The Impact of Pregnancy Complications on Perinatal Mental Health

Thrive • May 17, 2022

By Thrive Wellness Reno’s Director of Perinatal Psychiatry, Andrea Thompson, APRN, FNP-C, PMHNP-BC

While the majority of pregnancies are without complications, pregnancy abnormalities do occur and may be mental or physical in nature. Common complications can include hypertension, preeclampsia, and perinatal mood and anxiety disorders (PMADs) . Even if a pregnancy complication isn’t a mental health condition, it can still have spiraling effects on mental well-being both during pregnancy and postpartum. The potential harm associated with pregnancy compilations can make an emotionally turbulent time even more challenging for parents to navigate. Just as prenatal care can help reduce some of the risks of developing pregnancy complications, seeking mental health support can help guide expecting parents in processing their pregnancy experience and any challenges they face along the way.

DEPRESSION AND ANXIETY

Under the umbrella of PMADs , depression and anxiety are among the most common mental health complications of pregnancy. According to the National Institutes of Health (NIH) , up to 13% of women in the U.S. experience symptoms of depression after childbirth. Additionally, up to 43% of moms who struggle with depression during their pregnancy or postpartum periods also experience co-occurring anxiety. 

Risk factors for experiencing depression or anxiety during pregnancy may include:

  • A personal or family history of depression or anxiety
  • Being a young parent
  • Being a single parent
  • Lack of social or financial support
  • Pregnancy complications
  • Relationship struggles with significant other

Symptoms of depression during pregnancy may include:

  • Difficulty concentrating
  • Feeling sad, hopeless, worthless, apathetic
  • Inability to find enjoyment in activities one previously enjoyed
  • Thoughts of suicide

Symptoms of anxiety during pregnancy may include:

  • Irritability
  • Muscle tension 
  • Restlessness 
  • Uncontrollable worry 

Depression and anxiety are some of the most treatable pregnancy complications. Through therapeutic support, such as that offered by perinatal mental health specialists , expecting and postpartum parents can discover the root causes of their depression and anxiety while learning healthy, effective coping strategies for their mental health symptoms. 

HYPERTENSION

High blood pressure, also referred to as hypertension, can cause increased pressure in the arteries. In a pregnant person, elevated blood pressure can restrict blood flow to the fetus, which can increase the risk of preterm labor and preeclampsia. According to the CDC , among women aged 20 to 44, high blood pressure happens in one in every 12 to 17 pregnancies. 

Circumstances that may play a role in whether or not a person will develop elevated blood pressure include:

  • First pregnancy
  • Lifestyle, including the way one nourishes their body and their level of physical activity
  • Older than age 35
  • Pregnant with multiples
  • Substance use, including smoking and drinking alcohol
  • Use of fertility treatments

Symptoms of hypertension include:

  • Cold, clammy skin 
  • Faintness
  • Headache 
  • Nausea

By working closely with one’s healthcare provider, high blood pressure can be managed throughout a person’s pregnancy and the baby can be born healthy. Elevated blood pressure is also associated with stress, so mindfulness strategies , such as breathing practices, meditation, and yoga can help promote healthy blood pressure. 

GESTATIONAL DIABETES

Gestational diabetes occurs when diabetes that had not previously been a factor develops during pregnancy. Up to 10% of pregnancies are affected by gestational diabetes. 

Risk factors for gestational diabetes include:

  • Family history or cultural prevalence of diabetes
  • Pregnant with multiples
  • Older than 25

Potential medical risks of gestational diabetes include:

  • Preeclampsia
  • Hypertension
  • Cesarean delivery
  • Preterm birth

Often, gestational diabetes doesn’t cause any noticeable symptoms, so healthcare providers must test for the condition. With the oversight of a physician or midwife, and often with the help of nutritionists, gestational diabetes can be effectively managed through medication as well as guidance on movement and nourishment. 

PREECLAMPSIA

Closely associated with hypertension, preeclampsia is a serious pregnancy complication that can disrupt the functioning of all the body’s organs including the kidneys, liver, lungs, and brain. Those with preeclampsia face an increased risk of giving birth early and losing their pregnancies. According to the CDC , preeclampsia occurs in ​​1 in 25 pregnancies in the U.S. 

