Depression During Pregnancy

Pregnancy is a common condition among women of reproductive age and is generally perceived as a period of happiness for the mother. Pregnancy is a natural life event for women. While it can be a source of joy, satisfaction, maturity, self-realization, and happiness, it may also create anxiety, worry, and emotional burden (Arslan, 2010:37). Pregnancy is a highly stressful period in women’s lives and is often associated with anxiety and depression (Sevindik, 2005:26).

In daily language, the word depression is often used to describe a combination of emotions such as sadness, disappointment, and perhaps a degree of pessimism (Ertekin, 2006:26). Pregnant women may also experience many clinical signs and symptoms that overlap with major depression, including sleep and appetite disturbances, loss of energy, and decreased motivation. Medical conditions commonly seen during pregnancy may further complicate the diagnosis of depression during pregnancy (Karataylı, 2007:15).

Pregnancy brings forward emotional, existential, psychological, and behavioral expectations, conflicts, hopes, and desires related not only to womanhood but also to the maternal role. A woman’s psychological state and experiences can affect the course of pregnancy, while pregnancy itself may create significant emotional and psychological reflections. Pregnancy may give women a sense of self-confidence, self-expression, distinction, and value. For some pregnant women, this period may also make it easier to express dependency needs as well as expectations for attention, support, and help from their environment (Çivi, 2007:10).

During the first trimester of pregnancy, emotional ambivalence is common, and even women who previously appeared calm may display fluctuating behaviors in daily life. Sudden joy may quickly turn into sadness and distress. The thought of “I will have a child one day” may create happiness, while the thought of “not now” may lead to unhappiness. During the final trimester, despite physical limitations in movement, developing maternal feelings are believed to encourage protective behaviors toward the unborn child. After the 28th–32nd week, fears such as stillbirth, difficult labor, labor pain, death, not being a good mother, having to quit or interrupt work after birth, and financial burden on the family may lead to anxiety and stress in pregnant women (Sevindik, 2005:25).

RISK FACTORS

Risk factors that may make women more vulnerable to depression before and after childbirth can be summarized as follows:

• Family history of depression
• Previous history of depression
• Poor relationship with partner or single parenthood
• Lack of visible support from relatives and friends
• Difficult or unhappy childhood experiences
• Birth complications affecting the mother or baby
• Early, late, or multiple childbirths
• Negative feelings toward the baby
• Health problems in the baby or low birth weight
• Early separation of mother and baby or previous negative birth experiences
• Socioeconomic difficulties
• Unplanned pregnancies (Sevindik, 2005:34)

PREVALENCE

According to studies, the prevalence of depression and depressive symptoms during pregnancy ranges between 5% and 51% (Arslan, 2010:37). When studies examining the severity of depressive symptoms in pregnant women are reviewed, Sevindik reported that 30% of pregnant women showed no depressive symptoms, 33.8% had mild symptoms, 23.8% had moderate symptoms, and 12.5% had severe depressive symptoms. Similarly, Aktaş and colleagues found that 46.6% of pregnant women showed no depressive symptoms, 34.5% had mild symptoms, 13.9% had moderate symptoms, and 4.8% had severe depressive symptoms (Pişirgen, 2011:16).

REFERENCES

Arslan, B. (2010). Sociodemographic Characteristics Related to Anxiety and Depression in Pregnant Women. Medical Specialty Thesis. Süleyman Demirel University, Faculty of Medicine.

Çivi, S. (2007). Determining Depression and Quality of Life in High-Risk Pregnancies. Medical Specialty Thesis. Selçuk University, Meram Faculty of Medicine.

Ertekin, B. (2006). Investigation of Job Satisfaction and Depressive Mood of Nurses Working in Health Institutions in Mardin According to Certain Sociodemographic Variables. Master’s Thesis. Dicle University, Institute of Social Sciences.

Karataylı, S. (2007). Depression, Anxiety, Other Psychological Symptoms, and Quality of Life Levels Across Trimesters in Pregnant Women. Medical Specialty Thesis. Selçuk University, Meram Faculty of Medicine.

Sevindik, F. (2005). Prevalence of Depression During Pregnancy and Influencing Factors in Elazığ Province. Master’s Thesis. Fırat University, Institute of Health Sciences.

Pişirgen, T.N. (2011). Evaluation of Depression and Anxiety Levels in High-Risk Pregnancies. Medical Specialty Thesis. Eskişehir Osmangazi University, Faculty of Medicine.