Perinatal Mental Health Conditions: The Link Between Anxiety & Cardiovascular Health

Pregnancy can be a time of great joy and excitement for expecting parents; however, some may also experience mental health challenges during this period that can impact their well-being. Perinatal mental health refers to the emotional and psychological well-being of a birthing parent during pregnancy and the postpartum period. 

Understanding perinatal mental health may be important for both parents and their support networks. Recognizing the signs of distress, identifying risk factors, and knowing when to seek help may improve overall family well-being. Below, we’ll explore common perinatal mental health conditions, what new research says about their link to cardiovascular health, and effective mental health care strategies for new parents. 

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What is the perinatal period? 

The perinatal period refers to the time from pregnancy through the first year after birth. It includes both the prenatal phase (during pregnancy) and the postpartum phase (after giving birth). It’s a time of immense change for pregnant and postpartum women and individuals, and it can be a significant period for both the physical and mental health of the parents and the baby. 

While much of the focus is on the birthing parent, fathers or other non-birthing partners may also experience changes during pregnancy and the postpartum period, which can also affect their mental health and relationships. Individuals with underlying mental health conditions such as depression or who have a family history of mental health conditions may be at higher risk of developing perinatal mental health conditions. We’ll examine more risk factors below.

Common perinatal mental health conditions

During the perinatal period, individuals may be at risk of experiencing mental health conditions due to changes in hormone balances as well as lifestyle changes after giving birth. Examples of common conditions include anxiety, depression, post-traumatic stress disorder, and others. Understanding the warning signs and symptoms of these conditions can help individuals identify and get treatment for such disorders early. 

Perinatal anxiety 

Giving birth and becoming a parent can be stressful. This experience may be one factor that can increase a person’s risk of developing an anxiety disorder, such as generalized anxiety disorder or panic disorder. 

Anxiety disorders are relatively common and are estimated to impact 20% of birthing parents during or after pregnancy, but they can significantly impact daily life and well-being and typically require professional treatment to address. Common signs of perinatal anxiety may include excessive worry, restlessness, racing thoughts, and physical symptoms like nausea, muscle tension, or rapid heartbeat. 

Perinatal depression

Perinatal depression is a type of depression that occurs either during the prenatal period, postnatal period, or both. Symptoms are usually similar to those of major depressive disorder. They may include things like persistent sadness, fatigue, hopelessness, and apathy, which can make it challenging for a parent to bond with their baby. 

According to the Centers for Disease Control and Prevention (CDC), early detection can be important in improving long-term outcomes for those with perinatal depression. That’s why they recommend that medical professionals screen new parents for depression early on and often. 

Trauma and post-traumatic stress disorder (PTSD)

Trauma can sometimes occur during birth, such as sudden and unexpected medical emergencies that put the birthing parent and/or their baby at risk. Birth trauma can lead to fear of future pregnancies and difficulty bonding with the baby. 

After a traumatic birthing experience, some parents may also experience symptoms of post-traumatic stress disorder (PTSD), which can severely impact daily functioning and well-being. Common examples include flashbacks, nightmares, and hypervigilance. 

Other perinatal mental health challenges

Other perinatal mental health conditions may also develop in a parent who has recently given birth and/or their partner. Examples include:

• Postpartum psychosis: a rare but severe mental health condition that occurs in postpartum women or other birthing individuals after childbirth. Symptoms may include severe mood swings, delusions, hallucinations, and paranoia. 
• Perinatal mood swings: when hormonal changes contribute to the development of extreme mood swings, which can impact interpersonal relationships and make it challenging to focus 
• Perinatal obsessive-compulsive disorder (OCD): characterized by intrusive, distressing thoughts (obsessions) and compulsive behaviors that attempt to reduce anxiety. Fears may be centered around harming the baby or excessive worries about the baby’s health. 
• Perinatal bipolar disorder: a mood disorder that involves extreme mood swings, often including both depressive episodes and manic episodes. Symptoms can worsen during pregnancy or postpartum due to hormonal changes and sleep deprivation.

Risk factors for perinatal mental health concerns

Although perinatal mental health conditions can impact any birthing parent or their partner(s), certain factors may increase the likelihood of experiencing them. Recognizing these risk factors can help individuals, healthcare providers, and human services experts take proactive steps toward prevention and early intervention. Some key risk factors for developing a perinatal mental health condition include: 

• Personal and family mental health history. Individuals with a personal or family history of mental health conditions, such as depression or anxiety, may be more likely to develop these conditions before and after childbirth. 
• Lack of support. Friends and family can provide support during and after pregnancy, which may help reduce stress and anxiety and act as a protective factor against developing mental health challenges. A lack of support can cause a person to feel overwhelmed, which may increase stress and risk of illness. 
• Environmental stressors. Factors such as divorce, financial struggles, poverty, lack of adequate healthcare, an unsafe living environment, discrimination, family conflict, abuse, or moving homes while pregnant can all increase stress and raise the risk of perinatal mental health conditions.
• Traumatic or high-risk births. Difficult births that require medical interventions, such as an emergency C-section, can sometimes cause postpartum PTSD. Additionally, previous experiences with pregnancy loss or miscarriage can elevate stress and anxiety around childbirth. 
• Unplanned pregnancy. Unplanned pregnancies may result in higher stress levels, uncertainty, and/or emotional conflict. 

