Beyond the bump: How to support your mental health during pregnancy

You arrive at your midwife appointment straight from work, your mind still juggling deadlines, errands, and everything else life demands. The routine begins: urine samples, blood pressure, a checklist of questions about symptoms and swelling. Before you know it, you’ve got one minute – maybe two – left to squeeze in a couple of your own questions. 

And somewhere along the way, a question catches you off guard - “How is mum actually feeling?”

Pregnancy is rightfully celebrated as a joyful chapter of life. And for many, it is. But growing a human is physically demanding, emotionally complex, and at times, deeply stressful. Between morning sickness, fatigue, changing relationships, work pressures, and the ordinary stressors of everyday life that do not pause just because you’re pregnant, it can feel like a lot to carry at once.

The first trimester can be especially difficult. You often can’t see a bump or feel your baby kick, leaving you without any external reassurance that everything is progressing normally. Anxiety can quietly fill that uncertainty. It comes as no surprise that around 1 in 5 women in the UK experience mental health problems in pregnancy or in the first year after birth (1).

In this article, we’re delving into the link between pregnancy and mental health, the link with our gut (and its microbes), and nutritional strategies to support the gut-brain axis throughout pregnancy. 

This is not just for expecting mums. It’s also a great resource for partners, family, friends, and colleagues, too. Because the support system around mum can play a pivotal role in her mental health and wellbeing.

Why should we prioritise  mental health during pregnancy?

It’s completely normal to feel worried or overwhelmed during pregnancy. Many women find themselves thinking about:

• Changes in identity and role, including becoming a parent or stepping back from work

• Shifts in relationships and family dynamics

• Whether they will be a good parent

• Concerns about the baby’s health or pregnancy complications

• Fear of childbirth

• Physical symptoms and loss of control over their body

• Feeling unsupported or alone

These concerns are amplified when we consider hormonal changes, sleep disruption, physical symptoms, and major life transitions occurring simultaneously (2). Low mood and anxiety are the most frequently reported symptoms, affecting about 10-15% of pregnant women (3-4). You also might experience:

• Reduced energy levels

• Disturbed sleep

• Poor appetite

• Difficulty concentrating

• Feelings of low self-worth

• Unexplained physical symptoms - headaches, nausea, digestive issues

• Feeling sad, weepy, hopeless, overwhelmed, guilty or angry

• Unable to find pleasure in any activities you previously enjoyed

• Withdrawing from others

While it’s normal to feel this way from time to time, it’s helpful to pause and ask yourself: Am I just having a bad day, or has it been a bad month? If your symptoms last for more than two consecutive weeks, consider reaching out to your healthcare team (5).

Why does the gut microbiome matter during pregnancy?

An area of research gaining increasing attention is the role of the gut microbiome in mental health during pregnancy. The gut microbiome refers to the trillions of microorganisms living throughout the digestive tract. Far from being passive residents, these microbes play an active role in regulating the immune system, maintaining the integrity of the gut lining, influencing hormone production, and communicating directly with the brain through what is known as the gut-brain axis (6).

During pregnancy, the gut microbiome undergoes substantial remodelling. Although researchers are still working to understand what drives these changes, evidence suggests they may shape how we extract energy and nutrients from food, regulate blood sugar, and maintain immune balance during pregnancy (7).

How does our gut microbiome influence mental health during pregnancy?

Researchers are increasingly exploring whether our gut microbiome may help explain why mental health challenges arise during pregnancy, particularly through communication along the gut-brain axis. This is where the science becomes really interesting.

Studies suggest that the diversity (i.e., the number and variety of bacterial species) within the gut microbiome, often considered a marker of resilience and overall gut health, may be linked to psychological outcomes. Higher microbiome diversity earlier in pregnancy has been associated with a better ability to cope with stress in the postpartum period (8). Another study involving 140 pregnant women found that higher levels of mental distress were associated with lower diversity of species within the gut microbiome (9). 

Changes during pregnancy are not only limited to which bacteria are present in the gut, but also affect the bi-products and substances that those bacteria produce. Research suggests that shifts in these bi-products,particularly short-chain fatty acids (SCFAs), may influence a mother’s memory, concentration, and emotional wellbeing (10). Reductions in SCFAs, along with changes in inflammation later in pregnancy, have been linked to a greater risk of perinatal mental health challenges (11). Factors such as a low-fibre maternal diet may reduce SCFA production, and have been linked to a higher risk of depression during pregnancy (12).

