Pregnancy is supposed to be one of the happiest times of a woman’s life. But some women will find themselves struggling with depression during that time. In fact, the American Congress of Obstetricians and Gynecologists (ACOG) reports that approximately 14-23 percent of women may suffer from depressive symptoms while pregnant.

Perhaps that isn’t so surprising. After all, pregnancy brings quite a few changes to a woman’s body and life—enough that it might lead one to believe a case of the blues could be just a normal part of carrying a child to term. But when should you worry that there may be more to it?

Jennifer Breazeale, M.D., an OB-GYN at Kelsey-Seybold in Houston, Texas, says that, for most women, clinical depression should not be a huge concern during pregnancy.

Signs of Depression During Pregnancy

“We don’t see it that often in women without a history of depression,” she says. “It’s a much bigger issue with women who do have that history of depression prior to pregnancy. And if you do have that history, it’s something you need to share with your doctor so you can keep an eye on it.”

That said, if a pregnant woman is having feelings of sadness, irritability, or lack of joy to the point where it is interfering with daily living while pregnant, Breazeale says you should call your doctor immediately because it is something that needs to be addressed.

For those without a history of depression, postpartum depression can be more of a concern. Breazeale says the combination of that quick drop in pregnancy hormones, sleep deprivation, and lifestyle changes soon after giving birth can make even the most stoic woman more emotional. And postpartum depression appears in many women who have never experienced depression before.

“A few days after giving birth, and for a while after, most women are more emotional and may cry more easily,” she says. “But you need to worry when it’s not just little episodes of crying or irritability. When you see more long-term situations where a woman feels isolated, overwhelmed, and gets to the point where she can’t get out of bed and doesn’t want to take care of the baby. And it’s more common than many people realize.”

Finding Treatment for Depression

If your symptoms get to that point, Breazeale says your first call should be to your OB-GYN. And, she says, a woman’s partner could be the first to recognize an issue.

“Women often feel like they can’t say they are depressed. It’s really hard to admit that you aren’t happy. New moms feel like they are supposed to be happy and just can’t figure out how to say that they aren’t. We actually screen patients after they give birth to see if they might be experiencing depression with a set list of questions. And some women will act like they are fine at the visit, tell me that they are doing just fine, and it’s only after I ask these questions that I see they are actually really having a hard time,” she says. “A partner is often the first person to see that there might be a problem. They know their wife and how she normally acts better than anyone else. So if you see something isn’t quite right and you are worried, you can also make a call to your wife’s OB-GYN.”

Taking that first step can be difficult, no doubt, but Breazeale says that it’s important, because there is a lot that your OB-GYN can do to help alleviate the symptoms. “There’s a lot we can do now to help with different therapies and medications to help you feel better,” she says. “But the first step is letting your doctor know what’s going on so they can get you that help.”

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