How to Care for Your Mental Health During Pregnancy

There’s a whole lot of focus on the physical side of pregnancy—and for good reason! But your mental health deserves just as much attention. Between surging hormones, body changes, sleep disruptions, and the enormous life shift you’re preparing for, it’s no wonder that many parents-to-be feel overwhelmed, anxious, or just...not like themselves.

Mental health struggles during pregnancy are remarkably common. Perinatal depression—which includes depression during pregnancy and in the first year after birth—affects about 1 in 7 women, making it one of the most frequent medical complications of pregnancy. And research suggests that the majority of postpartum depression cases actually begin before delivery. A landmark study published in JAMA Psychiatry found that among women who screened positive for depression postpartum, 33% developed symptoms during pregnancy, and another 27% had symptoms even before becoming pregnant. Similarly, a review in World Psychiatry reported a prevalence of 15 to 20% for antenatal anxiety disorders, with self-reported anxiety symptoms affecting roughly 1 in 4 pregnant people by the third trimester.

That’s why it’s a good idea to protect your emotional wellbeing along with your physical health before your baby arrives. Here’s how…

Prioritize sleep.

If “sleep when the baby sleeps” is famously annoying advice for new parents, “just get more sleep” can feel equally unhelpful when you’re pregnant, dealing with heartburn, midnight bathroom trips, and a belly that makes every sleeping position uncomfortable. But research consistently links poor sleep during pregnancy to a higher risk of depression and anxiety. One study found that pregnant people sleeping fewer than about 6.5 hours per night were more than three times as likely to screen positive for depression compared to those who slept longer.

You can’t eliminate every pregnancy sleep obstacle, but you can stack the deck in your favor:

• Sleep on your side. Side-sleeping (left is ideal) with a pillow between your knees or under your bump takes pressure off your spine, improves blood flow to your uterus, and is the safest position after about 20 weeks.
• Cool down your bedroom. Pregnancy increases your blood volume—sometimes doubling it!—which raises your body temperature. Keeping your room between 60 and 68°F can help you stay comfortable.
• Front-load your fluids. Aim for 8 to 12 cups of water a day, but drink the bulk of it in the morning and afternoon, then taper off about two hours before bedtime to minimize those middle-of-the-night bathroom trips. (More on the importance of hydration during pregnancy!)
• Try white noise. As pregnancy hormones reduce your deep sleep, white noise can mask disruptive sounds and help you doze off more easily. (Bonus: You’ll already be a pro at using it when your baby arrives!)
• Ask about your iron levels. About 1 in 2 pregnancies are affected by iron deficiency, which is a leading cause of restless leg syndrome (RLS)—a notorious sleep saboteur. If RLS is driving you nuts at bedtime, ask your provider for a simple blood test.

For more, check out our Pregnancy Guide to Better Sleep.

Move your body.

Exercise during pregnancy isn’t just about “staying in shape” or prepping for labor (though it helps with both!). It’s one of the single most effective things you can do for your mental health. Physical activity releases endorphins, lowers stress hormones, improves sleep, and may even help prevent the development of depressive disorders in the postpartum period.

Aim for at least 150 minutes of moderate-intensity aerobic activity per week during pregnancy (think: brisk walking, swimming, stationary cycling, or prenatal yoga). If you weren’t active before pregnancy, start slow—even 10-minute walks count! And if you were a regular runner or gym-goer before pregnancy, you can likely continue with modifications.

Try to get outside for your workout when you can! Morning sunlight exposure can help regulate your circadian rhythm (making it easier to fall asleep at night) and research shows that morning exercise may help you fall asleep faster than evening exercise.

Eat to nourish your brain.

A diet rich in whole foods supports healthy neurotransmitter production, stabilizes blood sugar (which helps prevent mood swings), and reduces inflammation that has been linked to depression. For a deep dive, read our full guide on how diet affects mood in pregnancy.

Here are a few standout mood-boosters:

• Omega-3 fatty acids: Found in low-mercury fish like salmon, sardines, and trout, omega-3s support brain health and may reduce the risk of perinatal mood disorders. Try for 2 to 3 servings (8 to 12 ounces) of low-mercury fish per week.
• Fiber-rich foods: Whole grains, fruits, vegetables, and legumes stabilize blood sugar and feed the beneficial gut bacteria that help produce serotonin—the “feel-good” neurotransmitter. Irish researchers have identified the combination of fiber, magnesium, and B vitamins as especially important for mental health in pregnancy.
• Folate-rich foods: Dark leafy greens, beans, nuts, and seeds support mood regulation and are essential for your baby’s neural tube development. Learn more about the importance of folic acid during pregnancy.
• Water: Even mild dehydration can worsen irritability and cloud your thinking.

Build your village now.

Social support isn’t just a nice bonus during pregnancy—it’s a scientifically documented protective factor against perinatal depression and anxiety. A systematic review in the Journal of Affective Disorders identified poor social support as one of the strongest and most consistent risk factors for antenatal depression and anxiety.

So, start building your support team now, before Baby arrives! Identify who you might call if you need a helping hand or shoulder to cry on, and give loved ones a heads up that they have permission to check in on you. Your village might include your partner, family members, or close friends…it also can extend to professionals, like a therapist, counselor, or support group, as well as those who can pitch in to help with cleaning, meal prep, or childcare.

