Anxiety 37 weeks pregnant

Is Increased Anxiety A Sign Of Labor? Here's What Experts Had To Say

Thanks to movie and TV representations of childbirth, most people are familiar with the more "traditional" signs of labor — water breaking, back pain, contractions. But is increased anxiety a sign of labor? The answer, it turns out, is complicated.

Does Heightened Anxiety Mean Labor Is Coming?

"It's not in the textbooks," Dr. Karen Duncan, an OB-GYN and assistant professor in the Department of Obstetrics and Gynecology at NYU Langone Health, tells Romper via phone. Duncan does think there may be more to this than what we currently recognize, though, and says that many of the mental symptoms of labor are overlooked or ignored.

"[Anxiety is] not a classic sign of labor, but I think it's likely that when women are getting into really early labor they do have some anxiety and heightened awareness," she says. "And it's probably the subconscious recognition of something going on in your body, maybe before you even mentally realize you're having cramps or you're having some back pain. It could be one of the earliest signs of something going on."

Of course, having a sense of worry during pregnancy, particularly as labor approaches, is common. "Many people about to deliver a baby are anxious about labor and new parenthood, and many feel anxious as they approach delivery," Amanda Tinkelman, a Brooklyn-based psychiatrist and certified perinatal mental health specialist, tells Romper. Most parents could probably talk about a time during their pregnancy where they became more anxious than usual — some don't feel ready, or feel ready but fear for the worst from a medical point of view. Tinkelman says this kind of increased anxiety is typical.

"There's a lot of unknowns," Duncan confirms. "Labor itself is a complete lack of control... Not knowing when you're going into labor alone... is extremely anxiety provoking for some women."

Why Anxiety Leading Up To Labor Is Common

Most pregnant people's anxiety will not reach the level of an anxiety disorder, in which troubled or worried thoughts affect one's quality of life by becoming persistent, inconsolable, and/or irrational. But both Duncan and Tinkelman agree that anxiety disorders in pregnancy have historically been under-reported.

"In the past, people would be more aware of postpartum depression as a potential complication of pregnancy," Tinkelman explains. "Now, we are beginning to appreciate that many people develop symptoms during pregnancy, not just postpartum, and many develop anxiety symptoms, and not just depressive symptoms. For this reason, the currently preferred term to identify these most common complications of childbearing is perinatal mood and anxiety disorders, abbreviated PMADs."

Both Tinkelman and Duncan say that while those with a pre-existing anxiety disorder are at heightened risk of anxiety (and worsened anxiety) during pregnancy, the development of an anxiety disorder during this time is not uncommon and multi-factorial. Changes in sleep patterns, psycho-social stresses about motherhood, adjusting to bodily changes, past trauma(s), and hormones, may all contribute.

"Hormones add to [anxiety]," explains Duncan, which is why she says women with a personal or family history of anxiety disorders should be aware of their risk during pregnancy.

Oscar Wong/Moment/Getty Images

How To Deal With Anxiety Before Labor

Duncan says those who are suffering from increased or new anxiety should talk to their care provider. "There is help. You don't have to suffer in silence."

Duncan also says that optimizing sleep, gentle exercise, yoga, acupuncture, talk therapy, childbirth classes, support groups for pregnant people, and medication are all treatments that can help. "There's definitely not a one-size-fits-all solution," she continues, "but there are a lot of possible solutions."

Don’t ignore feelings of anxiety. One study published in Women and Birth: Journal of the Australian College of Midwives, found that “experiencing psychological distress such as depression, anxiety, and/or perceived stress during pregnancy may increase the risk for adverse birth outcomes, including preterm birth.”

There's a lot even experts don't understand about anxiety, particularly during pregnancy and including, yes, whether that increasing sense of dread you're feeling as your due date nears is a sign of labor, or if it's the thought of labor that's fueling your anxiety. But based on what is known, either is possible. And, fortunately, we're learning more every day thanks, in no small part, to the fact that we're talking about it.

"There's been a bit of a stigma attached to... anxiety, but there shouldn't be," says Duncan. "The more we talk about it, the more we de-stigmatize it."