While the direct cause of preeclampsia is unknown, there are several risk factors including:

  • Elevated blood pressure
  • First pregnancy
  • History of preeclampsia
  • Pregnant with multiples

Preeclampsia most commonly happens during first pregnancies, but a person who developed preeclampsia in a previous pregnancy is seven times more likely to experience the condition in subsequent pregnancies, according to the NIH .

Symptoms of preeclampsia include:

  • Changes in vision, such as blurry or spotted vision
  • Constant headache
  • Difficulty breathing
  • Nausea or vomiting in later trimesters
  • Pain in the upper abdominal region
  • Sudden weight gain
  • Swelling of the face or hands

When preeclampsia affects brain function by causing seizures or coma, the condition is known as eclampsia. Preeclampsia can also occur after giving birth, usually between 48 hours and 6 weeks following delivery. 

According to the NIH , every year, preeclampsia and eclampsia cause 50,000 to 75,000 maternal deaths worldwide. While preeclampsia can be life-threatening for the parent and baby, those diagnosed with preeclampsia can fully recover and have healthy babies with treatment and close monitoring from their healthcare providers.

PRETERM LABOR

Preterm labor occurs when labor begins before 37 weeks gestation. According to the CDC , in 2020, one out of every 10 infants were born prematurely. In the final months and weeks of pregnancy, babies are still reaching important milestones. Their brains, lungs, and livers are still developing in the womb. Babies born early face an increased risk for birth defects , including problems breathing, feeding, seeing, and hearing. Additionally, preterm labor can also cause infant death , with 17% of infant deaths associated with preterm birth, according to the CDC . As with preeclampsia, the causes of preterm labor are largely unknown, but there are certain risk factors.

Risk factors of preterm birth include:

  • Family or personal history of preterm labor
  • Hypertension
  • Infections, including urinary tract infections and sexually transmitted infections
  • Large uterus
  • Preeclampsia
  • Pregnant with multiples
  • Previous history of preterm births
  • Substance use, including smoking and drinking alcohol
  • Use of fertility treatments
  • Younger than 20 and older than 35

Because preterm labor isn’t well understood, it’s difficult to fully mitigate one’s risk of giving birth prematurely. However, seeking early prenatal care that continues throughout pregnancy can help monitor and address any factors that may lead to preterm birth.

PREGNANCY LOSS

Pregnancy losses that occur before 20 weeks are usually referred to as miscarriages, while those that occur after 20 weeks are called stillbirths. For women with confirmed pregnancies, research shows that the miscarriage rate is between 10 and 20%. In the U.S., 1 in 100 pregnancies ends in stillbirth, according to the CDC .

No matter when a pregnancy loss takes place, it can be a tragic, distressing, and mournful loss for parents. A study published in the British Journal of Psychiatry found that 15 percent of the women participants who experienced miscarriages also struggled with depression and anxiety in the years that followed. Another study published in the Journal of Child Psychology and Psychiatry found that infants born after a stillbirth exhibited disorganized attachment behavior . In other words, as parents come to terms with their perinatal loss, they may struggle to bond with their other children. 

PREGNANCY COMPLICATIONS AND PERINATAL MENTAL HEALTH

As parents prepare their lives for a new baby, they may experience shifts in their mental health. Whether physical or mental in nature, pregnancy complications can inject even more distress into their perinatal experience as parents navigate medical appointments, endure additional testing, and encounter unknowns. Many parents facing pregnancy concerns keep their struggles private and continue to attend to their professional, family, and social obligations — a pattern of behavior that can promote feelings of isolation.

Pregnancy challenges can and often do impact parents’ postpartum experience as well. Experiencing depression and anxiety during pregnancy puts parents at a greater risk for developing PMADs after giving birth.

THERAPEUTIC SUPPORT FOR THOSE FACING PREGNANCY COMPLICATIONS

For those facing pregnancy complications, therapy can provide compassionate support, validation of experiences, and a safe environment to express and process fluctuating emotions. Medication can also help treat mental health struggles associated with pregnancy concerns for some individuals. Further, open communication channels between a person’s OBGYN or midwife and their mental health treatment team can ensure targeted, well-rounded care. 

