Relationship Troubles Add to 'Pre-Baby' Blues

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Study Suggests Pregnant Women in Unhappy Relationships May Be at Risk for Depression

By Denise Mann
WebMD Health News

Reviewed by Laura J. Martin, MD

March 14, 2011 -- Pregnant women in strained relationships with their partners may be more likely to experience "pre-baby blues," finds a new study published online in BMC Public Health.

While the consequences of postpartum depression on the baby, mom, and family are well-known, anxiety and depression during pregnancy can result in pregnancy complications such as premature birth or low-birth-weight babies.

"Many expecting couples participate in courses that prepare them for the delivery [and] these courses could therefore be extended to include topics and exercises that strengthen the positive aspects of the relationship," conclude study researchers who were led by Gun-Mette Rosand of the Norwegian Institute of Public Health in Oslo.

In the new study of close to 50,000 Norwegian moms, researchers evaluated 37 potential predictors of maternal angst, including spousal support, smoking, alcohol use, and work stress. Pregnant women who reported that they were dissatisfied with their relationship with their partner were at the greatest risk of becoming depressed during their pregnancy.

Illness, work stress, and alcohol problems in the year before the pregnancy also increased women's risk for pre-baby blues, the study showed. A strong, supportive spouse, however, helped buffer pregnant women from the effects of these stressors.

During pregnancy "the man is thinking about financial pressures and how he will have to share his wife or lover with the baby, so he withdraws, and then the women interprets the withdrawal as a sign he doesn't want this and that makes her more anxious," says Mary Jo Rapini, a psychotherapist in Houston specializing in relationship issues.

The thought that a baby will bring a couple together or save a crumbling marriage is a total fallacy, she says. "If a baby does anything, it will cause the stress that tears a marriage apart."

"It makes sense that women would have less anxiety when they are having a baby with someone who is committed and looking forward to being a parent," she says.

Getting your partner engaged in the pregnancy by taking him to birthing classes and doctor's appointments can help, she says.

"Try to focus more on the relationship by talking to your partner about how you can keep the relationship tight after the baby is born," Rapini says. "Keep date night and discuss issues that you can foresee happening."

While a little anxiety during pregnancy is par for the course, feeling depressed and filled with doom and gloom for more than two weeks is a sign that you may need help, she says.

Karam Radwan, MD, a psychiatrist at the University of Chicago Medical Center, says that help is available for pregnant women who are depressed or anxious.

"In the past, we have been reluctant to use medication during pregnancy, but this thinking has changed because we know the mental health of the mom can affect the baby," he says. "A supportive partner is important."

Individual counseling, couples therapy, and/or family therapy can help get a seemingly disengaged partner back on board, he says. "Sometimes it is the relationship that is the problem, not the husband, the wife, or the pregnancy."

SOURCES: Mary Jo Rapini, psychotherapist, Houston.Karam Radwan, MD, psychiatrist, University of Chicago Medical Center.Rosand, G.M.B. BMC Public Health; vol 11: p 161.

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