Are there any foods that support the gut-brain axis during pregnancy?

Dietary fibre

When we consume dietary fibre, whether that’s from fruits, vegetables, wholegrains or legumes, it’s broken down by our beneficial gut bacteria to produce SCFAs. These compounds have been shown to communicate with the brain via the vagus nerve, with early research supporting a role in reducing stress (13), and depression (14). Fibre intake during pregnancy is often low, with one study showing only 20% of pregnant women meet the recommended daily intake of 30g (15). 

Fermented foods

Fermented foods such as yogurt, kefir, kimchi, and miso contain live microorganisms that may influence the gut microbiome. We know that diets high in fermented foods have been linked to increased microbial diversity, which supports the gut-brain connection. Because of this, researchers have explored whether they support mental health during pregnancy. However, the evidence remains inconsistent. For example, a large study of more than 9,000 pregnant women in Japan found no significant association between fermented food intake and reduced psychological distress during the second or third trimester (16). But based on their overall benefits for gut diversity, you may still wish to consider fermented foods as part of a plant-rich diet. For example, enjoying berries with yoghurt or kefir at breakfast time and adding kimchi to salads or enjoying on its own as a snack.

Omega-3

Omega-3 fatty acids, including DHA and EPA, are found in foods like oily fish, walnuts, and chia seeds. DHA and EPA help produce anti-inflammatory signalling molecules, which are important for brain health. In fact, randomised placebo-controlled trials found that omega-3 supplements (especially with higher EPA-to-DHA ratios) significantly improved symptoms of perinatal depression. (16). It’s important to note you should eat no more than 2 portions of oily fish a week, such as salmon, trout, mackerel or herring whilst pregnant. Fish like swordfish, raw shellfish, cold-smoked or cured fish (for example smoked salmon or gravlax, including in sushi), should be avoided. (17)

Our top tips to support mental health during pregnancy

Supporting mental health during pregnancy is a shared effort. The tips below are split into two groups: actions for mums, and actions for those supporting her, since both are important for a healthy gut-brain connection. Because it’s true what they say, it really does take a village…

For mums

Supporting your mental health during pregnancy involves eating a balanced, gut-friendly diet, staying active with gentle movement, and managing stress through rest, social connection, and emotional awareness. 

• Keep quick, gut-friendly snacks on hand, including ready-made yogurt or kefir pots, pre-chopped carrot sticks with hummus, a handful of nuts and seeds, or apple slices with nut butter 

• Boost plant diversity by stocking up on frozen vegetables, cans of mixed beans, dried herbs, and seed toppers

• Include omega-3-rich foods, including oily fish (e.g., salmon, sardines), walnuts, flaxseed, and chia seeds. If you feel the need to, consider an omega-3 supplement after discussing with your healthcare team

• Eat regularly throughout the day to support stable energy levels and blood sugar balance

• Engage in gentle, regular movement such as walking, stretching, or pregnancy yoga to support mood regulation and stress resilience

• Join a local pregnancy group to build social connections and emotional support

• Protect sleep where possible by keeping a consistent bedtime routine and asking for practical help when rest is needed

• Speak openly about mood changes or emotional difficulties during antenatal appointments, even if they feel minor

For the support system

This is your opportunity to show up. Pregnancy places significant physical and emotional demands on mum, and consistent support can meaningfully reduce stress and mental load.

• Keep the home environment clean, calm, and organised to reduce stress

• Help with food shopping, meal preparation, or batch cooking to make nourishing food easier to access

• Keep easy, nutrient-dense snacks available so regular eating feels effortless (see tips in the For mums)

• Offer practical actions and take initiative, such as doing laundry, cooking dinner, or attending appointments together instead of asking “What can I do to help?”

• Protect opportunities for rest by helping reduce unnecessary responsibilities

• Encourage and support attendance at pregnancy groups or social activities

• Learn the signs of prenatal mental health symptoms so changes are recognised early

What about the role of live bacteria supplements for mums?

Live bacterial supplements can support a healthy gut microbiome for certain occasions or life stages, including:

• During or after antibiotics

• While travelling 

• Supporting your baby’s gut microbiome

• Supporting mum’s vaginal microbiome

• When your immune system needs additional support, such as cold and flu season or during times of stress

When it comes to live bacterial supplements, you need to be specific, choosing the right strain, at the right time, at the right dose. You can find the latest evidence and guidance on how to choose the right live bacterial supplement here.