NURTURING CARE FOR EXPECTING PARENTS

When seeking professional mental health support related to pregnancy complications, parents may consider speaking with a perinatal mental health therapist who can offer a specialized perspective that’s intimately aware of many of the concerns faced by parents who are pregnant or have new children. At Thrive Wellness, our perinatal health experts specialize in perinatal mental, physical, and behavioral health care. Together, they collaborate on your care so that you feel supported through any pregnancy challenges. Reach out to learn more about our perinatal health services as they vary by location. 

About the Author

Thrive Reno’s Director of Perinatal PsychiatryAndrea Thompson, APRN, FNP-C, PMHNP-BC

Andrea Thompson, APRN, FNP-C, PMHNP-BC is a Nurse Practitioner whose background has stemmed in primary care, primarily working with under-served and under-insured populations. After several years in family practice, she completed a Post Master’s certification as a Psychiatric Mental Health Nurse Practitioner. In early 2019, she started a program the first of its kind in Northern Nevada to integrate mental health services into a women’s health/OBGYN practice where she had a focus on perinatal mood and anxiety disorder diagnosis and treatment which solidified her passion for Perinatal/Reproductive Psychiatry. She has also completed certificate training with Postpartum Support International. As a postpartum depression survivor herself, she has a passion for helping other women throughout their journey to mental wellness. She and her husband moved to the Reno area several years ago from Seattle, WA to settle into a place to raise their family; they have three young boys. Aside from spending time with her family outdoors, Andrea is also active in the efforts to improve the sexual health education offered to the youth in our community as well as advocating at the state level to support Nurse Practitioner autonomy and Maternal Mental Health.

