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Mental & Emotional Health Services: Before, During & After Pregnancy

Pregnancy and early parenthood are filled with joy and excitement. But you may also feel stress, anxiety and sadness. You might be overwhelmed with new responsibilities and lack of sleep. Perhaps you went through a high-risk pregnancy, have a medically complex baby, or experienced pregnancy or infant loss.

If feelings of stress, anxiety and sadness disrupt your everyday life you may have a perinatal mood and anxiety disorder (P.M.A.D.).

The Perinatal Behavioral Health Service team at the Women & Infants Center provides compassionate care for P.M.A.D. We work with all parents to develop a care plan that is right for you.

What Are Perinatal Mood and Anxiety Disorders (P.M.A.D.)?

About 80% of new parents experience “the baby blues” or “the postpartum blues.” They may feel overwhelmed, stressed, worried or sad. 

If these feelings are very strong, worsen or last longer than two weeks, it can be a sign of a mood or anxiety disorder. Approximately 15-20% of new or future parents are diagnosed with P.M.A.D.

A small percentage of new parents may experience postpartum psychosis. Symptoms include violent thoughts toward yourself or your child, hearing or seeing things that aren’t there and believing things that aren’t true. This rare but serious condition requires immediate medical help. 

P.M.A.D. can occur as early as when you’re trying to become pregnant and can last up to one year after childbirth. Some conditions occur after your baby is born, like postpartum depression or anxiety. No matter when you experience these feelings, our team can help.

Perinatal Behavioral Health Service: How We Can Help

The team at the Women & Infants Center specializes in helping new and future parents strengthen and improve their mental health. Our compassionate, expert care includes:

  • Team approach: Our therapists, social workers and psychiatrists work with your care team before, during and after pregnancy to support you when you have emotional and mental healthcare needs. We screen for P.M.A.D. and evaluate your mental health. If you need treatment, we work together to plan your care.
  • Whole-person attention: We treat you as an individual to care for your mind and body in a way that fits your life.
  • World-class resources: Specialists at Barnes-Jewish Hospital, St. Louis Children’s Hospital and Washington University School of Medicine work together across disciplines to provide comprehensive, patient-focused care. Our experts are at the forefront of treatment for P.M.A.D. and are the region’s leaders in female health.
  • Inclusive care: We care for parents of all gender identities who experience symptoms of P.M.A.D. at any stage of the new parent journey, including following pregnancy or infant loss.

What Are the Symptoms of P.M.A.D.?

P.M.A.D. can range from mild to serious. Symptoms include: 


  • Crying or sadness
  • Wanting to be alone
  • Lack of interest in your baby or activities you used to enjoy
  • Thoughts of hurting yourself or others


  • Worrying about caring for your baby
  • Worrying about being a good parent
  • Feeling scared but not sure why
  • Panic attacks

Feeling overwhelmed or stressed:

  • Wondering if you can make it through another day
  • Wishing the challenges would go away
  • Feeling that life is too hard 

Other feelings:

  • Anger
  • Irritability
  • Shame
  • Guilt

Physical symptoms:

  • Changes in appetite or sleep
  • Heart palpitations or heaviness in chest
  • Rapid breathing (hyperventilation)

You don’t have to have all of the symptoms or wait until they become “bad enough” to seek help. You deserve to feel better. We can help.

Who Can Have P.M.A.D.?

Any parent or parent-to-be can have P.M.A.D. You may be more likely to have P.M.A.D. if you: 

  • Have a history of depression or anxiety
  • Are under stress
  • Don’t have support from your family, community or partner
  • Are in a strained relationship with your partner
  • Have experienced past trauma
  • Went through a high-risk pregnancy or delivery
  • Have a medically complex or sick baby
  • Have a difficult time accessing the care you need
  • Have experienced pregnancy or infant loss 

Treatment for P.M.A.D.

P.M.A.D. is common and treatable. Our social workers, therapists and psychiatrists provide individualized care when, where and how you need it. Treatment options include:  

  • Individual and couples counseling: We offer therapy for you, your partner or both of you together. Therapy can be brief or continue long-term.
  • Medical help: We provide a variety of P.M.A.D. treatment options, including psychiatric services. Psychiatry is medicine and/or therapy from a medical doctor who specializes in mental health.
  • Community partnerships: We can refer you to mental, behavioral health and other services in your community for help that’s close to home.  

When Should I Seek Help?

If you feel sad, stressed or worried at any time on the journey to parenthood, don’t wait until you feel worse or until you have all the symptoms of P.M.A.D. You don’t have to have a diagnosis of P.M.A.D. to get help. The earlier you receive treatment, the sooner you’ll feel better — and be able to give your baby the best care you can.

Contact Us

To make an appointment with a Washington University P.M.A.D. specialist at the Women & Infants Center, call 314.454.5052.