Abstract: This study examined women's experiences of depression during pregnancy and the treatment decision-making process, as well as the contributing role of biological, psychological, and social factors. Treatment preferences and satisfaction with information provided by healthcare providers were also explored. Nine women participated in semi-structured interviews regarding their clinical history, precipitating biopsychosocial factors, interaction with healthcare providers, and treatment decisions. A questionnaire devised by the researcher was used to gather demographic information and psychiatric history. The Edinburgh Postnatal Depression Scale (EPDS) was used to determine the severity of the participants' depression during pregnancy. The average participant score was 16.2 on the EPDS 'during pregnancy' form, which is above the recommended cut-off score of 13. Data collected from the interview and questionnaire yielded three main areas of findings. First, the majority of women had a psychiatric history prior to the pregnancy (66.7%) and all had a familial history of depression, particularly maternal. Psychological factors, including ambivalence, fear of losing identity, self-doubt, and feelings about prior reproductive losses, as well as social factors, such as unplanned pregnancy, familial stress, and financial concerns were also found to precipitate the women's depression during pregnancy. Second, the women experienced depressive symptoms specific to pregnancy such as strain in the marital relationship, shame and guilt about being depressed while pregnant, concerns their baby would be affected, anxiety, and disgust with their pregnant body. Third, many of the women resisted telling their doctor about their symptoms, desired information and advice about depression during pregnancy and treatment options, resisted psychotherapy and pharmacological treatment, and opposed the idea of utilizing a support group. The doctor's treatment recommendations were found to be the most influential factor in the women's decisions surrounding treatment. In light of these findings, an informational pamphlet for women was designed to facilitate a thorough discussion about symptoms, mood management, and treatment options with their doctor.