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By Brianna Villalpando, LMSW, LCSW March 19, 2025
Teen eating disorders are serious. As a parent or caregiver, one of the most difficult situations you can face is noticing that your teen may be struggling with a basic human need like eating. Adolescence is already a rough period for many teens filled with fluctuating emotions, changing bodies, and social pressures. However, sometimes coping with these challenges can manifest in unhealthy ways, like developing complicated relationships with food, body image, control, or exercise. Many teens face body image issues as their bodies mature, excessive pressure to meet unrealistic expectations fueled by social media and peers, and emotional instability and anxiety during their adolescent years, all of which can combine to create the perfect storm for an eating disorder. These challenges can often make your teen more vulnerable to unhealthy coping mechanisms , such as restricting food intake, excessive exercise, or engaging in disordered eating behaviors . If you’ve started noticing signs that something may not be right, it’s essential to take action to help your teen get the support they need. Recognizing the Signs of an Eating Disorder Eating disorders can vary in appearance, but there are some common signs and symptoms to watch for. If you notice any of the following behaviors or changes in your teen, it may indicate a problem that requires further attention: Preoccupation with body image : Teens with eating disorders often show increased focus on their weight or appearance, frequently expressing dissatisfaction with their body. Excessive discussions about dieting : If your teen frequently talks about dieting, food restriction, “getting skinny,” or often makes weight-related comments, this could be a red flag. Obsession with calorie counts : Teens who are obsessed with tracking every calorie, comparing the caloric content of foods, or controlling their calorie-intake may be struggling with an eating disorder. 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It's important to emphasize empathy and understanding, conveying that your primary concern is your teen's health and well-being. Initiating this conversation compassionately can create an environment of trust and openness to explore the problem. Selecting a calm, comfortable, and private setting is vital so your teen feels safe discussing a sensitive topic that may cause them to feel anxiety or shame. Effective communication hinges on using open-ended questions and active listening. Encourage your teen to share their thoughts and feelings without fear of judgment. By actively listening, you validate their experience, making them feel heard and understood. Before diving into the conversation, educating yourself about eating disorders can provide a solid foundation for discussing the issue knowledgeably. Some quick preparation with research allows you to dispel myths and provide accurate information when you talk to your teen. Why It's Crucial to Seek Medical Help When you notice warning signs, it’s important not to wait to get help. Eating disorders can be life-threatening, both physically and emotionally. They take a serious toll on a teen’s health, affecting their metabolism, hormonal function, and overall well-being. Beyond the physical impact, eating disorders can often involve deeply ingrained psychological and emotional challenges, such as low self-esteem, anxiety, depression, and trauma. After an initial conversation, the first step is to schedule an appointment with a medical provider. Your teen’s primary care doctor or a pediatrician can help evaluate their physical health and provide guidance for next steps. Be prepared to discuss the specific behaviors or signs you’ve observed, as this will help your provider better understand the situation. The doctor may conduct a physical examination, lab tests, and discuss your teen's emotional and psychological state. Building a Support Team Once you’ve taken the first step to ensure your teen’s immediate medical needs are addressed, it’s time to build a multidisciplinary treatment team . This may include: Therapists : A licensed, specially trained therapist who specializes in eating disorders or adolescent mental health can help your teen address the emotional and psychological root causes of their disorder. Medical doctors : Your teen’s doctor can monitor their physical health during the recovery process, ensuring they are safe while navigating the challenges of nourishing their body. Nutritionists or dietitians : A professional who specializes in eating disorders can create a nutrition plan tailored to your teen’s specific needs and help them rebuild a healthy relationship with food. Psychiatrists : In some cases, medication may be prescribed to address underlying mental health issues contributing to their behavior. Act Quickly and Seek Professional Guidance It’s crucial to act as soon as you recognize signs of an eating disorder in your teen. The longer eating disorders go untreated, the harder they can be to overcome. Recovery from an eating disorder is a complex journey, involving both physical and mental obstacles to tackle. It can be incredibly difficult for both the teen and the family to manage this process at home without professional support. A well coordinated team of medical providers, therapists, and eating disorder specialists is essential in guiding your teen through their recovery. This team can help monitor your teen’s progress, provide emotional support, and ensure that your teen is getting the care they need for both short and long-term recovery. Supporting Your Teen on Their Recovery Journey Eating disorders are serious, but with the right care and support, recovery is possible. If you suspect that your teen may have an eating disorder, don’t hesitate to reach out for help. 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By Brianna Villalpando March 12, 2025
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Have you noticed an increase in conflict with friends, family, or colleagues? Are you feeling stuck in patterns of negativity that seem hard to shake? If your mood is affecting how you function at work, school, or in your personal life, it may be time to talk to a therapist. Pay attention to your behaviors; are you withdrawing from activities you usually enjoy? Are you reacting more intensely to situations than usual? If your emotional state is beginning to impact your relationships, interactions, or your ability to move through everyday life, a therapist can help you explore underlying causes and develop tools to improve your social wellness. 2. Am I Isolating Myself to Avoid Conflict? There’s a big difference between being introverted and isolating yourself as a way to avoid conflict. 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A trauma-informed therapist can help you process these experiences, understand their impact on your life, and work toward healing and recovery. 