During pregnancy, many pregnant women end up working with a healthcare provider who isn’t the doctor they’re most familiar with – after all, OB/GYNs and primary care providers often don’t fit into the same Venn diagram. And while midwives certainly can be PCPs and many are comfortable caring for women throughout the different reproductive phases of their lives, many women don’t begin seeing midwives until pregnancy.
This may mean that the healthcare provider you see the most often during this time isn’t the person who’s the most familiar with your medical history. If you’re at a higher risk of developing depression during pregnancy, or postpartum depression, it can be helpful to talk to your doctor about that risk, even if you aren’t experiencing depression, so your doctor knows to keep an eye out. This is especially true if you’ve been treated for depression or mental illness in the past but are not currently on medication. If you may need or want a new prescription during or after pregnancy, it can be helpful to have a plan worked out with your healthcare provider in advance.
Starting the conversation
Choose the healthcare provider you’re most comfortable with to open up the conversation. If you already have a psychiatrist or therapist, you can also ask that person to have a conversation with your prenatal healthcare provider about your mental health history. If that person is your prenatal provider, that’s awesome, but if it isn’t, you can definitely go to an OB/GYN for your checkups and still open up the conversation about PPD or depression during pregnancy with the healthcare professional who knows you best, and who you feel the best about telling sensitive information. That means it’s totally a-ok to call your PCP and talk to them about how you’re feeling before you jump into it with your OB/GYN. For women who feel comfortable opening up to their OB/GYN, that’s an excellent option, but it’s certainly not the only choice for a place to start.
A general practitioner may or may not be an expert on the subject, but they can run you through what they know about your options, and help you connect with other providers who they’re familiar with. More than that, though, it will give you your first experience of trying to talk through these feelings with someone you feel more comfortable talking to. Even if you end up having to say the same things again later, you’ll have had the practice expressing how you’re feeling, and what kind of help to ask for, than you did before.
There are questions that your healthcare provider should be ready to ask you, about how you’re feeling about yourself and about your baby, by the time your postpartum appointment comes around. If they don’t ask you detailed, comprehensive questions about your mental health history, your feelings, and your fears starting in pregnancy and stretching through the postpartum period, they may not be getting the full picture of your recovery, and you may find yourself needing to volunteer the information so you can get help if you need it.
- Pregnancy and pre-existing mental health conditions
- Consulting the PPD experts: depression meds during pregnancy
- “Are you asking the right questions?” The Postpartum Stress Center. The Postpartum Stress Center. Retrieved July 2 2018. http://postpartumstress.com/for-professionals/assessments/ppd-screening/.
- “Postpartum depression.” March of Dimes. March of Dimes, May 2018. Retrieved July 2 2018. https://www.marchofdimes.org/pregnancy/postpartum-depression.aspx.