Know Your Boundaries
Ann Douglas, author of The Mother of All Pregnancy Books, states that there are many hurdles women diagnosed with depression must overcome when wanting and trying to conceive. These hurdles include questions regarding medications, hormone levels, and preparing mentally and emotionally for motherhood. "One of the biggest hurdles such couples may face is low libido in the depressed person," Douglas says. "Depression tends to dampen one's enthusiasm about sex and certain types of antidepressants may only add to the problem."

"My medication affected my libido a bit, and we probably did have to work a little harder to get pregnant," says Constance Lovelace, a lab technician from Asheville, N.C. "Our sex life wasn't as spontaneous at times, but since we wanted to get pregnant, we did try a little harder. The way we looked at it was that since we did have to work a little harder, we might as well take advantage of it. We added a little spice and variety to our sex life -- like bubble baths or massages -- which made it seem less like we were working for the pregnancy and more like we were just having fun."

Know the Facts
The American Academy of Pediatrics recommends that women who are on antidepressants receive the lowest possible dosage of these medications while they are trying to conceive. As there are many types and brands of antidepressant medications, it is best to discuss your regimen with your doctor to ensure both you and the baby are in the best health possible.

"While some medications are thought to be safe for a pregnant woman and her baby, others are not recommended for use during pregnancy," Douglas says. "This is the main reason why it's so important to talk to your doctor about the types of medications you're using before you start trying to conceive. Preconception planning is important for any mother-to-be, but it's particularly important if you have a history of clinical depression and/or are currently taking some sort of medication to treat depression."

Heather Edwards, a stay-at-home mom from St. Paul, Minn., was keeping her depression under control with medication when she conceived her second daughter, Grace. "If it hadn't been for the meds, I honestly don't know if I would have been able to cope with the first months of pregnancy," she says. "I have done one pregnancy without meds and two with meds. I had less mood swings and crying while on meds. For depressed women on medication, I would suggest that they stay on them... if their doctor says it's safe. For me, it made for an easier pregnancy and significantly less postpartum depression."

Expect Anything
Fairly common knowledge, and verified by the AAP, is the fact that hormones can fluctuate quite intensely during times of depression, menstrual cycles and pregnancy. According to Douglas, due to the amount of hormone fluctuation various women can experience, it is difficult to know how each woman will respond.

"It's hard to predict how the hormonal changes of pregnancy will impact depression," says Douglas. "Some recent studies have demonstrated that prenatal depression is even more common that postpartum depression. Women with a history of depression need to prepare themselves for the possibility that hormones could cause a struggle with depression during pregnancy. Fortunately, this is not the case for the vast number of women with a history of depression, but it's important nonetheless to prepare for the fact that this may occur."

Prepare Yourself
When planning for a baby, parents will read, paint, buy, prepare and do all they can to help baby feel welcomed and loved. Douglas says a woman who suffers from depression needs to add one very important thing to the planning: her own well being. "Women with a history of depression who embark on a pregnancy should do whatever they can to minimize stress both prior to and after the birth," she says. "Because they face an increased risk of experiencing postpartum depression, they may want to line up some additional help on the home front -- perhaps contracting the services of a postpartum doula or asking a relative to pitch in for a while. Don't be afraid to say, 'I need help,' and then take it."

If you're experiencing a period of acute depression, Douglas warns that it's not a good time to contemplate a pregnancy. That doesn't mean you'll never be a mother; it just means you'll get there a little later than you planned.

"Pregnancy requires a certain amount of emotional resilience," Douglas says. "You need to have the emotional energy to cope with the inevitable highs and lows and the assorted aches and pains of pregnancy, and it's hard to feel up to these challenges if you're struggling with depression. Talk to your doctor. Talk to your family. But most of all, talk to yourself to make sure you are ready -- mentally and emotionally -- for the challenge and the glory of being a parent."

Want to see more?

• Motherhood and Mental Health
• Taking It Easy
• Are You Ready to Try to Conceive?

About the Author: Carma Haley Shoemaker is a nurse and iParenting senior contributing writer living in Virginia with her husband, three sons and their collection of pets.