Anxiety During Pregnancy: Causes And Healthy Coping Mechanisms

Pregnancy is an exciting time for expecting parents, but it also comes with worries, anxieties, and other symptoms that cause both mental and physical changes for the woman carrying the child. Stress, fear of birth, fear of the unknown, and the daily problems that arise from the physical and hormonal changes of pregnancy can often lead to increased levels of anxiety along with emotional fluctuations. Perinatal anxiety or anxiety while pregnant is one of the most prevalent emotional responses during pregnancy with at least 1 out of 5 women diagnosed with an anxiety disorder during this time.  If you are pregnant and experiencing anxiety, you may feel like you are isolated and do not know how to manage the symptoms. Read on to become informed on the causes of anxiety and ways you can manage the symptoms to help prevent you and your future baby from undue stress. 

Anxiety And Pregnancy

Anxiety during pregnancy is a natural reaction to the many different changes that are occurring, such as increased hormone levels, upcoming life changes, and the physical effects. Some people who have a pre-existing anxiety disorder or manage other mental health conditions have varying responses to pregnancy, with some feeling more at ease and others noticing a sharp increase in their anxiety levels. Every person is unique, including their physiological body, thus each pregnancy is also unique and will vary in its effects and symptoms.

Healthcare providers will generally check in during prenatal appointments about an expectant mother's mental health and any symptoms of an anxiety disorder. It is important to address all concerns during appointments to ensure the best possible care and resolution (or at least reduction) of symptoms.

Early Pregnancy Anxiety

Perinatal anxiety refers to the anxiety that may arise throughout pregnancy. Early pregnancy can be an exciting time for many parents-to-be. It also may come with fear and apprehension, especially for those who have had a history of traumatic pregnancies or miscarriage. 

Miscarriages primarily occur within the first trimester and can be traumatic for many women and their partners. While some may be able to manage the loss of the embryo without an emotional or psychological effect, others will react very strongly to the loss.  In these cases, severe depression, anxiety, and post-traumatic symptoms (especially in the cases of recurrent loss) may follow the miscarriage, If left untreated, they may morph into anxiety disorders, post-traumatic stress disorder, or even obsessive compulsive disorder. If you have experienced a loss of pregnancy, do not hesitate to reach out for professional help to help you heal.

The first trimester is a time when pregnant women are at a greater risk of spontaneous abortion. This time is also stressful for those who are concerned that their actions while unknowingly pregnant may have negatively affected their unborn child. For example, some people who do not know they are pregnant will drink, smoke, or take certain medication. These women may be worried they unknowingly damaged the growing fetus simply. Ultrasound and blood tests monitor the fetus during the pregnancy to help confirm that it is developing healthily and not affected by substance use or medications taken before confirming pregnancy. 

With unexpected pregnancies, the first few weeks may be stressful as they have to plan for the future, including finances, family, and other areas impacted by a baby. They also may be thinking about the future. It is common to worry about how  employment will be affected, how to plan for maternity leave (and if it is will be a paid). Especially with single parents or those in low-income situations, these fears are a real concern and leads to a significant amount of stress.

Pregnancy Resources

There are pregnancy resource centers who assist mothers in receiving the care and support they need, including programs like WIC (Special Supplemental Nutrition Program for Women, Infants, and Children). These resource centers may provide blood tests and ultrasounds for those without insurance or providing expectant parents with the information to help them become recipients of government assistance. These are medical care and often food benefits, which are extremely useful in providing a proper diet for the mother while pregnant and providing formula and solid baby foods later on once the child has been born. Many also have parenting classes available for teaching about fetal development, breastfeeding, and parenting, both babies and young children. You can also ask these pregnancy resource centers if they offer specialized services for pregnant women with anxiety disorders, panic disorders, or other mental health issues that may become more prevalent during pregnancy. They may have low-cost or free options for cognitive behavioral therapy available for you to use.

Middle And Late Pregnancy Anxiety

Once a mother reaches the second and third trimesters of pregnancy, the risk of a miscarriage greatly decreases and they can expect to likely have a viable fetus.

