Mental Health: During Pregnancy and Postpartum

by | Feb 6, 2023

Recently, we have heard the term “mental health” used almost daily, perhaps even casually. It’s a term that finds itself on the lips of the media and splashed across social media timelines. Occupational Therapist, Katiso Ndumo, takes us through mental health and how it can be affected during pregnancy and postpartum.

What is meant by mental health? According to the World Health Organisation (WHO), mental health is defined as a “state of well-being in which the individual realises his or her abilities, can cope with the normal stresses of life, can work productively and fruitfully, and can contribute to his or her community” ( (PAHO/WHO, 2023)). 

The Oxford dictionary defines mental health as; a person’s condition regarding their psychological and emotional well-being (oxford languages, 2023).

Based on these definitions, mental health is one’s overall well-being, taking into account emotional and psychological well-being and how an individual responds to the pressures and stressors of daily life. 

During pregnancy, a woman undergoes several body changes affecting her physical, emotional, and mental well-being. Body changes are seen (appearance) and unseen (hormonal). Many women face other psychosocial stressors, such as unwanted pregnancies from a one-night stand or casual relationships. This results in a lack of support from the father of the baby. Financial stressors can also leave a pregnant woman feeling unworthy, sad, rejected, regretful and a host of other negative feelings. This can happen throughout pregnancy and postpartum, affecting their mental health state. 

Postpartum depression is also characterised by feelings of (Mayo, 2023) 

  • Depressed mood or severe mood swings 
  • Excessive crying 
  • Difficulty bonding with your baby 
  • Withdrawal from family and friends 
  • Decreased appetite or increased appetite.
  •  Inability to sleep or excessive sleeping
  • An overwhelming feeling of tiredness or lack of energy 
  • Loss of interest in activities you used to enjoy 
  • Intense irritability and anger 
  • Fear & anxiety 
  • Hopelessness 
  • Feelings of worthlessness, guilt 
  • Decreased cognitive function. 
  • Restlessness 
  • Thoughts of harming yourself or your baby 
  • Suicidal thoughts 

These symptoms can be mistaken for ‘baby blues’, but signs are more intense and last longer for about a few weeks to months after giving birth. However, these symptoms may present themselves even during pregnancy for some women. 

(Mayo, 2023) 

In this digital age, social media has had a tremendous impact on the lives of individuals pregnant women. The pressures placed on women during pregnancy, such as looking good, fancy photoshoots and over-the-top baby showers, may cause many women to feel some of the symptoms mentioned earlier, such as worthlessness, guilt or hopelessness. They may withdraw from loved ones or cry excessively, leading to postpartum depression. This results from pregnant women not seeing the reality of pregnancy and postpartum life. They are shown a filtered world with filtered conversations and only see the positive and happy 

experiences. This causes severe misalignment in expectation and reality, leading to thoughts of inadequacy. The media has planted the idea of a super mom, a pregnant woman or a mother who can do it all. You’re expected to handle full-time work, side hustles/ business, and be a present mother and a good wife or partner. Pregnant women or mothers start comparing themselves and realise it is impossible to live up to the unrealistic image of perfection that has been projected. 

As Betty Friedan stated: You can have it all, just not all at the same time.” So, the first step to establishing good mental health is being realistic about pregnancy and life after that. Have conversations and read books and get the image in your head clear. In the next Milestones issue, we discuss preventing postpartum depression. 



Katiso Ndumo is an Occupational Therapist with a love and passion for paediatrics and mental health. Currently, she practices as part of a mental health team, at local clinics in the Randburg community working with children and adults.