5. Am I Hurting Myself or Others? If your mood or behaviors are causing you to hurt yourself or others, it’s crucial to seek help immediately. Whether it’s through emotional or physical self-harm , or unintentionally inflicting harm on the people around you, this is a serious sign to find support from mental health professionals. A therapist can provide a safe, nonjudgmental space to talk about what you’re going through and help you work toward healthier ways of coping. If you’re in immediate danger or experiencing thoughts of self harm, it’s essential to reach out for help as soon as possible. There’s no shame in seeking support when you're struggling with harmful thoughts or actions. Why is Professional Mental Health Support Necessary? Although there may be barriers to seeking therapy, reaching out for professional mental health support is worth it to address the emotional and psychological issues that you shouldn’t have to deal with alone. Therapists have the knowledge and tools needed to guide you through your struggles, offering insights and solutions that aren’t available outside of the therapeutic setting. Their expertise promises not only a deeper understanding of your challenges, but the application of practical methods and skills to resolve them in your everyday life. Additionally, trained mental health professionals offer personalized strategies and coping mechanisms tailored to your unique situation and needs. These strategies are informed by evidence-based practices and a therapist’s experience working with and healing emotional and mental struggles. Personalized therapy helps clients receive the most relevant and effective guidance for their personal challenges. Embracing the Journey Toward Mental Wellness Recognizing that you might need support is the first step toward feeling better and getting the most out of life. Therapy isn’t just for when things are at their worst; it’s a proactive way to improve your emotional health, work through challenges, and build skills for resilience. If you relate to any of these situations, it might be time to reach out and explore therapy as an option. It’s okay to need help, and you don’t have to navigate this journey alone. If you’re unsure whether therapy is right for you, consider talking to a mental health professional to discuss your concerns and explore specialized support options available to you. You deserve to feel your best, and therapy can be a stepping stone to help you reach your goals. Are you in need of support? At Thrive Wellness, we offer personalized therapy and treatment to support you in whatever you're going through, don't be afraid to reach out for help . We also offer a FREE comprehensive guide to wellness in our “How to Thrive” guide . This guide offers practical, easy-to-follow habits that promote physical, mental, and emotional well-being. Start your journey towards a balanced and fulfilling life today with these simple yet transformative steps.
By Sage Tippie February 14, 2025
This Eating Disorders Awareness Month, we’re focusing on fighting the misinformation and stereotypes surrounding eating disorders that so often create barriers to diagnosis and treatment. Myths about eating disorders can perpetuate harmful stereotypes and keep people from receiving effective and timely treatment when they need it. It’s no secret that the field of eating disorders is riddled with misinformation, leading to confusion, stigma, and shame for those struggling. In this blog post, we'll explore the common myths about eating disorders and fight them with concrete facts in the hopes of building a more informed and educated community when it comes to these serious mental health conditions. Eating Disorder Myths Versus Facts Myth: Only those who are medically underweight have an eating disorder. Fact: Someone can have an eating disorder at any weight. In fact, less than 6% of those diagnosed with an eating disorder are medically underweight. There is even a specific diagnosis for those who are not underweight showing the symptoms of anorexia called atypical anorexia. People of all sizes are at risk for serious complications from an eating disorder, not just those that are underweight. Myth: Only women have eating disorders Fact: Although often associated with teen girls, eating disorders can affect those of any gender and age. While stereotypes and stigma surrounding eating disorders may tell us that men are not commonly affected by them, research has found that nearly 25% of those who present for eating disorder treatment are male. Keeping an open mind around who can be affected by eating disorders allows for more accurate and timely diagnosis and treatment for those who need it. Myth: Eating disorders are just about food. Facts: While eating disorders always involve an unhealthy relationship with food or body image, they also are rooted in biological, psychological and sociocultural aspects. Eating disorders cannot be treated just by changing eating behaviors, but by addressing the mental aspect of the illness as well. This is why integrated treatment involving a team of social workers, primary care specialists, therapists, and in some cases occupational therapists or psychiatrists is so crucial: a holistic approach is needed to treat all aspects of an eating disorder. Myth: Eating disorders aren’t that serious. Fact: Eating disorders are extremely serious and life-threatening mental disorders that require dedicated treatment. In fact, anorexia nervosa has the second highest mortality rate of any psychiatric disorder. By taking eating disorders and their diagnosis and treatment seriously, we can save lives. Myth: Eating disorders are a choice. Fact: Just like any other illness, eating disorders are not a choice or a phase, nor is recovery from an eating disorder just a simple decision to start eating more or less. Recovery is not dependent on willpower, but on ongoing professional treatment and long-term support. The recovery process can be lengthy and challenging, requiring patience and a supportive environment and team on your side. It is a gradual, step-by-step journey, rather than an instantaneous decision made on one person’s part. Myth: Eating disorders always involve negative body image. Fact: Avoidant/restrictive food intake disorder (ARFID) does not have to do with body image. Those with ARFID may avoid many foods because of texture, taste, color, or smell, or feared outcomes of eating like choking or vomiting. Like any other eating disorder, ARFID is serious and requires specialized treatment like exposure-response prevention therapy. Myth: Eating disorders only affect White people. Fact: Although Black, Latina/o/x/e, Indigenous/Native, and Asian people are historically underrepresented in studies of eating disorders, large-scale studies have found that rates of eating disorders are the same or higher in all racial and ethnic groups as compared to white individuals (NEDA). Removing racial stereotypes around eating disorders can help to remove barriers that BIPOC individuals commonly face when seeking treatment. Dispelling the Myths: A Path Towards Understanding By addressing and dispelling these myths, we can create a safe space that promotes understanding and empathy. Eating disorders are not choices or phases, but debilitating mental health issues that can affect anyone. Recognizing the seriousness of these disorders is so important in reducing stigma and ensuring that those who are struggling receive the care and support they require. This month and every month, we encourage you to fight misinformation and stick up for those experiencing eating disorders, because knowledge and education can be one of the greatest assets to recovery for those who need it. If you or someone you know is in need of eating disorder support, don’t be afraid to reach out , our team of healthcare professionals are here for you. To learn more about eating disorders and the journey to recovery, download our free eating disorders guide .
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