Genetic testing and blood work are done to rule out any abnormalities or fetal health conditions that need to be addressed either before birth or immediately after the child has been delivered. These tests can trigger anxiousness as the parent or parents await news about the future of their unborn child. Once these tests have been done and come back with no signs of any problems, the positive news relieves a great amount of stress. In the cases where the tests come back showing complications though, this is often an unexpected and fearful discovery for the parents. The fears of an unhealthy pregnancy (depending on the diagnosis) and the worries of caring for a child and providing them with the highest quality of life after birth become a significant source of anxiety. 

Not all parents have the means to care for children with severe impairments or lifelong health conditions, which can increase overall worry and impact numerous aspects of a family's future. Some children may even be found to have conditions so significant that doctors may inform the family of a shortened life expectancy after birth. This is one of the most devastating things a parents can hear about their unborn child. In the worst-case scenario, there may also be health concerns that may require a medical termination of the unborn child or confirmation to expect a stillbirth. 

In less extreme cases, where the fetus is proven to be healthy and growing without problems, parental concerns are preparing for the future. For instance, if this your first child, you may be worrying about your ability to handle parenthood and the approaching childbirth.

The second trimester is generally the period when an expectant mom gets a few short weeks of energy and feels the best before the exhaustion and physical pains of carrying a child take over for the last three months.

The third trimester is generally when the fetus is growing rapidly and the mother’s body is changing to get ready for childbirth. Exhaustion is a factor that can greatly impact an expectant mom ability to manage physical and emotional stress. The size of the baby begins to affect quality of sleep as it is difficult to find a comfortable position. Furthermore, the uterus is preparing for childbirth and will begin to irregularly contract (Braxton-Hicks contractions) at any time. These contractions are often painful and can increase anxiety for both parents as the inevitability of labor approaches. 

This is also a period when the parents need to pay very close attention to the progression of pregnancy and report any remarkable changes to their doctor. Dizziness, high blood pressure, and edema (swelling) can indicate a serious condition known as pre-eclampsia. These symptoms need to be reported to their obstetrician to make sure the mother and fetus are safe. Fortunately, most obstetricians respond quickly when they recognize the symptoms and treat the mother as soon as possible. This relieves both their anxieties over the situation and hopefully resolves the symptoms themselves.

All necessary tests will be done to ensure the mother and baby are healthy with no imminent complications. The parents are then informed of any changes they may need to make for the healthiest possible pregnancy.

Labor

Labor can cause a great amount of anxiety, no matter how many pregnancies a parent has been through. Parents who have given birth experience anxiety because they know what to expect and the unpredictable nature of childbirth. New mothers typically are apprehensive and fearful of the unknown and inevitability of childbirth, whether through vaginal birth or a cesarean section. There are many classes, as well as online information, available to help parents understand the birthing process, what to expect, and how to best prepare themselves

Healthy Coping Mechanisms And Treatment While Pregnant

The following section introduces healthy ways for you to manage stress and anxiety through relaxing techniques such as mindfulness meditation, exercise, and massage therapy. Before trying any of the following, check with your healthcare provider to make sure the suggestions are safe for you and your unborn baby. Do not try any new medications or supplements, exercise, or relaxation therapy without speaking with your healthcare provider first. 

Meditation And Mindfulness Practice

A safe and non-invasive technique relieve stress and anxiety throughout the mind and body is meditation and mindfulness relaxation techniques. Mindfulness meditation is derived from Buddhist meditation practices that focus on accepting and drawing attention to the present moment. This practice of being mindful is intentional and allows oneself to focus on the emotions, sensations, and thought of the present moment in a non-judgmental way.  Mindfulness meditation has been shown to improve worry, anxiety and depression in pregnant women while helping to increase self-compassion. 

Prenatal Massage Therapy

Similarly, finding a professional that provides prenatal massage is another non-medicated option to help relax an expectant mother. A pregnant woman is unable to receive traditional forms of massage therapy as it is unsafe and may trigger labor.  A massage therapist who specializes in prenatal massage can relieve tension safely and provide significant pain relief and relaxation for the pregnant person. Furthermore, massage therapy can improve circulation, enhance general well-being, improve mood, and relieve muscle aches and joint pain. All of which can benefit an anxious pregnant parent. 

Exercise

Exercise, if possible, is also a good form of relaxation and prepares the body for the birthing process. Not all expecting parents will be physically capable of excessive physical activity, but even a short thirty-minute walk a few times per week can cause a significant improvement in both physical and mental symptoms. It is always advised to avoid any heavy lifting while pregnant, so generally, some light form of cardiovascular exercise is best for expectant mothers.

