Anxiety During Pregnancy and After Birth
Raelene Hurry, M.Ed, RCC, Surrey Therapist
If you are pregnant or you are a new parent, you probably have a variety of emotions right now.
Perhaps you wanted a child and you are happy about it, but for some reason, you feel anxious and can’t seem to shake the negative, worrisome thoughts that are preventing you from being able to enjoy this time in your life. Maybe you became pregnant unexpectedly and you are panicking about having a child. The possibilities are endless, but the fact is, you are not alone! As many as one in five women will experience Perinatal Anxiety (anxiety during pregnancy or during the baby’s first year). Like many of my clients, you may have thoughts or experiences like:
“My heart races and I feel like I can’t breathe.”
“I feel so overwhelmed.”
“This is supposed to be a happy time in my life.”
“I can’t concentrate or make decisions.”
“I am terrified I will, or my partner will have another miscarriage.”
“I’ve wanted a baby for a long time and now I’m pregnant or a new parent, so why can’t I relax and enjoy it?”
“I don’t sleep because I need to check on my baby constantly.”
“I’m scared of ____ (the birth/ something going wrong/ being a bad parent/ Covid…)”
My birth experience was traumatic and now I am on edge all the time”.
“I won’t leave my child with anyone else because ___.”
Anxiety is a natural part of the human experience. When we feel uncertain or out of control, we may feel unsafe or threatened, which results in feeling anxious. When we feel anxious, we may notice it affects our:
Thoughts (obsessing over the “What Ifs”, overthinking, imagining the worst)
Emotions (fear, worry, anxiety, sadness, dread, disappointment, anger)
Physiological sensations (racing heart, shallow breaths, sweating, headache, nausea)
Behaviour (inability to sleep, avoiding places or people, repeatedly checking on things)
Pregnancy and becoming a new parent is a very unique and complex time in your life that is full of uncertainty and change.
We can’t predict the future to know how the birth will be, what our children will be like, or how we will handle parenting. Our bodies go through tremendous changes physically and hormonally, which contributes to shifts in our physical experience, our emotional state, and our sense of Self. The lack of sleep we experience while pregnant, or as a new parent, can contribute to big emotions and difficulty thinking clearly and coping. It is natural to experience a range of emotions during this time in your life. However, when perinatal anxiety is interfering with your life, relationships, sleep, or ability to be present or experience happiness, it is time to take action.
The Effects of Perinatal Anxiety
Chronic stress and anxiety during pregnancy has been shown to impact the fetus. According to Harvard Health, “anxiety increases the risk for:
preterm birth,
low birth weight,
earlier gestational age,
and a smaller head circumference (which is related to brain size)”.
Additionally, maternal anxiety may predict postnatal outcomes such as:
Greater parenting stress
Negative impact on maternal mood
Negative impact on the parent-child attachment relationship
Negative impact on behavioural outcomes of the child
The great news is that there are many things that can be done to help reduce your levels of anxiety and fear, make you feel better, and positively impact the growth of your baby!
Having perinatal anxiety does not make you a bad parent! It just means you may need to take action to work through it.
How to Manage Perinatal Anxiety
Increase your support network. Be open and honest with your supporters, so they understand what you are going through. Just talking to someone can be helpful in alleviating your concerns. You might be surprised to know you are not alone in your experience! Consider joining a postpartum support group or finding a baby group at the local health unit and connecting with other new parents. Connecting with others allows you to learn alongside one another and find friendship and support with people who understand what you are going through.
Be willing to accept help. Sometimes this may increase your anxiety temporarily, but allowing others to help may prove to you that you don’t have to do it all alone, that your baby will be okay with someone else for a short time, and in small doses, it will help you face your fears. Also, you need time for self-care, which may require asking for help from others.
Take care of yourself. We can’t grow a human being inside of us or raise that human optimally if we are depleted and overly stressed.
Nutrition:
Eat nutritious foods and drink plenty of water. Your brain, body, and baby need you to have it!
Movement:
Move your body; this helps to expel anxious energy circulating in your body. Maintain an exercise schedule that is approved by your doctor. There are many fun ways to keep moving during pregnancy and even alongside your baby afterwards.
Rest:
Rest when you need to, and try to maintain a bedtime schedule during pregnancy. When you need it, give yourself permission to nap with your baby instead of tackling your long to-do list.
Goals:
Set small, realistic goals for yourself. It’s normal to feel overwhelmed during this time, and you won’t be as efficient as you may have been in the past. As a brand new parent, your goals may simply be to shower, eat and drink water each day. Be kind to yourself and have patience.
Time to Self
Take time to do things that you enjoy. Perhaps that is listening to music, reading a book, watching a great show, doing something creative, or spending time with friends or in nature.
If you find you are not managing well on your own, working with a therapist can be beneficial. Each therapist has their own approach and may utilize different modalities to help you navigate your anxiety. Cognitive Behaviour Therapy, Polyvagal Theory, Mindfulness and Self-Compassion are just a few of the many helpful approaches for navigating anxiety.
Mindfulness. Mindfulness has been shown to have a positive impact on present moment awareness and a reduction in anxiety. Try to use a meditation app like Expectful or Insight Timer daily. Practice these skills with a therapist who can guide you. Actively engage in Mindful Minutes in your day; notice the mountains, the colour of the sky, the shape of the leaves on the tree outside your window, or put on an app and breathe deeply and consciously for as little as one minute, or as long as you are able.
Self-Compassion. According to Dr. Kristen Neff, self-compassion involves acknowledging that you are not alone in your suffering, actively choosing to be kind to yourself rather than judgmental about your struggles, and reflecting on your thoughts and emotions from a clear and curious place without over-identifying with the emotions and allowing them to overwhelm you. With practice, you can learn to treat yourself with compassion, which leads to feeling happier and more emotionally regulated.
Cognitive Behaviour Therapy (CBT). This is often known as the gold standard for working with anxiety and depression. Working with a therapist and engaging in CBT can help you develop an awareness of your thoughts, emotions, and behaviours. It can then help you challenge distorted thinking patterns and change your behaviours, resulting in less anxiety.
Polyvagal Approach. A therapist with training in a Polyvagal Approach can help you learn to access and alter your own nervous system to cope with anxious feelings. People are often surprised by how quickly they notice a shift in their emotional state when they experience this approach and intentionally work with their own nervous systems. It is a nice complement to other modalities as well.
Medication. For some, particularly those with pre-existing anxiety disorders, medication may be appropriate and helpful. It is important to discuss the risks and benefits of medication during pregnancy with your doctor.
Pregnancy and becoming a parent are significant life transitions that come with uncertainty, doubts, fears, and concerns. But, by taking steps to prevent or reduce the intensity of the perinatal anxiety that you may be experiencing, this can also be a time of joy, excitement and awe.
https://www.health.harvard.edu/blog/how-can-you-manage-anxiety-during-pregnancy-202106252512
https://self-compassion.org/the-three-elements-of-self-compassion-2/
https://link.springer.com/article/10.1007/s00737-017-0746-5
https://womensmentalhealth.org/posts/anxiety-during-pregnancy-options-for-treatment/