Perinatal Mood And The Fourth Trimester

How Does The Fourth Trimester Affect Perinatal Mood?

While most people are familiar with the term postpartum depression, the reality is that approximately two-thirds of mood disorders begin before the baby’s birth. According to the best OBGYN in Alpharetta, perinatal (meaning during pregnancy and up to one year postpartum), mood disorders affect 1 out of 5 to 1 out of 8 women. Perinatal mood disorders are twice as common as gestational diabetes yet spoken of much less. 

Why? Societal expectations are that motherhood is a time of joy. If mom and baby are healthy, all else is secondary. However, many women are left feeling isolated, alone, and confused.  Women may be faced with anxiety, intrusive thoughts, and worry. These feelings are not socially acceptable to discuss.

What can help? Sleeping at least 5 hours (uninterrupted) can protect against a worsening of mood disorders. Planning can also help.  Instead of focusing only on what will be needed when the baby arrives, think about creating an explicit support system. Plan for specifics – who can cook, help with laundry, and run errands. People want to help but will often offer open-ended statements like – let me know if you need anything. 

Who is at increased risk? Women with a personal or family history of depression or anxiety are at increased risk. Women with high-risk pregnancies are also at increased risk. If you think you may be at higher risk, you can seek out the help of a therapist during the pregnancy. Be proactive and not just reactive.

The fourth trimester is the first three months postpartum. This is a vulnerable time for both mom and baby. The transition from pregnancy to motherhood leads to a change of routine (or complete lack thereof). Periods of transition and disorganization can lead to anxiety.

Remember, peripartum mood disorders are common. If you have worried thoughts, like what if I drop my baby? what if I don’t wake up when the baby cries? – you are normal!  When you verbalize your thoughts, they will feel less impactful. Seek advice from your provider on navigating and managing these thoughts and knowing that you will be supported.

Help is available – you don’t have to suffer alone.  Postpartum support international ( offers virtual and local support groups. is focused on maternal mental health. offers resources as well. Additionally, our office has a list of therapists, psychologists, and psychiatrists who have helped our patients with peripartum and postpartum mood disorders. We are here for you.

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