Anxiety During Pregnancy: Causes And Coping Mechanisms
Updated August 28, 2020
Pregnancy is an exciting time for most mothers and expectant parents, but it also comes with its share of worries, anxieties, and a host of wild symptoms that cause all kinds of changes both mentally and physically for the woman carrying the child. Sometimes, all this change can be a bit much for new mothers and even veterans of parenthood and pregnancy. And it's good to be aware of what's on your mind, what's going on with your body, and what steps you may need to take to keep yourself healthy as you bring a new life into the world.
Anxiety And Pregnancy
Feeling anxious in pregnancy is not uncommon and not at all abnormal. There are so many factors at play that anxiety is a perfectly normal reaction to all the life changes, bodily changes, and even hormone levels wreaking havoc on the parents-to-be. Some mothers who already experience anxiety or struggle with 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 and other issues. Every woman is different, each body is different, and even every pregnancy a woman has can and will vary in its effects and symptoms.
Doctors will generally check in during prenatal appointments about an expectant mother's mental health and any symptoms, and it's important to address all concerns at every possible appointment with a professional to ensure the best possible care and resolution (or at least reduction) of symptoms.
Early Pregnancy Anxiety
To be pregnant and anxious at the same time is not at all an uncommon combination. Early pregnancy is exciting for a lot of new mothers, but also comes with an extreme amount of fear for those having ever experienced past losses of pregnancy or that may have genetic or physical health issues that would put them at risk of losing a baby early on.
Miscarriages primarily occur within the first trimester, and many women have been pregnant without knowing and passed the unviable embryo so early on that they had simply mistaken the irregular and slightly heavier bleeding like a period that didn't adhere to their usual cycle schedule. Some have no problem with this occurring due to not knowing or simply not having enough time to get fully attached, yet some mothers will react very strongly to the loss and experience severe depression, anxiety, and post-traumatic symptoms (especially in the cases of recurrent loss).
The first trimester is a time when the risk of loss is the highest. It is also a common period of worry for mothers that weren't expecting to conceive to be concerned that their actions while unknowingly pregnant may negatively affect their unborn child. Women that drink or smoke may experience anxiety over damaging their growing child simply because they had not missed their periods yet or had a positive pregnancy test result until weeks after the fact. However, most actions during this period do not have a permanent effect unless unhealthy habits are continued into far later into the pregnancy, so much of the anxiety is reasonable yet shouldn't be that significant of a concern.
With unexpected pregnancies, the first few weeks may also be incredibly stressful as the newly pregnant mother has to figure out her plans for the future regarding finances, family, and other areas impacted by a baby being brought into the world. She also may be stressing out over how her employment will be affected depending upon which field she works in and the issue of maternity leave once the baby is born. Especially with single mothers or women in low-income situations, these fears are a huge concern and can lead to a significant amount of stress on both the mother and the baby.
Luckily, many pregnancy resource centers are willing to assist mothers in receiving the care and support they need. This can be physical, such as providing 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.
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 that will make it to the finish line.
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. Once these tests have been done and come back with no signs of any problems, the positive news relieves a great amount of stress off the mother and the family. In the cases where the tests come back showing complications though, this is often an unexpected and sometimes terrifying 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 deformities or lifelong health conditions, no matter how badly they may want to do so, and this can cause a lifetime of worry and affect numerous other 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, and this is one of the most devastating things a mother can hear about her 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. This can be incredibly traumatic and lead to severe depression and other symptoms in the mother as well as the other parent and family members.
In less extreme cases, where the fetus is proven to be viable and healthy and growing just fine, most of a mother's worries are preparing for the future, likely worrying about how to handle parenthood if this is their first child, and coping with unpleasant physical symptoms.
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 a mother's body is pushed to its limits and most simply want the child to be born already. Exhaustion is a huge factor that can greatly impact anyone's psyche, but especially an expectant mom with a lot already on her plate. Feeling all of the wiggles and kicks of the life growing in their bellies is a reassuring and often a sweet and fun experience, but it takes a toll when the unborn baby decides to kick all night and keep the mom awake. Even less comfortable is when the baby finds a particular organ (usually the bladder or the stomach) to bounce against and thump to death. If a fetus kicks a mom's ribs too much during pregnancy too, the pain from that can last even weeks after birth!
