The last taboo

A recent study reported in the British Medical Journal sends out a powerful message to doctors and midwives: new mothers should be screened for the warning signs of depression long before delivery day.

While postpartum depression tends to attract the lion's share of attention, the researchers involved in this study determined that women are far more likely to be depressed during pregnancy than after giving birth. While 13.4 percent of women who were 32 weeks pregnant showed symptoms of depression, just 9.1 percent of women with eight-week-old babies exhibited those same symptoms.

So if prenatal depression is, in fact, more common than postpartum depression, why aren't more pregnant women talking about it? The reason is simple: there's even more of a taboo about admitting that you're suffering from prenatal depression than there is to admitting that you're suffering from postpartum depression. After all, aren't you supposed to be positively euphoric for the entire duration of your pregnancy, morning sickness and all?

Of course, it doesn't help that many of the symptoms of prenatal depression mimic common pregnancy complaints. It can be hard to determine whether the fatigue, insomnia and appetite changes that you are experiencing are garden-variety pregnancy complaints or symptoms of full-blown prenatal depression. If those symptoms are accompanied by such classic depression symptoms as persistent sadness, a loss of enjoyment of life, anxiety, an inability to concentrate and/or extreme irritability, you should at least consider the possibility that you could be suffering from prenatal depression.

Risk factors

While it's impossible to predict ahead of time who will and won't develop prenatal depression, researchers have identified some key risk factors for prenatal depression. You face an increased risk of developing prenatal depression if:

• You have experienced episodes of depression in the past
• You have a family history of depressive illness
• You have experienced one or more stressful events during your pregnancy (e.g., you've recently moved, changed jobs, separated from your spouse or are trying to cope with the death of a close friend or family member)
• You are experiencing a complicated pregnancy (e.g., your doctor has put you on bed rest or you are at risk of experiencing premature labor)
• You have experienced infertility and/or pregnancy loss in the past and are very fearful about having something go wrong with this pregnancy
• You have a past history of emotional, sexual or physical abuse.

If you suspect that you are becoming depressed, it's important to talk to your doctor about how you are feeling. He or she may want to prescribe some sort of medication and/or refer you to a therapist who can provide you with some much-needed support.

Regardless of what sort of treatment is recommended, it's important to seek out treatment as soon as possible to reduce your risk of developing postpartum depression. Fifty percent of women who experience depression during pregnancy also experience depression during the postpartum period. And, as any woman who has experienced postpartum depression will tell you, it's no way to embark on the adventure called motherhood.