Perinatal Mental Health in Pregnancy: What to Know

Q: How long does the perinatal period last?

Perinatal mental health covers the time from the start of pregnancy through to up to two years after birth. Many NHS services define the postnatal window as up to 12 months after birth, though support needs can run beyond that. If you are still struggling at any point in those first two years, it is right to seek help.

Q: How do I know if what I am feeling is more than the baby blues?

The baby blues usually settle within two weeks of birth. If low mood, tearfulness, or emotional exhaustion carry on past two weeks, start later, or come with losing interest, not enjoying things, or constant worry, these can be signs that you would benefit from support. Speak to your GP, midwife, or health visitor. Describing what you have noticed is enough to start the conversation.

Q: Can I get support without a GP referral?

In most areas of England, you can refer yourself to NHS Talking Therapies without seeing your GP first. Check your local service to confirm. Your GP, midwife, or health visitor can also refer you if you prefer. If you are in Wales, Scotland, or Northern Ireland, ask your GP or call NHS 111 to find out what local options you have.

Q: Will I be separated from my baby if I need inpatient treatment?

If you need inpatient care for a severe condition such as postpartum psychosis, Mother and Baby Units let you be admitted with your baby, so you can have treatment together. Availability varies across the UK, and your clinical team will talk you through what you can reach and help arrange the right care for you.

Q: What should I do if I am in crisis right now?

Call NHS 111 and select the mental health option, or contact the Samaritans on 116 123 (free, available 24 hours). If you are in immediate danger, go to your nearest emergency department or call 999. In Scotland, call NHS 24 on 111. In Wales, call NHS 111 Wales. In Northern Ireland, contact your GP out-of-hours service or go to your nearest emergency department.

Pregnant woman lying down, touching her belly and looking away.

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The low mood that catches you off guard, the worry that will not quieten, the exhaustion that goes beyond tired. These can show up during pregnancy or after birth, and you might not always have a name for them. What you feel can sit anywhere on a wide spectrum, from the tearfulness of the first days after birth through to conditions like depression, anxiety, and postpartum psychosis. Perinatal mental health covers your mental health from the start of pregnancy through to up to two years after birth, and noticing where your experience sits is the first step towards the right support.⁵

These experiences are more common than you might expect. Up to one in four people are affected during pregnancy or in the early years after birth. Around 70% of those affected hide or play down what they are going through, and suicide remains one of the leading causes of maternal death in the first year after birth. Speaking up early gives you the best chance of getting support while it is most useful.¹⁶

The range of perinatal mental health conditions

Depression and anxiety are the most common, though the term covers more than that. It also includes obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), postpartum psychosis, and eating disorders. Each one comes with its own pattern of symptoms and its own route to support. This article gives you the overview, with separate articles going deeper into individual conditions.²⁷

Baby blues and when feelings go beyond them

A woman cradles her belly, showing signs of labor. In the background, hands gently hold a baby.

After birth, you might feel suddenly tearful, low, or fragile even when things have gone well. These feelings are often called the baby blues, and they are very common. They usually settle within two weeks of birth. If sadness and low mood carry on past those two weeks, or start later, that can be a sign of postnatal depression. Other signs worth watching for are losing interest in things that usually matter to you, not enjoying much, and a tiredness that does not lift. If any of this feels familiar, it is worth speaking to your GP, midwife, or health visitor.⁸

There is a difference between expected day-to-day worry and perinatal anxiety. While feeling concerned about a new baby is normal, perinatal anxiety involves intense, constant worry that disrupts daily life. This can include persistent fears about your baby’s safety, your own health, or a constant feeling that something bad will happen. If worry is taking over your day, bring it up with your GP or midwife.³⁹

Factors that can raise the likelihood of difficulty

These conditions can affect anyone, but certain factors can raise the likelihood. These include a history of mental health problems, a traumatic birth experience, a lack of social support, physical health complications, and severe sleep deprivation. Discussing these background factors with your midwife or GP helps your care team monitor you more closely and spot any early signs sooner.⁴¹⁰

How to seek support and what is available

The first step is to speak to your GP, midwife, or health visitor. Any of them can listen, offer initial support, and refer you on to specialist services if you need them. You do not need a clear diagnosis or a crisis to start the conversation. Describing what you have noticed is enough.¹¹

For mild to moderate difficulties, your GP can refer you to NHS Talking Therapies (once known as IAPT). In most areas you can also refer yourself directly, without seeing your GP first. Check your local service to confirm what applies where you are. This service runs in England. If you are in Wales, Scotland, or Northern Ireland, ask your GP or midwife about the local talking therapy services near you.¹²