Prenatal Classes

Some anxiety when pregnant, especially for the first time, is not knowing how to parent or what to expect when taking care of a new baby. Taking prenatal classes will educate you on every aspect of fetal development, the birthing process, the healing process, breastfeeding, motherhood, and what to expect of growing children in their first few years. Having a general understanding about the life changes just around the corner can certainly cause reduce anxiety and prepare you for the life ahead.

Prenatal Yoga

Prenatal yoga is a type of mind-body relaxation exercise that is modified to be safe for pregnant women. In prenatal yoga, the person performs a series of movement poses and stretches while practicing breathing techniques. This type of yoga must be taught by a trained professional who knows what is safe for the pregnant body and can guide parents through modifications. This movement and meditation practice carries many benefits, including relaxation, alleviation of stiffness or discomfort, and prepares the body for labor and delivery. 

Lamaze Breathing Classes

Finally, one of the best ways to cope with the apprehension of labor and delivery, as well as the process itself, is Lamaze breathing techniques. These are very commonly taught in classes available at pregnancy resource centers, as well as in the hospitals themselves. This allows a mother to focus on her breathing, calming herself despite the circumstances, while providing the brain and body with more oxygen. 

Post-Partum Anxiety And Treatment

Identifying and treating prenatal anxiety and depression is incredibly important for the overall health of the mother, as well as the development of the unborn child. This vigilance that cares for the mental health of new parents does not end when the baby is born.  

Appearing sometimes as severe postpartum anxiety, postpartum depression (PPD) is an extremely serious mental health condition that can affect new parents and caregivers soon after the birth of the baby. While the focus in the past of postpartum depression was typically on the person who gave birth, non-birthing parents and caregivers also deal with this depressive disorder after labor and delivery is over. Postpartum hormone changes and sleep deprivation can lead to higher rates of PPD in women after birth. However, non-birthing parents also will experience anxiety and depressive symptoms and may not reach out due to social stigma related to heterosexism and cisgenderism. 

Postpartum depression can strike at any point after childbirth, whether during the first few days of the postpartum period or even weeks or months later. Symptoms of postpartum depression may include:

• Intense anger

• Depressive mood

• Difficulty bonding with the baby

• Irritability

• Fatigue

• Disordered Sleep

• Self-harm compulsions or thoughts of hurting the baby

• Not feeling “like yourself”

Many parents and caregivers choose to hide their depression from their friends, family, and physicians for several reasons, including shame and the preconceived notion that this is a normal response to this time. This leads to a person not receiving the help that they need and they experience heavy emotional distress that is left untreated. The exhaustion, the isolation, and the overwhelming responsibility of being a new (or even repeat) parent is not something that should be taken lightly. If you, your partner, or someone you know is showing any of these symptoms seek professional help as soon as possible to intervene with the progression of the disorder and relieve the symptoms that are affecting their quality of life. 

The Importance Of Seeking Help

If you are unable to manage the symptoms of anxiety or simply want to talk to a therapist for support. seek the assistance of a licensed mental health professional to help guide you through the coping and healing process. Your therapist can help you understand why you are anxious and give you strategies to improve your response to stress.  Having professional help is one of the best options for identifying and reducing symptoms and their triggers, both while pregnant and in one's daily life outside of pregnancy.

If you are pregnant and your feelings of anxiety are becoming a significant concern, notify your doctor, mental health professional, and even your ob-gyn specialist of any psychological changes or concerns you may have. Do not hesitate to choose the course of treatment that is most effective and most comfortable for you.

Seek guidance and treatment at any local mental health center or practice as soon as possible if you feel like something is amiss. If an on-site visit is not possible due to your health or caring for a newborn or young child, do not hesitate to reach out for help or further information via BetterHelp's online therapy resources. Online therapy is a convenient and cost-effective option that allows you to get the support you need from the comfort of your own home. Furthermore, online therapy has been shown to be as effective as in-person therapy, with people showing improved symptoms from depression and anxiety with regular talk-therapy sessions. Do not hesitate to set up a session with a therapist, especially if you are feeling like you cannot manage it on your own.