What is Perinatal Mental Health? Understanding the Emotional Changes During and After Pregnancy

Pregnancy is often described as a time of joy, excitement, and anticipation. And sometimes it is. But it can also be a time of uncertainty, overwhelm, and emotional complexity—and those realities can exist side by side.

I’m Rachel Tenny, a Licensed Clinical Mental Health Counselor Supervisor (LCMHCS), and over the years, I’ve worked with so many individuals navigating the emotional rollercoaster that comes with pregnancy and the postpartum period. As a parent myself, I know firsthand how layered and unpredictable these seasons can feel.

That’s why I want to talk openly about something we don't hear enough about: perinatal mental health.

What is Perinatal Mental Health?

Perinatal mental health refers to your emotional and psychological well-being during pregnancy and in the first year after giving birth. It's not just about avoiding depression or anxiety—it's about recognizing that your inner world matters while your outer world is undergoing one of the biggest transformations of your life.

Hormonal shifts, physical changes, past trauma, sleep disruptions, and everyday stressors can all impact how you feel during this time. It’s completely normal to experience a wide range of emotions: excitement one day, fear the next; gratitude and grief, sometimes all at once.

And here’s an important truth:

• It’s okay if you don’t feel like yourself.
• It’s okay if you don’t love every moment of pregnancy.
• You can be grateful for your pregnancy and still struggle with how it feels.
• Your mental health matters just as much as your physical health.

Common Emotional Experiences During Pregnancy

If you’ve felt more emotional than usual, more worried, or simply different—you’re not imagining it. Some common emotional experiences during pregnancy include:

• Mood swings or irritability
• Crying more easily than usual
• Feeling worried or “on edge”
• Difficulty sleeping, even when you’re tired
• Feeling numb, disconnected, or out of sync with yourself
• Thoughts like, “I should be happier” or “What if something goes wrong?”

None of these feelings alone mean that something is wrong—but they’re worth paying attention to, especially if they start to interfere with your day-to-day life.

Managing Anxiety and Emotional Overload

Pregnancy can bring up a lot of "what ifs"—many of which are out of your control. Some worry is normal, but when anxiety starts taking over your days (and nights), it’s important to find ways to ground yourself and reconnect with the present moment.

You’re not doing anything wrong by feeling anxious.
Your brain is trying to prepare you for the unknown—but when preparation turns into rumination or fear, it can start to chip away at your peace.

Some signs anxiety might be building include:

• Racing thoughts or mental “loops”
• Trouble falling asleep or staying asleep
• Tightness in your chest or a racing heart
• Feeling like you can’t “turn off” your mind
• Constant reassurance-seeking or avoiding certain topics

In those moments, even small practices can make a difference.
Taking a few slow breaths, moving your body, or gently refocusing your attention can help you come back to the present. You don’t have to completely calm your mind—you just need to remind yourself that you are safe and supported.

If you’re looking for simple ways to ground yourself during anxious moments, I share practical ideas and techniques over on Instagram at @sometimesatherapist. Having a few tools ready can make a tough moment feel a little more manageable.

You Are Still You🤍

Pregnancy isn’t just about growing a baby—it’s about reshaping your sense of self.
It’s normal to feel identity shifts, changes in your relationships, and even grief over parts of your old life you’re leaving behind. These changes don’t make you a bad parent—they make you human.

Protecting your mental health during this time isn’t selfish. It’s a profound act of love—both for yourself and for the life you’re bringing into the world.

Introducing: An Introduction to Perinatal Mental Health

If you're navigating pregnancy, preparing for birth, or adjusting to life postpartum, I created An Introduction to Perinatal Mental Health to support you through it all.

Inside, you’ll find:

• Education about emotional shifts during pregnancy and postpartum

• Practical tools to manage anxiety and overwhelm

• Reflection prompts to connect with your feelings and needs

• Gentle strategies for building a support system and setting boundaries

Final Thoughts

Pregnancy and postpartum are times of incredible change—physically, mentally, and emotionally. You’re allowed to feel overwhelmed. You’re allowed to grieve what’s shifting even while you celebrate what’s ahead. Most of all, you’re allowed to ask for support along the way.

Wherever you find yourself right now, I hope you’ll remember: you are not alone, and you are doing better than you think.

Grab your guide to help you feel connected and supported during the perinatal period. 

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Want more support? I am accepting therapy clients in Charlotte, NC as well as virtually in NC and SC.

I also offer virtual and in person groups for individuals in NC and SC, so make sure you check those out too!

Are you a therapist? I offer supervision and consulting for therapists as well as The Therapist Toolbox Resource Library for other providers.