Prenatal Depression Is a Serious Issue That Too Few People Talk About

There is no one untouched by crises of mental health. And yet, when you or someone you love is going through it, it can often feel like you’re alone in the dark, searching for a light. In honor of World Mental Health Day, we are publishing a series of essays, starting today and running through the weekend, that tackle this topic through a personal lens. We hope these essays offer a little insight into the many ways that people struggle, and how they can come out the other side with dignity and grace.

When I was six weeks pregnant, I went hiking with a friend. Halfway up the mountain, I paused to catch my breath. I knew what I needed to say but I found myself struggling to say it. There was a heavy knot of dread in my stomach.

“I have some news,” I told her. “I’m pregnant.”

My friend was ecstatic. She started jumping up and down and shrieking with joy. I forced myself to smile but when she grabbed me for a hug, my face drooped. It felt like my lips weighed fifty pounds. I couldn’t even really remember how to smile properly. I held on to the hug for too long so she wouldn’t see my face and ask me what was wrong.

Because, what was wrong? I was married, had a career I loved, was healthy, and now was going to be a mother. I should have been thrilled to be pregnant; I had wanted to have a child for years. Why did I feel so awful?

Prenatal depression hit me fast. One night I went to bed, excited to have a baby. The next morning, I woke up and I didn’t want a child anymore. A dark cloud of dread hung over me. It felt like I had just gotten terrible news.

That first week, I canceled plans and spent afternoons curled up on the couch. Then, I stopped answering emails and checking my phone. I told myself I was just tired, or just nauseous. One day I was driving home on the freeway and my eyes kept flickering to the concrete median in the middle of the road. Would it be so bad, I thought, if I just drove into it? At least I wouldn’t have to feel this way anymore. In that moment, the idea of never waking up again sounded like a relief.

Here’s what’s scary about prenatal depression, officially called Antenatal Depression: It’s fairly common, affecting between 10% to 20% of pregnant women —and yet, nobody has heard of it.

“It’s a common misunderstanding that pregnancy should always bring joy,” Dr. Amalia Londoño Tobón, a perinatal psychiatrist at MedStar Georgetown University Hospital, told me. When women experience depression during pregnancy, they feel guilt and shame and that leads them to hide their symptoms.

That’s what happened to me; I hid my symptoms and I kept my feelings secret. I didn’t understand why I was so depressed, so I assumed that it was because I was genetically predisposed to being an uncaring mother. I rationalized that as soon as I got pregnant, a switch must have gone off in my brain, activating whatever genetic code caused someone to be an unfit mother.

I come from a long line of less-than-nurturing mothers. The women in my family are known for their wit and their grit, but not exactly their warmth and sensitivity. My grandmother spoke several languages and could get a whole room laughing, but she also dropped off her kids at an orphanage to go on vacation. She went to a psychiatric instruction after giving birth to her fourth child, but she didn’t want to talk about it. She would tell me how much she had disliked her own mother, my great-grandmother.

My mother tried to break this cycle, giving up her career to be a stay-at-home mom, and reading books on gentle parenting before it was an Instagram fad. But this was the ‘90s, before it was understood how unresolved childhood trauma impacts parenting. In some ways, my mother was successful in breaking the cycle of neglect and disconnection, but in other ways, she perpetuated the patterns she was pushing against.        

Before getting pregnant, I had been sure that I would be the one to finally break this loop. I spent years in therapy trying to heal. Learning to reparent myself. Processing the traumas of my own childhood. Reading about co-regulation and secure attachment. I was determined to single-handedly be so nurturing, so warm, so mothering, that all of my future descendants would be healed.

Now here I was, not even a mother yet, and already a bad one.

As the pregnancy progressed, I would stare at babies in cafes, or on the sidewalk, and wonder why I’d ever wanted one of those weird little loud things. Why had I longed so much to smell a small fuzzy head? A friend asked me to hold her baby so she could eat and I felt myself shrinking back. The baby was so heavy. My arms started to hurt. I just wanted to hand him back to his mother.

The worse I felt, the more I pretended. To my midwife, to my therapist, to my friends, to my husband. Even to my unborn baby, who I would talk to in forced chipper voices: “Hi Baby!” I became convinced that if I didn’t say out loud how much I didn’t want this child, the child wouldn’t be able to tell.

I was scared and I was running out of time, so I did what any crystal-loving horoscope-fluent millennial does in a time of trouble, I went to see a psychic.

She wasn’t a scarf-and-heavy-eyeliner psychic. She was a cardigan-and-sensible-shoes psychic. She worked in a boring office with generic art on the walls. I told her why I was there: I had always wanted to be a mother, and now that I was pregnant, I didn’t. She said nothing. She watched me. I began to regret the $160 this was going to cost me.

Then she told me that the first awareness I had ever had, as a tiny little seed of a fetus, was that I wasn’t welcome in the world.

Later that week, I went out to dinner with my mother and we started talking about my pregnancy, and then about her pregnancies. “I remember being six or seven weeks pregnant with you,” my mother said, “And I wasn’t sure that I wanted another baby. I remember feeling like I didn’t want to be pregnant.”

I finally had my proof. I was the unwelcome baby, now unable to welcome my own baby. The power of generational trauma was so strong, I told myself, that I was helpless to stop myself from traumatizing my child.

I probably would have continued to believe this—might even still believe it today—if I hadn’t done a late night google search on depression during pregnancy and found a forum where I read posts from hundreds of other women who were experiencing the same thing. People were depressed about babies they had longed for. Some people weren’t sure they wanted second children. Some people had had prenatal depression before and reassured the rest of us that it could go away quickly after giving birth. One post mentioned that if you have had a bad reaction to progesterone birth control, you may be more likely to have depression during pregnancy when your body is flooded with progesterone.

When I read that, I started crying with relief. I had stopped taking birth control years before because I’d had such a bad reaction to it. In fact, the feelings I was having now were a more intense version of what I had experienced back then. I wasn’t caught in a generational curse. I wasn’t a bad mom. I was just on a hormonal trip.

According to Dr. Tobón, fluctuations in estrogen and progesterone during pregnancy play a big factor in mood disturbances. But genetics, such as a family or personal history of mental health concerns, and environmental stressors, play significant roles as well.

Knowing that my depression was happening to me, but it wasn’t me, and it had nothing to do with my ability to parent, changed everything. I started talking to my friends and family and providers about what was going on. I started texting with women I met on the internet who were going through the same thing. I still was depressed, sometimes overwhelmingly depressed, but I was not alone.

Within 12 hours of giving birth to my son, I was myself again. Excited, joyful, full of life. The depression vanished as quickly as it had come. When I got pregnant with my second child, the depression came back in full force. But I was more prepared for it this time, and I spoke openly about what I was experiencing. And once again, hours after giving birth, the depression lifted and I felt like myself again.

Prenatal depression was not an easy introduction to motherhood, but it taught me an important lesson: there is no switch—even a hormonal one—that turns you into a bad, or good, mother. You don’t need a perfect pregnancy to have a great birth experience, and you don’t need a great birth experience to have a good postpartum and you don’t need a good postpartum to be a perfectly adequate parent. Over the years, I’ve tried—and succeeded! and failed!—a hundred times, a thousand times, to break the generational cycle of trauma for my children. I’ll try again today. I’ll try again tomorrow. I’ll just keep trying.

Emma Pattee is the author of the forthcoming novel Tilt, out next year.

If you or someone you love is suffering, please seek help.