While I’ve always had big dreams for myself — move to New York City, build a writing career, start my own company, travel the world — I’ve also dreamt of having a family. So when I flipped over a pregnancy test in July to reveal a positive sign, I was instantly in love. My husband and I couldn’t believe it, and suddenly, looking down at my stomach had a whole new meaning. Suddenly, there was a little life in there, slowly turning into my son or daughter. And while I am mostly excited, I have also experienced intense anxiety throughout my pregnancy.
All sorts of thoughts have plagued me from the beginning: ‘Is the baby okay?’, ‘Am I eating the right things?’, ‘Will there be a heartbeat?’, ‘Will I make it through the first trimester?’, ‘Will the genetic testing come back normal?’ — and the list goes on. As I get deeper into my second trimester, my worries have changed to stressing over the anatomy scan, feeling the baby kick, and thinking a bit about labor and delivery. When I talk to my mom friends, they reassure me that it’s normal — and it’s only the tip of the iceberg with parenting. Once your child has arrived, there’s a whole new set of anxieties to work through.
Like other expecting moms, I’m doing my best, giving myself grace, and trying to find helpful solutions to get through the days, the weeks, and the months before my little love makes its grand entrance. If you are in my shoes, remember, you’re not alone. Here’s the guide to anxiety during pregnancy, from causes to solutions, straight from the experts:
You have no control over your pregnancy.
Anxiety, in general, is caused by fear of the unknown and not having control over outcomes. According to Rachel Ruiz, a licensed clinical social worker, anxiety during pregnancy is natural, especially since it’s one of the most unpredictable life events. While you can map out other life events like college graduation, marriage, buying a home, and so on, conceiving and giving birth often feels like the luck of the draw. In fact, Ruiz says only 2 to 5 percent of women give birth on their due date, and an estimated 1 in 4 couples will struggle to get pregnant. Another 1 in 5 will experience a miscarriage before the 12th week of pregnancy. These uncertainties can feel paralyzing and stressful, particularly for those who desperately want to become parents.
You are afraid of miscarriage or fetal defects.
When we found out we were expecting, we had to hop on a plane to Denmark, my husband’s home country, to visit his family. This meant I had seven hours of internet-free time to sit and stew about being pregnant. Unsurprisingly, I didn’t sleep, and I started worrying about my chances of miscarriage.
According to Joyce Marter, a licensed psychotherapist and author, this type of anxiety is more common for women who have experienced previous pregnancy/birth complications, miscarriages, or stillborns. Even so, all moms-to-be want their babies to be healthy, so it’s to be expected.
In addition to loss, many also worry about fetal defects, which are often detected at the 12-week ultrasound and genetic testing or the anatomy scan around 20 weeks. “This is a normal concern and one that can be exacerbated if you’ve had previous pregnancy complications, or if you or your baby’s father have a history of congenital disabilities or predisposition for genetic complications, or are an older mom. This can also be more common if you were drinking or using substances or had some kind of accident, illness, or injury during the pregnancy,” Marter says. “These fears may worsen before doctors appointments, ultrasounds, or medical tests.”
While pre-pandemic pregnant women experienced anxiety, a global health crisis definitely can heighten your senses.
Your body is constantly changing.
Starting in the initial first few weeks of pregnancy, a woman’s body changes. Her breasts swell, she may experience nausea, extreme fatigue, and other unfamiliar aches and pains. All of these symptoms and shifts can induce anxiety since it’s an all-new territory, says Dr. Bindiya Gandhi, double-board certified family medicine and integrative medicine doctor and the Medical Director at Revive Atlanta MD.
“Every week is different; your body is changing, your mood, hormones and emotions are all heightened and with good reason. Your HCG levels rise drastically, and that can also impact anxiety. The thyroid hormone is overworking to support the baby, so underlying thyroid issues can arise, causing more anxiety,” she explains.
You are pregnant during a difficult time.