Aside from all of the sleep deprivation and human punching bag issues, a big area of concern for mothers in the third trimester is the debate between Braxton Hicks contractions and true labor contractions. Even mothers that have had multiple children can sometimes have a hard time judging which one is, which before true labor begins. Braxton Hicks are the body's "practice" contractions, and they can sometimes be pretty rough. Sometimes they may be strong and even come in regular intervals, mimicking how the contractions during true labor behave. For any concerns regarding labor, an expectant mother needs to contact their physician and ask for a professional opinion immediately. Sometimes, they will even be encouraged to go to their doctor's office for a quick physical checkup just to be sure everything is progressing fine, and there is no risk of early delivery (which causes numerous and potentially life-threatening complications for a baby that isn't fully developed).
This is also a period when a mom needs to pay very close attention to her body and report any odd changes to her doctor. Dizziness and even swelling in certain body parts may indicate a blood pressure issue or some other complication that immediately needs to be addressed to avoid harming the unborn baby. Luckily, most obstetricians are fantastic about responding quickly and treating the mother as soon as possible to relieve both their anxieties over the situation and the symptoms themselves.
All necessary tests will be done to ensure the mother, the baby, and the mother's reproductive organs are in good shape, and the patient is informed of any changes they made need to make for the healthiest possible pregnancy.
The biggest, anxiety-inducing fear of all is labor itself. Veteran moms can still be a bit nervous over it, and new mothers especially get worried once they realize the baby is coming out of them somehow, whether through vaginal birth or a cesarean section (which requires being cut open and having surgical removal of the baby). There are many classes, as well as online information, available to help a mom understand the birthing process, what to expect, and how to best prepare themselves. It is not an easy process, but it's been done millions of times over, so rarely is there a reason to truly stress besides if there were confirmed complications with the mother or baby ahead of time. Majority of the time, doctors will be adamant about providing a safe and potentially painless (for those who get epidurals) delivery experience and having the mother holding her newborn baby in her arms in no time.
Safe Coping Mechanisms And Treatment While Pregnant
A quick go-to for many mothers with depression and anxiety during pregnancy is anti-depressants, and there are quite a few available that have been used for years and have shown the lowest possible risk of side effects or defects. No drug is 100% guaranteed to not potentially have an unusual reaction with how chaotic an expectant mother's body is while pregnant, but quite a few have such a low risk that there haven't been any significant problems documented. This is a great option for moms who need something quick and effective; though with all medications, there is always the chance it may not help due to altered body chemistry, and another form of treatment will need to be utilized.
Depending upon the dosage and specific medication used, there is also the risk of the newborn infant experiencing mild withdrawal symptoms within the first few days after birth if the mother remains on medication during labor and delivery. However, low or weak doses will generally have an unnoticeable effect, and it's mainly the higher doses that cause this to occur. Some of the safest options are also suitable for continued use after the birth has taken place, and the mother is breastfeeding.
Some non-medicinal coping mechanisms would be meditation and mindfulness. Both of these will help the mother to use natural means to relax, calm her mind and body, and handle stress significantly better. With the mental anxieties coupled with the physical discomforts, meditation is an ideal option for those it works successfully for.
Similarly, finding a professional that provides prenatal massage is one of the best ideas for an expectant mother, regardless of what other coping methods she chooses to utilize along with it. A pregnant woman cannot just get any type of massage due to pressure points on the body that could accidentally trigger labor too early on. Someone specializing in prenatal massage knows exactly where to relieve tension safely and provide significant pain relief and relaxation for the mother-to-be. This is a huge stress reliever and incredibly healthy for both the mother and baby by reducing pain, encouraging good circulation throughout the body, and relieving anxiety.
Exercise, if possible, is also a good form of relaxation and preparing the body for the birthing process. Not all mothers will be physically capable of much 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 cardio is the preferred exercise for expectant mothers.
Seeking the assistance of a licensed mental health professional is also an ideal coping mechanism by investing in a professional that can help guide you through the coping and healing process. Also, build up a good relationship with you and have a thorough understanding of you, therefore allowing them to treat you better as your moods and behaviors fluctuate from all the bodily and hormonal changes of pregnancy. 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.
