One thing no-one warns you about when you become pregnant is the amount of terms to familiarise yourself with. You’ve got TTC (trying to conceive) and luteal phases, ‘DD’ (dear daughter) and ‘LO’ (little one) on maternity forums, and then of course snot-suckers, viability markers and episiotomies (please, no!) But one term I wish we talked about a lot more is perinatal mental health, or PMH.

I’d heard about maternal mental health difficulties after birth – the ‘Day 3 Baby Blues’, and things like post-natal depression. I’d not heard, or even thought, about mental health along the rest of the pregnancy journey.

Perinatal mental health refers to a mum’s mental health before, during and of course, after birth. And it’s something I’ve had to stare at straight in the eyeballs.

I had an easy and exciting first trimester – and then, as I’ve written about, ended up in hospital at 14 weeks where I met the term ‘complicated pregnancy’. It’s been a difficult ride since then: some fairly serious complications, lots of midwife and consultant appointments, and a few long nights of tear-stained worries.

When I hit the 17 week mark, I noticed that I was developing anxious habits and not quite feeling like ‘myself’. I had been signed off work for a few weeks, so the enforced stillness definitely had something to do with it. I was also pregnant, and feeling things more strongly is normal: this was confirmed when I found myself crying at a photo of cinnamon rolls a childhood friend sent me! But to tell you the truth, I knew deep down that something was wrong. I was less sure of myself, felt somehow smaller, and was anxious about things that wouldn’t have concerned me before. I also struggled to triage my thoughts in a rational way, giving too much weight to small things.

These were patterns and feelings I didn’t want to bring into motherhood with me, so I decided to sound the alarm. I decided that my mental health was a worthwhile investment, and that this investment would benefit me in pregnancy, but also allow me to begin motherhood on a firmer footing – benefitting my baby and wonderful, supportive husband as well as myself.

This is what I realised: my mental health is just as important as my physical health, into which I pour resource and time and effort. What’s more, the mental and physical realms are absolutely linked. Mental health is something that everyone has and that everyone should be able to look after.

There is some stigma around taking care of our mental health, and unfortunately this isn’t absent in the Church – thankfully, charities like ThinkTwice are helping to change that. What helped me was to understand that God cares for every part of us, that every part matters to Him. Body, soul and mind: all are linked, and are all loved and known by Him. Just as I believe my baby is ‘fearfully and wonderfully made’, so am I – and that makes me worth caring for, in my entirety.

And as I began to open up, I realised that so many other women were experiencing similar struggles. Whether they were trying to conceive, processing the very major life transition of preparing for a baby, or learning to care for their sweet little newborn, they reported feeling anxious, or ‘down’ more than usual. They struggled with their thoughts also, and many just didn’t feel like themselves. I wasn’t alone.

In fact, Channel Mum (who have just launched a really accessible mental health resource) carried out some research that suggests 80% of mums experience issues with their mental health. That’s 4 out of 5 of us: so we really need to talk about it.

This is not something we should be scared of. Good mental health is a totally achievable goal.

And what better time to start building it than when we are pregnant. Our worlds are changing drastically, and a little rocking of the boat is to be expected: but so is a little steading of that boat.

These four things have helped me to steady mine.

Flipping the switch

A good friend of mine talks about taking her thoughts captive: catching them, weighing them up and then deciding what to do with them. I’ve tried to be vigilant about catching negative or anxious thoughts. And when one makes its way into my mind, I challenge it by ‘flipping the switch’. That is, I’ll immediately think of something good, maybe something that I’m thankful for or just something that has gone well/been fun/makes me feel good about that day. And then I think of another, until I have at least three. Doing this actually changes your neurological function, and makes it much harder for negative thoughts to spiral. Maybe it helps you to imagine turning a car around – I imagine a STOP sign before flipping the switch.

Sheryl Sandberg’s 3 P’s

In her book ‘Option B’, Sandberg writes about challenging the 3 P’s when faced with difficult circumstances. She suggests trying to be mindful that what is happening isn’t personal – it isn’t caused by you; it isn’t permanent – things will change; and it isn’t pervasive – it does not need to affect the whole of your life. Measuring the 3 P’s up against my own thoughts has been a really helpful way of framing what I’m going through.

Talking about it 

Talking to friends and family, and to other mums and mums-to-be sounds simple, but it’s powerful. Verbalising things can make them less scary or big – and we find that we are not alone.  This is normal (even though it’s not OK). We are worth taking care of. If reading this marks your first step towards better mental health, welcome: I like to imagine you sitting across from me, hands around a mug of something warm. There are so many others like us, and so many who can help. Reach out. Talk to someone. You are not alone.


I found a fantastic counsellor who is also a midwife and offers a set ‘course’ of four sessions for women who are dealing with complicated pregnancies, traumatic births and post-natal difficulties. This helped me process the shock and trauma (with a small ‘t’) of what has happened, think about how to trust my body through pregnancy, birth and caring for a newborn, and develop some mechanisms for relaxing and staying calm. I’m a firm believer that everyone could benefit from counselling at any stage of their journey, and it has really helped me in this particular stage of mine!

Not everyone will come to know an end or a cure to their difficulties. Perhaps issues will surface during pregnancy and last much longer than nine months. That may ring true for you, or you may find that you are able to find a solution quickly. Either way, I pray that you would know the Great Physician near to you. Hymn-writer William Hunter penned that beautiful line. It’s one that has brought me comfort as I have battled through physical and mental challenges, and has empowered me to take steps towards being well. I hope it does the same for you.

Your mental health is precious, and worth looking after. It is normal to experience issues at any stage of the birthing process, and it’s OK to talk about them. You’re not alone.

Gemma lives in Northern Ireland with her husband, Dan. She is a writer and speaker who works in communications and global international development. Her top pregnancy craving is crunchy fruit. She blogs at

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