For many, pregnancy is a happy, glowing experience, but it is a myth that this is true for everyone. Pregnancy, childbirth and becoming a parent are times of great transition. Major hormonal and physical changes occur during pregnancy, and responsibilities and uncertainties multiply. Many women (and men) experience stress reactions during pregnancy and/or following a miscarriage or termination of pregnancy. Approximately 15-20 % of pregnant women experience depression. It can also be confusing that normal pregnancy experiences such as fatigue, appetite changes, and poor sleep are similar to depressive symptoms. It is important not to assume that these symptoms are just part of pregnancy.

Depression during pregnancy has been associated with low birth weight and pre-term delivery (less than 37 weeks). Severe anxiety during a pregnancy can cause harm to the growing fetus due to higher cortisol (hormone) levels and restricted blood vessels in the placenta. While this is troubling information, the good news is that treatment and support will contribute to the well-being of the mother, baby and entire family.

In my work related to pregnancy issues, I help women work through a variety of emotional concerns. Here are some examples:

• Worrying about the health of her pregnancy (this can be especially difficult if there is a history of miscarriages, or infertility.)
• Extremely negative or uncertain feelings about parenting related to a woman's personal history in her family of origin.
• A resurgence of grief, loss and/or guilt related to past miscarriages or abortions.
• Concerns regarding staying on psychotropic medications (for depression or anxiety) during pregnancy and postpartum.
• Worrying about the responsibility of caring for a new baby.
• Dealing with the emotions related to an unplanned pregnancy.
• Having a history of a postpartum mood disorder and therefore wanting to make a proactive plan for postpartum support and care.