Pregnancy: Depression, Antidepressant Drugs and The Baby – Part 4

Posted by: Kevin Flatt

Depression During Pregnancy – Depression Deepens – Doubt: Can they cope throughout the pregnancy and after the baby is born. Perceived consequences of depression and antidepressant use and the baby. Conflicting information provided by physicians and psychiatrists.

Phenomena resulting from traveling into despair – Conceiving the threat.

This category represents the phenomena that result from the conditions encountered in traveling into despair. It occurs when the women try to make sense of their feelings and are unable to do so. Their ability to understand what is happening wanes as the symptoms of depression continue unabated.

Initially, the women “denied a lot of the stuff, kept it in, denied it, deluded myself and just kept going.” They attributed their emotional state to being “too busy at work” or “I’m just pregnant, nothing is wrong”.

The women described their efforts to maintain a sense of normalcy in their lives as “putting on a happy face”. By denying or ignoring what they were feeling they were able, at least for the short term, to pretend to themselves and to those around them that everything was on track. “So, that’s what I do, I wear a mask for people, so be it.”

As the women failed to improve they attempted to alleviate the way they felt by meditating, tuning out, and turning to comfort food. One woman, who found relief by watching television said, “It would be the only way that I could tune my brain out, stop the thoughts, you know, thinking”.

However, none found the relief for which they were searching. Despite their best efforts their coping strategies were not adequate. This was explained as, “Normally you can kind of problem solve your way out of it, but there was just no problem solving”.

They acknowledged “that there was something wrong”, that they “can’t do it anymore” and they saw themselves as needing help. They feared that the depression was “a risk for the baby more than it is for me”, they made the decision that they will “deal with this, and do whatever I have to do” to be “better before this baby comes.” All women described an urgency that they attend to their depression prior to the birth of their baby.

The core categories of the subjective phenomena are; Loss of control, Altered perception of self, and Doubting maternal ability.

Loss of control
A frightening loss of control permeated every aspect of the women’s lives. They were unable to control their feelings, emotions, thoughts, and actions. The practicalities of the everyday were seen to be outside of their control; they had difficulty imagining how they would cope throughout the pregnancy and after the baby was born.

It was really frightening. I felt out of control. The anxiety that
that provoked for me was just like right over the top. I thought
how am I ever going to function, how can I possibly get through
the entire pregnancy like this.
(#18) (Note: As mentioned in Part 1, confidentiality was maintained by assigning each participant a code number).

Altered perception of self
The women looked to the familiar to try to come to grips with how they were feeling. They compared the current self with the previous self, with previous pregnancies and with others who were pregnant.

You see other pregnant women are jogging, buying baby clothes,
working up until the last possible moment. You think why aren’t
I doing that.

For all women the current self was in conflict with their image of the pregnant self; many no longer recognized the current self as the old self.

I think that’s initially what got me down the path, was just
thinking this isn’t like me.

Doubting maternal ability
Many questioned their ability to mother, their decision to become pregnant in the first place, their ability to continue with the pregnancy, and they lacked hope for the future.

I just questioned a lot of like what am I doing, why am I
pregnant, why did I try to get pregnant.

In addition, many women believed that their antenatal depression would harm their developing baby; they feared that they would develop postpartum depression (PPD), and that they would be unable to care for their family and the coming baby.

I just had lots of fears that I wasn’t going to be able to be a mom,
because I sometimes felt so disabled.

Context in which the strategies of becoming the best mom that I can developed.

The strategies employed by the women in becoming the best mom that I can developed within the following interacting contexts: duration and intensity of depressive symptoms, perceived consequences of depression and of antidepressant use, personal, interpersonal, and societal influences, and availability of information.

These contexts, which were influenced by both the causal conditions and the resultant phenomena, were paradoxical and interacted to create a tension that intensified the women’s uncertainty about their strategies.

The women saw themselves as “getting worse”, when they had “more bad days than good”. Many described a depression so intense that it “affected every minute of the day” and that they “couldn’t see it ending”.

They compared how they were feeling to their expectations of pregnancy which were shaped by past experiences and from what they had read in “pregnancy books, parenting magazines, and talking to others who were pregnant”.

Women who had been pregnant previously and had not experienced depression recognized their mood as inconsistent with their previous pregnancy. It was that knowledge that helped them to determine their need for professional help.

Women who had experienced depression and its management prior to pregnancy had the knowledge that enabled them to assess their level of depression. They recognized when they needed to seek professional help and they had intimate knowledge of the effect of counseling and antidepressant use on their mood.

For women who were expecting their first baby and had not been depressed prior to pregnancy the decision was based upon their expectations. Many imagined the pregnant self would be “all roses and just so excited and everything”.

I think that I had this expectation that when you are pregnant
everything is rosy and perfect, and you are aglow. All these things
we’re sort of led to believe. So, I think when reality hit, I felt like

On the other hand, personal, interpersonal, and societal influences, and availability of information acted as obstacles to their actions. Some women were embarrassed to seek care, others experienced difficulties forming therapeutic alliances with healthcare providers.

Some women were fiercely “against medications” and others feared that they would be judged to be a bad mother if they took antidepressants while pregnant. When information provided by physicians and psychiatrists conflicted, women were confused and uncertain as to their course of action.

Part 5 will be published soon. Support from husbands, parents, siblings and friends?

Realted articles:

Dealing with Depression during Pregnancy – Part 1

Depression During Pregnancy – Part 2

Women With Depression During Pregnancy – Part 3

The researchers were Heather Bennett, Heather Boon, Sarah Romans and Paul Grootendorst. The above is a partially modified reproduction of their research. Also their references have been omitted for ease of reading.

Bennett HA, Boon HS, Romans SE, Grootendorst P. Becoming the best mom that I can: women’s experiences of managing depression during pregnancy – a qualitative study. BMC Women’s Health 2007, 7:13 (11 September 2007). © 2007 Bennett et al., licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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