Study referenced:

Aleksandra Staneva, Fiona Bogossian, Margo Pritchard, Anja Wittkowski, The effects of maternal depression, anxiety, and perceived stress during pregnancy on preterm birth: A systematic review, 2015

Experts:

Dr. Karen Duncan, an OB-GYN and assistant professor in the Department of Obstetrics and Gynecology at NYU Langone Health

Amanda Tinkelman, a Brooklyn-based psychiatrist and certified perinatal mental health specialist

If you or someone you know is experiencing depression or anxiety during pregnancy, or in the postpartum period, contact the Postpartum Health Alliance warmline at (888) 724-7240, or Postpartum Support International at (800) 944-4773. If you are thinking of harming yourself or your baby, get help right away by calling the National Suicide Prevention Lifeline at 1-800-273-8255, or dialing 911. For more resources, you can visit Postpartum Support International.

This article was originally published on Oct. 4, 2019

Anxiety During Pregnancy: Tips for Coping

Intro

A few months ago, you were thrilled to see that second line on your positive pregnancy test. Now? You’re feeling worried at every twist and turn that something might be wrong. It’s a feeling you just can’t shake, and it’s starting to affect your everyday life.

Isn’t pregnancy supposed to be a time of joy? If you suffer from anxiety, it can be complicated. Here’s more about anxiety during pregnancy and some ways you can cope.

You may have heard that postpartum depression is a major concern for women after delivery. But there are other mood conditions that may affect your pregnancy. More than 1 in 10 pregnant women experience anxiety at some point.

Some women experience a decrease in their symptoms during pregnancy, but your anxiety may get worse. After all, not everything that makes you feel anxious is under your control. Hormonal changes during pregnancy may affect the chemicals in your brain. This can cause anxiety.

Pregnancy is also a time of tremendous change. Some of these feelings and sensations are welcomed, while others are downright uncomfortable and scary. You may even have complications or other issues that arise that keep you up at night.

Some degree of worry is natural during pregnancy. After all, the process may be entirely new for you. You may have faced situations in the past, like miscarriage, that give you reason for concern. But if these worries start to interfere with everyday life, you may have anxiety.

Symptoms include:

feeling an uncontrollable sense of anxiousness
worrying excessively about things, especially your health or baby
inability to concentrate
feeling irritable or agitated
having tense muscles
sleeping poorly

Occasionally, bouts of anxiety may lead to panic attacks. These attacks may start very suddenly with the symptoms above, and progress. During a panic attack, your symptoms may be very physical in nature, which can make the experience that much worse.

Symptoms of a panic attack include:

feeling like you cannot breathe
feeling like you’re going crazy
feeling like something awful may happen

While anyone can develop anxiety during pregnancy, there are certain risk factors that may contribute, including:

family history of anxiety or panic attacks
personal history of anxiety, panic attacks, or depression
previous trauma
use of certain illegal drugs
excess stress in everyday life

Mild cases of anxiety usually don’t require any specific treatment, though it’s a good idea to mention your feelings to your doctor.

In severe cases, your doctor may recommend medication after weighing the benefits and risks.

Well-meaning friends may have told you that you need to stop worrying because it isn’t good for the baby. While their sentiment comes from a good place, you may feel like stopping the cycle is easier said than done. Still, research shows that there is good reason to get your anxiety under control.

High levels of anxiety during pregnancy are associated with a risk of developing conditions like preeclampsia, premature birth, and low birth weight.

1. Talk about it

If you’re feeling very anxious during your pregnancy, it’s important to tell someone. Your partner, a close friend, or family member may be able to offer support. Simply sharing your thoughts and feelings may be enough to keep them from taking over your everyday life. You may also ask your doctor to refer you to a therapist who is trained to help with anxiety. Some therapists specialize in helping pregnant women.

2. Find a release

Engaging in activities that help to lower stress and anxiety may be a good option for you. Physical activity helps your body release endorphins. These act like natural painkillers in your brain. Moving your body is one of the most recommended ways to manage stress.

Effective activities include:

walking
running
yoga

Don’t like to stroll, jog, or strike a pose? Do what you love! Anything that gets your body moving can help. Aerobic activity for as short as five minutes has been shown to have positive benefits. Always speak with your doctor before starting a new exercise routine during pregnancy.

3. Move your mind

You can try activities that help your body release endorphins without working up a sweat, including:

meditation
acupuncture
massage therapy
deep breathing exercises

The American Institute of Stress recommends deep abdominal breathing for 20 to 30 minutes per day to help with anxiety. Doing so will help provide more oxygen to your brain and stimulate your nervous system.

