Maggie McKay (Host): When you're pregnant, there are so many things to think about regarding your wellbeing. Dr. Rachel Hartline, Family Medicine Physician with Obstetrics at Upland Hills Health in Dodgeville, will talk about beyond pregnancy brain, and mental health care when you're expecting. Welcome to Upland Hills Health Inspire Health Podcast. I'm your host, Maggie McKay. Welcome Dr. Hartline. Thank you so much for joining us.

Rachel Hartline, MD: Yeah, I'm so happy to be here.

Host: To begin, how does pregnancy affect mental health? And can pregnancy create new mental health issues or make existing ones better or worse?

Rachel Hartline, MD: Yeah, I mean, pregnancy is a major life event. You know, you're bringing a new person into the world and growing them for nine months beforehand. So it's very normal for women and families to experience stress and new mental health concerns as they think about what that means for their life and figure out how to implement it.

Host: So can it make existing mental health better or worse?

Rachel Hartline, MD: Yeah. If you're a pregnant person who has preexisting issues with depression or anxiety, sometimes those can get worse during pregnancy or especially during the postpartum period. And so that's something that we want to make sure that you talk with your doctor about and have a plan for how to manage.

Host: Let's say a woman does not suffer from any known mental health issues. How can she maintain the good mental health she has during pregnancy?

Rachel Hartline, MD: To grow a healthy baby, you need a healthy mom. And so all of the things that work to promote good physical health are actually quite good for mental health as well. Especially exercise is a really good stress reliever for a lot of folks and helps build a lot of happiness hormones.

So exercise is a really great way to promote mental health. Staying connected with other folks. Especially just coming through COVID, I think we've seen a lot of folks who, for appropriate reasons, were more isolated. But that isolation is not healthy. So staying connected to other folks in your life and having social connections are also really important, and being part of a community.

Host: And what about extreme emotions or an intensely emotional experience, can that affect the fetus during pregnancy?

Rachel Hartline, MD: Pregnant women definitely don't need to be worried that if they have a really stressful day, the baby's going to have some kind of malformation or, major issue. But the baby sits in the same chemical soup as the mom sits in. So if you're sitting with kind of chronic daily stress, that can affect things and it's good to find ways to keep yourself healthy.

Host: And if a woman does suffer from mental health challenges and she's on medication, should she stop taking the medicine until after the baby's born?

Rachel Hartline, MD: I think it is super important for every woman to have that conversation with her doctor. We know much more about how medicines may affect pregnancy than we did even five or 10 years ago. And the answer for a lot of medicines is that it's safer to continue them during pregnancy than to discontinue them and have a mental health issue or a decline in mental health, because mom's health is really important to the health of baby. But that being said, it definitely varies from medication to medication and there are different risks and benefits of each of them. So it's something that the treatment should kind of discuss with her own pregnancy provider about what is the best for her particular situation.

Host: Are medications ever prescribed to address mental health issues that arise during pregnancy?

Rachel Hartline, MD: Absolutely. There are a number of safe medicines that we use to deal with common mental health issues such as depression and anxiety, as well as less common mental health issues during pregnancy. Just, for that same reason, knowing that it's important to have a healthy mom to have a healthy baby.

And so mental health is a super huge piece of that puzzle and one that we want to make sure we're addressing.

Host: So that medication doesn't affect the fetus?

Rachel Hartline, MD: Yeah, so it depends on which medicine, and kind of when you prescribe it during pregnancy, how it may affect things with babies. Some actually don't cross the placenta, most do. But there weighing those kind of risks and benefits with your provider together is probably the most important thing to consider.

Host: And Dr. Hartline, what do you say to spouses as far as mental health issues with the person who's pregnant?

Rachel Hartline, MD: Yeah. The spouse is going through this too. So it's important that they also take steps to make sure that they're healthy. And even though they're not necessarily the person who's growing the baby, they are along for the ride of new experiences.

And they're also an important support for the person who is growing the baby. And so, together, I think they need to function well as a team to help the new person coming into the world.

Host: Right. Is there anything else you'd like to tell women or their partners or their children that they need to know about mental health issues during pregnancy?

Rachel Hartline, MD: I would say that it's something that has in the past carried some stigma. But don't hesitate to talk to your doctor or provider about any concern that you have. There's no question that is too big or too small, and it's definitely something that we want to be able to help with, but it's not something that, we know you're going through unless you tell us. So, don't be afraid to ask.

Host: Good advice. Thank you so much for sharing your expertise and giving us this helpful information.

Rachel Hartline, MD: Yeah, my pleasure.

Host: Again, that's Dr. Rachel Hartline. Don't stop taking medications without talking to your doctor. If you're pregnant or thinking about becoming pregnant, talk to your doctor or mental health professional about any mental health concerns you may have.

To find out more, go to uplandhillshealth.org/providers/dr-rachel-hartline, H-A-R-T-L-I-N-E. If you found this podcast helpful, please share it on your social channels and check out our entire podcast library for topics of interest to you. This is Upland Hills Health Inspire Health Podcast. Thank you for listening.