Though it may seem like less of a coping mechanism and more of just a good idea in general, taking prenatal classes is a great way to educate yourself 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. Being armed with all the information you need is a wise way of relieving stress by helping you know what to expect, and therefore stress far less over anything you may be unsure and worried about. Feeling in the dark about the huge life changes just around the corner can certainly cause a large amount of anxiety, pregnancy factor even excluded.
Another good stress reliever for those still able to move their bodies somewhat is prenatal yoga. This stretches, trains, and relaxes the body, not only providing an endorphin boost and alleviating any stiffness or discomfort, but it also helps in preparing the body for the intense workout that is labor and delivery. Many places offer prenatal yoga classes, and there are also plenty of online videos and tutorials for those familiar with the practice and simply seeking the appropriate modifications to do while expecting.
Finally, one of the best ways to cope with the fear 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, and also provides the brain and body with more oxygen. Hyperventilating from panicking over the entire ordeal is very strongly not advised and potentially dangerous.
Post-Partum Anxiety And Treatment
Though identifying and treating prenatal anxiety and depression are normal and incredibly important for the overall health of the mother and baby, as well as the development of the unborn child, one of the hardest hitting pregnancy aspects to affect a mother's mental state comes after the months of growing a baby and bringing it into the world.
Appearing sometimes as severe postpartum anxiety, postpartum depression is an extremely serious mental health condition that most moms fear even mentioning once they experience it, but is widely common and can have very serious consequences and complications if not treated quickly and effectively. Hormones are problematic enough as it is, but having nine months' worth flood out of your body much quicker than they built up can cause some very unpleasant psychological effects, especially for those who struggle with depression and anxiety even outside of the time they've been pregnant.
Postpartum depression can strike at any point after childbirth, whether during the first few days afterward or even weeks or months later. Having a newborn is incredibly stressful in spite of how beautiful it can also be, but a new baby needs a significant amount of care and attention. Learning how to properly care for a new baby, learning your specific baby's preferences and cues, the intense sleep deprivation, and the overall exhaustion are enough to drive anyone a bit crazy. Most people also seem to forget that during this entire time, the mother is also healing from nine months of strain on the body, in addition to the intensity of labor and delivery. All of these factors, combined with the hormonal fluctuations and massive chemical changes in the body after birth, can be a nasty combination and set off postpartum depression and anxiety symptoms.
Many mothers choose to hide this from their friends, family, and physicians out of fear of someone thinking they're "crazy" or a risk to themselves or their children. Often, mothers will suffer in silence and go untreated, and occasionally there have been instances so severe that a mother has gone through with harming her children and herself. The exhaustion, the isolation, and the overwhelming responsibility of being a new (or even repeat) mother is not something that should be taken lightly. A mother experiencing symptoms such as a consistent and sometimes dangerously low mood, mood swings in general, anxiety, thoughts of self-harm or harm towards those around her (most specifically her children), feelings of guilt or inadequacy, intense anger, panic attacks, difficulty bonding with their baby, or an inability to function that is more pronounced than just the usual exhaustion of motherhood need to seek professional help as soon as possible. Doing so does not make them any less of a mother, and they're genuinely choosing the best possible option to help themselves and therefore help the children they're caring for that need a healthy and stable parent caring for them.
The Importance Of Seeking Help
Due to side effects and other concerns regarding medication or any other methods of treatment during a pregnancy or even post-partum (especially in the cases of breastfeeding), it's important to make a consistent effort to seek the help needed in whatever form is most appropriate to ensure the wellbeing of yourself, your unborn baby, or your newborn. If you are pregnant and anxiety is a significant concern, notify your doctor, mental health professional, and even your ob-gyn specialist of any psychological changes or concerns you may have and don't hesitate to choose the course of treatment that is most effective for you and what you also feel most comfortable with.
Pregnancy and parenthood (especially with young babies) is not a walk in the park, and as a parent, you need to be in the healthiest mental shape possible to properly care for yourself while pregnant or healing from childbirth and also be able to care for your new child in the most loving and attentive way conceivable. Letting your mental health and anxieties slide to the back burner is not an option due to the importance of your new role in life.
Seek guidance and treatment at any local mental health center or private practice as soon as possible if you feel like something is amiss. If an on-site visit isn't possible due to your health or caring for a newborn or young child, don't hesitate to reach out for help or further information via BetterHelp's online therapy resources.