better”

Some people experience intrusive thoughts — unwanted and distressing thoughts or images, often about harm coming to the baby.

Important: Intrusive thoughts are common in anxiety and obsessive–compulsive symptoms and do not mean someone wants to act on them.

Physical or Behavioural Changes

• Sleep difficulties beyond what is expected with a new baby
• Changes in appetite
• Extreme or ongoing fatigue
• Withdrawing from family, friends, or usual supports
• Difficulty feeling connected to the baby

Trauma-Related Experiences

Some parents may experience symptoms of trauma related to pregnancy, birth, or medical events, including:

• Flashbacks or nightmares
• Avoiding reminders of pregnancy, birth, or medical care
• Feeling emotionally numb or detached
• Feeling constantly alert or unsafe

Signs That Need Urgent Support

Immediate support is important if someone experiences:

• Thoughts of harming themselves or suicide
• Thoughts of harming the baby
• Hearing or seeing things others do not (hallucinations)
• Strong beliefs that do not match reality (delusions)
• Severe confusion, agitation, or sudden mood changes

If these symptoms occur, contact a healthcare provider, call 811, or seek emergency care right away.

The baby blues are common and often occur a few days after birth. They may include mood swings, tearfulness, or feeling emotionally sensitive.
Baby blues typically resolve within two weeks without treatment.

Perinatal mental health conditions:

• Last longer
• Are more intense
• Interfere with daily life or relationships
• Often benefit from additional support or treatment

There is no single cause of perinatal mental health challenges. Many factors may contribute, including:

• Hormonal changes
• Sleep deprivation
• Previous mental health experiences
• Stress, trauma, or perinatal loss (infertility, miscarriage, stillbirth, neonatal, unplanned pregnancy, etc.)
• Social isolation or limited support
• Pregnancy or birth complications
• Financial, housing, or work pressures

Experiencing mental health challenges during this time is not a personal failure.

Many loving and capable parents need support during this transition.

Key Message

Perinatal mental health is an important part of overall health during pregnancy and the first year after birth.
Experiencing challenges does not mean someone is a bad parent. Many people need support during this time, and reaching out for help is a positive step toward wellbeing for both parent and baby.

Perinatal mental health conditions can occur during pregnancy or within the first year after birth. They are common and highly treatable. Care is often tailored to each person and may depend on symptoms, personal history, stage of pregnancy or postpartum, and feeding choices.

Effective care may include:

• Therapy
• Medication
• Peer or family support
• Specialized care when needed

Early support can lead to better outcomes for parents, babies, and families.

1. Psychotherapy (Talk Therapy)

Psychotherapy is often a first-line treatment for mild to moderate symptoms and can be helpful at any stage of care.

Common approaches include:
Cognitive Behavioural Therapy (CBT)
Helps people identify and shift unhelpful thoughts and behaviours.

Interpersonal Therapy (IPT)
Focuses on relationships, role transitions, and strengthening social support—areas that are especially important during the transition to parenthood.

Trauma-focused therapies
Can support healing from experiences such as birth trauma or post-traumatic stress.

Therapy may be offered individually, in groups, or virtually, and may be helpful on its own or alongside medication.

2. Medication

Medication may be recommended when symptoms are moderate to severe, persistent, or not improving with therapy alone.
Antidepressant medications, particularly Selective Serotonin Reuptake Inhibitors (SSRIs) such as sertraline, fluoxetine, or citalopram, are commonly used to treat perinatal depression and anxiety.

These medications have well-studied safety profiles during pregnancy and breastfeeding. Current guidelines generally advise not stopping effective medication solely because of pregnancy or lactation without discussing options with a healthcare provider.

Medication decisions are best made through shared decision-making with a healthcare provider, considering both the benefits of treatment and the risks of untreated illness.

3. Combination Treatment

For some people, combining therapy and medication may provide the most effective support, particularly when symptoms are moderate to severe.

4. Supportive and Non-Clinical Supports

These supports can be helpful alongside clinical care or for people experiencing milder symptoms.

Examples include:

• Peer support groups and parent support programs
• Education and information for individuals and families
• Practical wellbeing supports such as sleep strategies, nutrition, gentle movement, and reducing isolation

These supports can strengthen coping and recovery but do not replace clinical treatment when symptoms are moderate or severe.

5. Specialized and Urgent Care

Some situations require immediate or specialized care, including:

• Postpartum psychosis
• Thoughts of suicide or significant safety concerns

In these situations, urgent mental health assessment and treatment may be needed. With timely care, recovery is highly possible. To find out more about local perinatal mental health supports and services, call 811, or visit a Doorways clinic in your community.

Perinatal mental health affects the whole family. Fathers, partners, and non-birthing parents can also experience depression, anxiety, and emotional stress during pregnancy and the first year after a baby is born.

These experiences are common, real, and treatable. With the right support, many people feel better.

How Common Is It?

• About 1 in 10 fathers and non-birthing partners experience perinatal depression
• Anxiety may be just as common or more common

Risk may increase when:

• A partner is experiencing depression or anxiety
• There is a history of mental health challenges
• Stress levels are high (e.g., sleep disruption, financial pressure, limited support)

Possible Signs and Symptoms

Perinatal mental health challenges can look different for fathers, partners, and non-birthing parents.

Emotional Changes

• Ongoing sadness or low mood
• Feeling overwhelmed, stuck, or disconnected
• Irritability, anger, or frustration
• Losing interest in work, hobbies, or relationships

Anxiety Experiences

• Frequent worry about the baby’s health or safety
• Worries about finances or providing for the family
• Feeling constantly on edge or unable to relax
• Panic symptoms (e.g., racing heart, shortness of breath)

Behaviour Changes

These signs are sometimes overlooked:

• Working excessively or avoiding home life
• Increased alcohol or substance use
• Taking more risks than usual
• Emotional withdrawal or increased conflict with a partner
• Feeling overly worried or protective about the baby

Physical and Thinking Changes

• Persistent fatigue or sleep problems
• Difficulty concentrating or making decisions
• Headaches, stomach pain, or muscle tension
• Feeling mentally “foggy”

Some people also notice thoughts such as:

• “I should be handling this better.”
• “Everyone else seems to be coping.”
• “I don’t want to burden my partner.”

These thoughts can be linked with guilt, shame, or self-doubt.

Seek immediate support if you have thoughts about harming yourself, your baby, or someone else.

Why Fathers and Partners May Be at Risk

The transition to parenthood can involve:

• Major life and identity changes
• Sleep disruption
• Financial or work pressures
• Relationship changes
• Feeling left out of care that focuses on the birthing parent
• Social pressure to hide emotions or “stay strong”

Why Support Matters

When mental health challenges are not addressed, they can affect:

• Relationships with partners
• Bonding with the baby
• Family wellbeing
• Children’s emotional development

Supporting fathers, partners, and non-birthing parents supports the wellbeing of the entire family.

Getting Support

Help is available and effective. Support options may include:

• Counselling or therapy (individual or couples)
• Peer support groups for fathers or partners
• Medication, when appropriate
• Self-screening tools (e.g., PHQ-9 or GAD-7)
•  Learning about common experiences during the transition to parenthood

Care should be respectful, non-judgmental, and family-centred.

Key Messages

• You do not have to handle everything alone
• Experiencing challenges does not mean you are a bad parent or partner
• It is possible to love your baby and still struggle
• Reaching out for support is a strong and positive step
• Recovery is common and possible