Postpartum depression affects between 10 and 20 percent of new mothers. It’s something most doctors and nurses are trained to identify.

But often, those same feelings plague women throughout their pregnancy. It’s called Perinatal Mood and Anxiety Disorder (PMAD). 

When the Arizona Department of Health Services conducted its maternal and child health needs assessment earlier this year, they found that many women suffered from heightened mood and anxiety disorders during their pregnancy.

Sara Rumann, with the health department, said that prompted the agency to create an online course for home visitors and other staff to raise awareness and increase screening for PMAD.

"This is so common and many women aren’t aware their even experiencing these symptoms. If you go into group of women, you’ll probably find that at least 1 out of 5 will had some of these symptoms and they didn’t realize it," said Rumann.

Symptoms can include profound sadness, fear, sleep problems, panic attacks and other behaviors. Rumann said one example would be a mother who is so concerned about the health of her unborn baby that gets too many ultrasounds, despite reassurances from her doctor.