While pre-pandemic pregnant women experienced anxiety, a global health crisis definitely can heighten your senses. There’s a lot to process right now, and it may feel heavier when your emotions are at an all-time high, says Dr. Shamini Jain, a clinical psychologist. “Between issues like the pandemic, climate change, and social unrest, most women are feeling anxiety about bringing a child into the world at this time,” she says. “There is much that feels unknown in the world, and often our response to the unknown is to have anxiety about the future.”
According to the AeroflowBreastPumps.com survey, the majority (68%) of moms reported increased feelings of isolation or poor mental health during pregnancy as well as increased feelings of depression, isolation, and/or disappointment in postpartum weeks. Nearly 2 in 5 (38%) mothers with private insurance reported they or their partner lost a source of income due to COVID-19 circumstances. The majority of mothers with Medicaid (72%) reported a pandemic-related loss of income and almost half of these women (45%) opted not to return to the workforce after their maternity leaves were over to avoid exposure and take care of children at home. One-third of all mothers in both groups (29%) were unable to attend all of their prenatal visits in person due to Covid restrictions. When they were able to attend visits in person, many (60%) were unable to have their partner or support person by their side.
How to manage pregnancy anxiety.
Though it’s not always easy to get off the couch, I try my best to stay mentally and physically active to distract myself from pregnancy anxieties. I also have a wonderful group of friends and a loving partner who helps me work through my thoughts when they feel overwhelming. Plus, I talk to my baby, and I try to remind myself that plenty of women have completely normal pregnancies.
Here are some other helpful tips if you’re battling pregnancy anxiety:
Express yourself through creative outlets.
When you’re suffering from anxiety, lying down and giving in to the thoughts will only make you feel worse. Instead, it’s more beneficial to find a creative outlet that gets you out of your head and into the moment. As Dr. Jain says, engaging our imagination is a quick way to feel better. “Whether it’s singing or playing an instrument softly or loudly, dancing around the house, creating a craft or art project, cooking a meal, wearing a fun, colorful outfit, writing a poem or a story, or even journaling, all of these activities have been shown to boost our mood and relieve stress and anxiety,” she explains.
Reach out to your support network.
If you can’t handle the fears, thoughts, emotions and stressors, pick up your phone and start calling or texting. Your people will be there for you, from your trusted friends and family and your partner (if you have one) to your OB-GYN. “Your mind and body are going through a lot, and anxiety is not your fault, and it is not a weakness,” Martyr says. “This is important for them to know so they can support you as best as possible and also because this puts you at higher risk for postpartum depression or anxiety. Anything you can do to address the anxiety now will help you down the road.”
Identify and dismiss intrusive thoughts.
Anxiety is often based on intrusive thoughts that appear to pop into your brain and paint an image of something you fear, explains Dr. Sheyda Mia Melkonian, Psy.D., PMH-C, a clinical psychologist. Rather than letting those worries pass right on by, you cling onto them, and they take over your mind. To put yourself back in the driver’s seat, she says it’s critical to identify these intrusive thoughts and to remind yourself that they are not real or true, but they are just thoughts.
“It is up to you if you choose to give them power and engage with them as opposed to identifying them as not based in reality as dismissing them,” she says. “This can be hard to practice, but it is one of the most helpful techniques in learning not to engage with the thoughts that drive your anxiety.”
Try to eat a healthy, balanced diet.
During your first trimester, you may have only been able to stomach a bagel and plain pasta. That’s okay! However, as you get further into your pregnancy, it’s essential to pay attention to your diet and try your best to eat healthy, nutritious foods, according to Dr. Anna Cabeca, a triple-board certified OB-GYN and author. This helps to stabilize pregnancy hormones. She says women should get plenty of healthy fats, which will slow the release of glucose when it’s combined with carbohydrates. If you are struggling to keep anything down, talk with your doctor, who can help make smart recommendations for your diet choices and health.
Last but not least, if none of these techniques are beneficial, consider seeking a professional that can work with you through pregnancy and postpartum. “Finding a therapist to talk with about her fears can be a big help,” says Dr. Sheila Forman, a psychologist. “If needed, anxiety medications can be taken during pregnancy. Obstetricians and psychiatrists know the impact of medication on pregnancy and can guide their patient through a safe and anxiety-free experience.”