Mental health in early pregnancy – the first trimester

Disrupting the balance

Little Foster-Pickup waves hello

I’m pretty good at managing my mental health. I know what helps, what doesn’t and how to recognise when I need to take better care of myself or ask for extra support.

But early pregnancy disrupted this balance. I’m nearly 17 weeks now and finally ready to write about the first trimester.

Awareness of perinatal mental health is increasing. Most people know about postnatal depression but I’ve seen more conversations about antenatal depressionperinatal anxiety and postpartum psychosis too. I’ve heard less about how to prepare for the way dramatic physical and psychological changes can interact with existing problems.

Taking antidepressants, managing eating problems and dealing with depression and anxiety

It turns out I’ve got a lot to say so I have separated them into three blogs.

Opening up

As I move through the second trimester I’m feeling less sick. I’ve got lots more energy. My ability to manage my muddled eating is back to pre-pregnancy levels and I have started to enjoy exercise again. Opening up on Facebook and to friends has helped. I’m lucky to have so many people around who understand. But I need to be aware that things will keep changing. I’ll have to readjust my relationship to exercise and my body again and again as I get bigger.

Could I have prepared better? I’m not sure how I could have done things differently. Everything is so unexpected, uncertain and changeable – it’s not something I could really imagine until I was in the middle of it.

Preparation and support


And next trimester (and indeed next time – if there is one) will probably be very different. Maybe we can prepare a little – read information, talk and share stories. This is important. The myth of pregnancy as a perfectly calm, exciting and enjoyable time is still pervasive. But we’ll never be completely sure how these complex chemical and environmental interactions will affect us. We need to make sure we admit when things are harder that we expected and ask for whatever help is available.

I have a referral to an obstetrician who specialises in mental health – but my appointment isn’t until June. In the meantime, I spoke to an amazing midwife who agreed that 27 weeks in was very late for starting any additional perinatal mental health support. She said the most sensible thing I have done is stay on the Sertraline and referred me to see a psychologist a little earlier. I’m not sure how (or if) these appointments will help but I’m keeping an open mind and making sure I have as much support in place as possible in case things get harder again.

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