Talk to a professional sooner rather than later.

Don’t wait until things feel “bad enough” to seek help! ACOG now recommends that all people receiving prenatal care be screened for depression and anxiety at their first prenatal visit, again later in pregnancy, and at postpartum visits. If your provider hasn’t brought up mental health screening, don’t be afraid to ask!

Evidence-based treatment options include:

• Psychotherapy: Cognitive behavioral therapy (CBT) and interpersonal therapy (IPT) both have strong research support for treating depression and anxiety during pregnancy.
• Medication: Certain antidepressants are considered safe during pregnancy, and ACOG’s guidance emphasizes that the risks of untreated depression can outweigh the potential risks of medication. This is a very personal decision to make with your healthcare team.
• Support groups and peer counseling: These groups can reduce isolation and help normalize what you’re going through.

Start your postpartum wellness plan now.

One of the most important (and least talked about) things you can do for your mental health? Plan ahead for the postpartum period while you’re still pregnant. Research shows that depression during pregnancy is one of the strongest predictors of postpartum depression—meaning that addressing your emotional health now can have a protective effect later.

For a comprehensive resource to guide you through this process, download the free Happiest Baby Postpartum Mental Wellness Toolkit—it’s packed with exercises and resources to help you emotionally and practically prepare for your new life with Baby.

When to Get Help Right Away

Feeling extra emotional during pregnancy is completely normal.

Your estrogen and progesterone levels are at an all-time high, and those hormones have a direct impact on the brain chemicals that regulate mood. Crying at a cereal commercial? Snapping at your partner for breathing too loudly? Perfectly understandable.

But when feelings of sadness, worry, or irritability become persistent—lasting most of the day, nearly every day, for two or more weeks—or when they start interfering with your ability to eat, sleep, work, or enjoy the things you normally love, it’s time to talk to your healthcare provider.

If you or someone you love is experiencing any of the following symptoms during pregnancy, please reach out to a healthcare provider right away:

• Persistent sadness, hopelessness, or emptiness lasting two or more weeks
• Severe anxiety, racing thoughts, or panic attacks
• Difficulty bonding with your pregnancy or feeling emotionally detached
• Thoughts of harming yourself or your baby
• Inability to sleep, eat, or carry out daily activities
• Withdrawal from family and friends

You can also reach the National Maternal Mental Health Hotline anytime—day or night—at 1-833-852-6262 (call or text). It’s free, confidential, and available 24/7 in English and Spanish.

Growing a human being is one of the most extraordinary things your body will ever do—and it’s okay to admit that it’s also one of the hardest. Taking care of your mental health during pregnancy isn’t selfish or optional. You deserve support, and you don’t have to figure this out alone.

More on Pregnancy, Parenthood & Mental Wellbeing:

• Pregnancy Insomnia & Mental Health
• Pregnancy Diet: How to Eat for a Healthy Mood
• How to Prioritize Your Sleep During Parental Leave
• The Happiest Baby Postpartum Mental Wellness Toolkit
• 5 Ways SNOO Supports Parents’ Wellbeing

• Screening for Perinatal Depression: ACOG Committee Opinion No. 757, Obstetrics and Gynecology, Nov 2018
• Onset timing, Thoughts of Self-Harm, and Diagnoses in Postpartum Women with Screen-Positive Depression Findings, JAMA Psychiatry, May 2013
• Perinatal Mental Health: A Review of Progress and Challenges, World Psychiatry, Sep 2020
• Association Between Objectively Assessed Sleep and Depressive Symptoms During Pregnancy and Post-Partum, Frontiers in Psychiatry, Jan 2022
• American College of Obstetricians & Gynecology: How Much Water Should I drink During Pregnancy?
• Suboptimal Iron Deficiency Screening in Pregnancy, Blood Advances, Nov 2021
• Physical Activity and Exercise During Pregnancy and the Postpartum Period: ACOG Committee Opinion No. 804, Obstetrics and Gynecology, Apr 2020
• National Sleep Foundation: Best Time of Day to Exercise for Sleep
• American College of Obstetricians & Gynecology: Healthy Eating During Pregnancy
• U.S. Food and Drug Administration: Advice About Eating Fish
• Diet and Mental Health in Pregnancy: Nutrients of Importance Based on Large Observational Cohort Data, Nutrition, Apr 2022
• American College of Obstetricians & Gynecology: Patient Screening
• Identifying the Women at Risk of Antenatal Anxiety and Depression: A Systematic Review, Journal of Affective Disorders, Feb 2016
• Treatment and Management of Mental Health Conditions During Pregnancy and Postpartum: ACOG Clinical Practice Guideline No. 5, Obstetrics and Gynecology, Jun 2023
• Screening and Diagnosis of Mental Health Conditions During Pregnancy and Postpartum, Obstetrics and Gynecology, Jun 2023
• National Institute of Mental Health: Perinatal Depression

Disclaimer: The information on our site is NOT medical advice for any specific person or condition. It is only meant as general information. If you have any medical questions and concerns about your child or yourself, please contact your health provider.