Sadly, we’re used to the term postpartum depression to the point that we might not even know that the terminology for mood disorders is quite varied: postnatal depression; antenatal depression; prenatal or perinatal depression. These are different terms to name linked concepts.
Let’s look at this terminology, to understand the difference between prenatal and perinatal depression.
Pre comes from Latin and it means ‘before’. Natal means ‘birth’. Therefore, prenatal refers to anything related to pregnancy before the baby is born.
Prenatal depression appears during pregnancy.
Ante also means ‘before’, therefore antenatal depression and prenatal depression both refer to the same disorder: clinical depression during pregnancy.
Peri means ‘around’. Perinatal depression, then, means depression that happens around birth.
Perinatal depression is a depressive disorder with its onset during pregnancy, birth or the first year after the baby is born.
Prenatal, antenatal and postpartum depression are all types of perinatal depression.
Read more about this in our article What Is Perinatal Depression?
Postpartum depression is the most well known type of perinatal depression. However, research has shown that among those women who experience depression around birth, more women suffer from severe depression during pregnancy than those who experience it in the postpartum period.
Although postpartum depression is much more often heard about than antenatal depression, it’s most likely that many women who show major depressive symptoms during pregnancy go undiagnosed until a major depression settles. It’s challenging to overcome depression without appropriate help.
Therefore, although there are usually more cases of depression during pregnancy than in the postpartum period, most of these cases aren’t diagnosed until the baby has been born and the untreated depression during pregnancy finally manifests.
Read more about this in:
What is the difference between prenatal or perinatal depression?
As we just saw the etymology of the words prenatal and perinatal, natal refers to the birth, pre means ‘before’ and peri means ‘around’.
The difference between prenatal and perinatal depression, than, is when it happens.
Prenatal depression means experiencing this disorder during pregnancy.
Perinatal depression refers to experiencing depression at any point from the beginning of the pregnancy until the baby is one year old.
Prenatal depression is a type of perinatal depression.
What is the difference between maternal and perinatal mental health?
Good mental health is essential to lead a healthy and balanced lifestyle. Personal and environmental factors influence our mental health; we might suffer a mental illness when this balance is broken.
We’ve seen that perinatal means ‘around the time of birth’. This includes the pregnancy and up to a year into the postpartum period.
‘Maternal’ refers to the mother. Maternal mental health, then, refers to a woman’s mental health after she’s become a mother and although all moms’ mental health matters, so does the mental health of a pregnant woman.
‘Perinatal’ is the best word to choose if you aren’t sure which one to use. You cannot go wrong with perinatal.
Why does depression during pregnancy often go unrecognized?
Patriarchy has led to a huge imbalance in terms of what society asks of women and men. In most places, women are asked to comply with societal rules from the time they are little girls. Little by little, almost constantly, women modify their behavior to comply with what’s expected of them.
As the young girl grows, the pressure becomes greater. When women get pregnant many of them will try to keep complying with what the world expects from them. They keep up with all their chores and manage the pregnancy and everything that accompanies it.
When they can’t cope they might blame it on the pregnancy, or work, but they keep going as they’ve always done, trusting it will get better while antenatal anxiety or depression keep crawling into their system. This untreated perinatal depression will keep growing until it becomes obvious. When it does, most of the time the pregnancy is already over.
How does prenatal depression affect a baby in the womb?
When a woman suffers from depression during her pregnancy there’s a lack of oxytocin, the love hormone. Pregnancy is usually one of the times when the oxytocin levels are increased.
Despite the discomfort some common symptoms of pregnancy might cause for many woman, it’s usually a time of happiness, joy, and love; as a result, oxytocin levels are kept high.
These feel-good hormones cross the placental barrier and the atmosphere in which the baby develops is a thriving one.
When pregnant women experience depression, the secretion of oxytocin stops almost completely. Fear hormones take over and this tike the result is extreme sadness. The environment in which the baby is developing becomes hostile to thriving and the baby switches to survival mode.
When human development is at stake, nutrients, vitamins and minerals are used up much faster and non-essential survival skills or attitudes, such as feelings of self-worth and the capacity to love and trust, might not be developing in this environment.
Find out more in Natural Oxytocin – Benefits Of The Hormone.
Birth defects are more common when development happens in these negative conditions.
Gabor Mate, the best-selling author and expert in trauma, says that autism and ADHD are the consequence of deep intergenerational trauma.
Watch this short video:
What are the effects of perinatal depression on the infant?
Unless something sudden happens once the baby is born – something that triggers postpartum depression – most depressive disorders start long before the symptoms start to reveal that something might be going on.
Whether depression starts during pregnancy or after birth, its impact on the baby’s health and emotional development is deep.
A baby expects a thriving environment and a happy, nurturing mother, who is there to satisfy all the baby’s needs. Instead, he encounters an emotionally unavailable mother who cannot nurture her baby because she has no nourishment for herself, nor any to share.
It’s important to avoid perinatal depression and its consequences on both the mother and baby and on other family members.
The earlier we can stop the consequences of perinatal depression, the better.
It would be ideal if maternal antenatal care was so awesome that we could prevent perinatal depression. Health care providers don’t usually have the time to deep screen for depression red flags.
If we cannot prevent depression, we might at least be able to identify risk factors with good primary care screening, get an early diagnosis and look at the different treatment options to treat perinatal depression promptly.
What are the recommendations for screening for depression during pregnancy?
In most countries, screening for depression consists of just a few questions in the appointment booking with the midwife or health care provider. If those answers don’t show any red flags, there’s no further screening for depression, or risk factors unless the pregnant woman or her family brings the subject up with the health care provider.
For many women, it’s difficult to open up to a stranger and many responses can be more polite than accurate. This is especially true at the beginning of the pregnancy, when everything is new and it might be even more difficult.
We know health care providers are overworked and there are so many screenings and tests that could be done for pregnant women, but perhaps it’s time to revisit exactly what we’re screening for during pregnancy and which health problems have priority. If more health resources were invested in mental health services administration, with the right preventive services task force, the rates of perinatal depression would just plummet.
Perinatal depression is the number one illness experienced by pregnant and postpartum women. It occurs more often any other illness you can think of. It’s time to bring the rates of perinatal depression right down. It’s time to find out why so many women aren’t finding joy in becoming mothers. We’re talking about healthy women who become pregnant and don’t simply experience the ‘baby blues’, but suffer major mental illnesses, such as anxiety and depression or postpartum psychosis.
The medical system is completely failing women and families. A system must be failing when it allows so many healthy women to suffer from perinatal depression.
Read more in BellyBelly’s article Postpartum Care Is Failing Women.
When should I seek care for prenatal depression?
It’s important to treat depression and have the necessary emotional support that you need as soon as possible. Even if you’re not sure, your suspicions of a mood disorder should be enough to encourage you to talk to a mental health professional and find out.
It’s not just maternal and child health that is at stake but also the welfare of other family members.
Talk to your health care provider about your mental health
This should be something natural. Even just talking to someone face to face or in a support group has a positive effect. Talk therapy and interpersonal therapy are treatments on their own. If there’s one person we should talk to about our mental health, though, it should be our provider. So, yes, do it! It will have a positive impact.