Trigger Warning: Discussion of Miscarriage and Prenatal Mental Health
My name is Christina. In 2021, I wrote about my journey with chronic illness and mental health. While new challenges have emerged, that blog still offers valuable insight.
No One Prepares You for the Pain
Not the emotional kind, though that’s its own battle, but the physical pain. The kind that breaks you, that makes you question everything. The kind that makes you wonder if deciding to have a baby was a selfish choice when your body is already at war with itself.
People talk about the joy of pregnancy, the glow, the excitement. But what happens when pregnancy feels like losing yourself? When every day is a new reminder of what your body can no longer do? When you already live with an illness that has stolen so much: your passions, your energy, your freedom, and now, pregnancy feels like yet another loss, something else your body might take away from you?
Understanding Prenatal Depression
When mental health during pregnancy is discussed, which is still often a taboo, the focus tends to be on postnatal (which refers to the period after giving birth) depression. But there are other perinatal mental health conditions, including perinatal obsessive-compulsive disorder (OCD), anxiety disorders, and post-traumatic stress disorder (PTSD). These are less commonly talked about, and many people have never even heard of them.
In this blog, I focus specifically on prenatal depression. This condition affects up to 20% of pregnant women and can be triggered by a mix of hormonal changes, stress, and pre-existing mental or physical health conditions.
Pregnancy is supposed to be this sacred, untouchable time. But when your body is already fighting a chronic illness, pregnancy feels like another battle. If left untreated, prenatal depression can have serious consequences, affecting not just the mother but also the child, increasing the likelihood of emotional and behavioural difficulties later in life.
My husband and I decided to have a baby because my health had improved, and I didn’t want to wait until I was older, risking further complications. It felt like the right time, a window where my body might cooperate. But even then, I wasn’t prepared for what was coming.
Symptoms of Prenatal Depression
According to the NHS, symptoms of prenatal depression include:
Persistent sadness or low mood
Fatigue so crushing, no amount of rest helps
Feeling disconnected from your baby, like it’s happening to someone else
Excessive anxiety or fear, especially about the pregnancy
Guilt—for struggling, for not being overjoyed, for not being enough
Feeling like you can’t do this
Thoughts of self-harm or suicide
Financial instability during pregnancy intensifies hormonal imbalances and mental health challenges. These stressors like housing insecurity, unhealthy relationships, and economic hardship increase self-blame and make the emotional and physical burden heavier.
Coping with an Expected Loss
No one tells you how common miscarriage is. It happens in 1 in 8 pregnancies yet when it happens to you, it feels like the loneliest thing in the world.
The Role of Progesterone in Pregnancy
Happily, I got pregnant again soon after. At 12 weeks, I started bleeding again. The scan showed a low-positioned yolk sac, a structure that provides nutrients to the developing embryo before the placenta forms.
The NHS response? Codeine for the pain. A suggestion to go home and wait for the inevitable miscarriage.
But I refused to accept that. I sought a private gynaecologist who prescribed progesterone supplements, a simple, accessible treatment that could have saved my first pregnancy.
Progesterone helps maintain the uterine lining and supports fetal development. Low levels increase miscarriage risk. And yet, for years, the NHS would only offer progesterone after three consecutive miscarriages.
Thankfully, due to women fighting for better care, the NHS now prescribes progesterone after just one miscarriage. But it's not enough. We shouldn’t have to beg for care that should be standard.
The Science Behind Prenatal Depression
Professor Carmine Pariante and his team have shown that prenatal depression disrupts the immune system, triggering inflammation. Cytokines, molecules that regulate immunity, interfere with serotonin and dopamine, affecting mood and emotional stability.
It's not just mental. It's physical. Depression, inflammation, and pregnancy all intertwine, affecting the body and brain in ways that can't be willed away. The hypothalamic-pituitary-adrenal (HPA) axis, which controls the body's stress response, also gets thrown off balance. High cortisol levels don’t just affect the mother, they impact fetal brain development, increasing the child's risk of neurodevelopmental disorders.
I wish I had known this earlier. I wish someone had explained that this wasn't just in my head—that my body was literally attacking itself. Maybe then I wouldn’t have felt so much guilt.
Honouring Women, Mothers, and Unspoken Struggles
March is a month that carries meaningful significance. It is a time when we celebrate International Women's Day, recognising the strength, resilience, and contributions of women around the world. In the UK, it is also the month we honour mothers on Mother's Day, and coincidentally, a day before my 30th birthday. But while these occasions celebrate the beauty of womanhood and motherhood, they also serve as a reminder that many women suffer in silence, through pregnancy complications, loss, and battles with their bodies. The stories of these struggles are often left unspoken, but they deserve to be heard.
Enduring the Struggle, Welcoming Life
After months of pain, uncertainty, and a body that felt like an enemy, my daughter arrived. The labour was traumatic, the kind that leaves scars. But somehow, she was healthy. She made it. In the future, I hope to share more about this experience to raise awareness about the challenges of childbirth and the importance of proper support. It’s all great in theory—catchy titles, strong statements—but what truly matters is action. Here are practical ways to offer support.
How to Support a Pregnant Woman in Pain
Small Gestures Matter: Bring flowers, a cup of coffee, or a reminder that they're still a person beyond this pregnancy. Don't wait for them to ask for help—just be there.
Help With the Practical Stuff: Clean the house, cook a meal, or, if you can't do any of these, send them a voucher to order something online or a cleaning service. Give them one less thing to worry about.
Listen Without Judgement: If they say "I'm struggling," don’t dismiss it as hormones. Believe them.
Encourage Professional Help: If symptoms persist, gently encourage speaking to a GP, midwife, or therapist.
Create a Support Network: Connect them with other mothers who get it—from work, the gym, or mutual friends.
Reflecting on My Experience
Believing my symptoms were just hormones or pre-existing conditions, I didn’t seek help. I thought it was temporary, something to endure. But looking back, I see that small gestures—kindness, understanding, and support—made a difference.
Today is a bad day. But tomorrow, I will keep fighting.
"And if I am a rock, I will crack,
And if I am a stalk of wheat, I will bear fruit,
And if I am a tear, I will laugh."
— Odysseas Elytis