Awareness may play an important role in mitigating the negative impacts of perinatal mental health conditions. Doctors and a parent’s support network can help monitor changes in maternal mental health and mood, which may assist in early detection of mental health conditions. With early detection, a person may be able to seek additional resources and support to manage symptoms and improve mental health. 

Impacts of perinatal anxiety and stress

Feelings of anxiety and stress are common for expecting parents, as having or adopting a baby can be a time of great change. When left untreated, these conditions may contribute to long-term challenges for both the individual experiencing them and their loved ones. Some of the potential impacts of anxiety and stress on parents may include the following.

Emotional impacts of anxiety and stress

Emotional impacts of anxiety and stress may include constant worry and overthinking. Individuals may find themselves ruminating or stressing out over many different topics, even those that are out of their control. Overthinking can cause parents to scrutinize every choice that they make, which can lower self-esteem and self-confidence. 

Additionally, chronic stress related to pregnancy or raising a child can cause mood swings and irritability. Small inconveniences may feel overwhelming, and it can be hard to regulate emotions. These effects can add stress to interpersonal relationships and may also cause a person to become isolated or socially withdrawn. 

Physical impacts 

Anxiety and stress can also cause a number of physical health impacts. Examples of physical impacts may include elevated heart rate, increased risk of cardiovascular disease, elevated blood pressure, and muscle tension. These impacts are thought to be related to the release of stress hormones, such as cortisol, that cause the body to enter and remain in a fight-or-flight state. 

New research on the cardiovascular impacts of perinatal mental health conditions

Anxiety, stress, and other mental health challenges may also impact cardiovascular health. For this reason, a new scientific statement published by the American Heart Association Highlights the importance of mental health screenings for birthing parents during the perinatal period. It reports that cardiovascular issues are the leading cause of maternal death, and that there's “robust evidence on the association of psychological health with cardiovascular outcomes.” 

In other words, mental health conditions like anxiety and depression during the perinatal period may increase the risk of cardiovascular issues and early mortality in birthing parents. This is likely because these conditions can lead to lifestyle habits that may impact the cardiovascular health of the parent, such as poor sleep and lack of exercise. It’s one reason why healthcare providers are encouraged to screen regularly for common perinatal mental health challenges. 

The statement also highlights certain disparities in maternal health and advocates for them to be addressed. For example, it shares that “The mortality rate for non-Hispanic Black birthing women is 2.6 times higher than for non-Hispanic white women.” In addition to increasing the frequency and availability of mental health screenings for all pregnant individuals, addressing systemic inequalities in healthcare and other areas that impact the health of birthing parents—such as housing and employment—can also be critical for improving overall health outcomes.

Building a support network for the perinatal period

For expecting parents, building a strong support network for the perinatal period and beyond can be important. Integrating mental health care providers and medical professionals into this network can be important. They may work together to ensure that parents are getting the care they need to improve their overall health and well-being. 

Friends, family members, colleagues, and neighbors may also play an important role in providing support for expecting or new parents. These supporters usually see a person more frequently than a medical professional, which may allow them to notice potential warning signs of mental health conditions more quickly. For a support team to be most effective, it can be important to develop open and honest communication so that mental health concerns can be addressed as soon as possible.  

Connecting with a mental health professional

During the perinatal period, it may be helpful for parents to connect with a mental health professional. A therapist can provide a safe space where prospective parents or new parents can express and process their emotions, address any past trauma, and get treatment for symptoms of mental health conditions as needed. Receiving this type of ongoing mental health care may reduce the risk or severity of mental health challenges during the perinatal period.

Are you experiencing perinatal mental health challenges?

Get support in online therapy

Exploring the option of online therapy

For new or expecting parents, it can often be challenging to attend regular in-person therapy sessions at a brick-and-mortar office. In contrast, online therapy sessions with a licensed therapist can occur from anywhere a person has an internet connection and a personal device. This means that parents can get the support that they may need from a place where they are comfortable. This type of care can also often be more affordable than in-person care without insurance, which can be helpful for new parents.

Research suggests that online therapy can often be an effective way to reduce anxiety and stress during pregnancy. Just like they would at an in-office appointment, a virtual therapist can implement techniques such as cognitive behavioral therapy, which may help a person identify and reframe negative thought patterns to improve mental health.