For moderate to severe or more complex needs, every area in England now has a specialist perinatal mental health team. These teams bring together psychiatrists, psychologists, and specialist nurses, and they look at the relationship between you and your baby alongside your own wellbeing. If you live in Wales, Scotland, or Northern Ireland, what is on offer differs, so speak to your GP or midwife about local services, or call NHS 111 for guidance.¹³

For severe and acute illness, including postpartum psychosis, there are specialist inpatient wards in England called Mother and Baby Units (MBUs). These let you be admitted with your baby, so you can get treatment without being separated. Availability and travel distances vary across the UK, so your clinical team will talk you through what you can reach.¹⁴

Additional sources of information and peer support

Alongside NHS routes, several organisations offer information, helplines, and peer support. Mind has detailed guidance on perinatal mental health conditions and a list of useful contacts. The Maternal Mental Health Alliance offers resources for parents and families affected by perinatal mental illness. The Association for Post Natal Illness (APNI) and the PANDAS Foundation run community and peer-led support. These are information and peer support rather than clinical services, and they can work well alongside formal care.¹⁵

Frequently Asked Questions

How long does the perinatal period last?

How do I know if what I am feeling is more than the baby blues?

Can I get support without a GP referral?

Will I be separated from my baby if I need inpatient treatment?

What should I do if I am in crisis right now?

Sources

[1] Antenatal and Postnatal Mental Health – NICE Clinical Guideline CG192

Antenatal and postnatal mental health: clinical management and service guidance (Section on early identification and prompt referral for perinatal mood conditions).
[2] Antenatal and Postnatal Mental Health – NICE Clinical Guideline CG192

Perinatal mental health problems affect 1 in 5 women, with depression and anxiety being the most common
[3] Mental health in pregnancy

It is natural to feel stressed or anxious at times during pregnancy - or when you have a new baby. These emotions are quite normal... Depression and anxiety are the most common mental health problems
[4] Antenatal and Postnatal Mental Health – NICE Clinical Guideline CG192

Section 1.5 (Identification and assessment): Identifies past mental illness, birth trauma, social isolation, physical complications, and sleep disruption as key risk/contributing factors, and instructs care teams to assess these at first contact to facilitate early detection and monitoring.
[5] Perinatal mental health

Perinatal mental health (PMH) refers to your mental health from the start of pregnancy through to up to two years after birth, and it covers a wide spectrum of conditions.
[6] maternalmentalhealthalliance.org

Around 70% of those affected will hide or downplay what they are going through, and suicide remains one of the leading causes of maternal death in the first year after birth.
[7] mind.org.uk

The most common perinatal mental health conditions are depression and anxiety, but the term also covers OCD, PTSD, postpartum psychosis, and eating disorders.
[8] Find care for your mental health before, during and after pregnancy

If feelings of sadness and low mood persist beyond two weeks, or begin later, that may be a sign of postnatal depression. Other signs include lack of enjoyment, loss of interest, and persistent tiredness.
[9] Perinatal mental illnesses

Perinatal anxiety involves intense, constant worry that affects daily life, such as fears about a baby's safety or your own health, as distinct from ordinary parental concern.
[10] Perinatal mental illnesses

Risk factors that can raise the likelihood of a perinatal mental health condition include a previous history of mental illness, a difficult or traumatic birth, lack of social support, sleep deprivation, and physical health complications.
[11] Find care for your mental health before, during and after pregnancy

The first step is to speak to your GP, midwife, or health visitor, who can listen, provide initial support, and refer you to specialist services if needed.
[12] Find care for your mental health before, during and after pregnancy

For mild to moderate difficulties, a GP can refer you to NHS Talking Therapies (formerly IAPT), and in most areas you can also self-refer directly.
[13] Perinatal mental health

Every area in England now has a specialist perinatal mental health team for those with moderate to severe or complex needs, including psychiatrists, psychologists, and specialist nurses who focus on the parent-baby relationship.
[14] Find care for your mental health before, during and after pregnancy

For severe and acute illness such as postpartum psychosis, Mother and Baby Units (MBUs) allow admission with a baby so that treatment can proceed without separation. Availability and travel distances vary.
[15] mind.org.uk

Mind provides detailed guidance on perinatal mental health conditions and useful contacts. The Maternal Mental Health Alliance offers resources for parents and families. APNI and PANDAS Foundation provide community and peer-led support.