To try it, get in a comfortable seated position and close your eyes. Imagine yourself smiling inwardly and release tension in your muscles. Then visualize that there are holes in your feet. Breathe in and imagine the air circulating through your body. Exhale and repeat.

4. Rest up

It’s important to make sure you’re getting enough sleep. Though sleep may seem elusive during pregnancy, making it a priority may help significantly with your anxiety symptoms. Do you wake up often at night? Try sneaking in a nap whenever you feel the urge.

5. Write about it

Sometimes you may not feel like talking. All those thoughts need someplace to go. Try starting a journal where you can let out your feelings without fear of judgment.

You may find that writing down your thoughts and feelings helps you organize or prioritize your worries. You can track different triggers to share with your doctor, too.

6. Empower yourself

Tokophobia is the fear of childbirth. If your anxiety is tied to childbirth itself, consider signing up for a birth class. Learning about the different stages of labor, what your body does, and what to expect at each turn may help demystify the process.

These classes often offer suggestions for dealing with pain. They’ll also give you an opportunity to chat with other mothers who may be worried about similar things.

7. Ask your doctor

If your anxiety is affecting your daily life or you’re having frequent panic attacks, call your doctor. The sooner you get help, the better. Beyond referral to a therapist, there may be medications you can take to ease your most severe symptoms. You should never feel embarrassed about sharing your thoughts and feelings, especially if they concern you.

Don’t feel like you’re getting enough support? You can always explore changing providers.

Anxiety during pregnancy is common. It’s also highly individual, so what may work to help your friend may not alleviate your own worries. Keep the lines of communication open with the people you love, try some stress management techniques, and keep your doctor in the loop.

The sooner you get help, the sooner you’ll be able to gain peace of mind for your health and the health of your growing baby.

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Harbingers of childbirth

Childbirth at term never begins suddenly for a woman, which is especially afraid of nulliparous pregnant women. The beginning of regular labor activity is preceded by the harbingers of childbirth, which prepare the expectant mother for the birth of the baby and remind her of the imminent birth. And although the harbingers are necessarily manifested by certain signs, some women may not notice them.

How does the body prepare for childbirth?

Aging placenta

The placenta, which produces hormones, plays a leading role in preparing the body for childbirth. From the 36th week, the ratio of secreted hormones changes: the production of progesterone, which is responsible for relaxing the smooth muscles of the uterus and prolonging pregnancy, decreases, and estrogens begin to be synthesized in greater quantities. Estrogens trigger the formation of uterine contractile proteins, due to which the susceptibility of myometrial cells to stimulation increases. In addition, high levels of estrogen increase the amount of prostaglandins in the uterus, which, in turn, trigger the release of oxytocin in the maternal and fetal pituitary glands.
Cervical maturation
The "maturity" of the cervix can be fairly accurately determined by vaginal examination. The process of "maturation" is due to the following mechanisms, during pregnancy in the cervix there is a gradual partial replacement of muscle tissue with connective tissue. Changes are observed in the cervical connective tissue itself: "young" collagen fibers are formed, which are extremely hydrophilic and therefore more flexible than collagen fibers outside of pregnancy. Clinically, this is manifested by loosening and shortening of the cervix, gaping of the lumen of the cervical canal.

Descent of the uterus
Descent of the uterus usually occurs in nulliparous women a few days before the onset of labor (in multiparous it occurs a couple of hours or with the onset of regular contractions). This symptom is due to pressing the head to the entrance to the small pelvis, which is explained by the adoption of the fetus in the most convenient position by the beginning of the contractions. People around usually say to a woman: “Oh, your stomach has dropped.” She feels it, as it becomes easier for her to breathe. In addition, expectant mothers note that in recent weeks they could eat quite a bit at one meal, and now it has become possible to “eat properly”. This is due to the fact that the descending uterus stops squeezing the stomach and diaphragm, so it becomes easier to breathe and eat.
The lowered and pressed head of the child, in turn, puts pressure on the rectum and bladder, which is manifested by increased urination and the urge to defecate.

Changes in well-being and mood
Shortly before the birth, the expectant mother may feel drowsiness, some apathy and a desire to retire from the noisy world. This is partly due to the inability to move easily and quickly, with a general change in state. But part of it depends on how the brain works. Gradually, the dominant of pregnancy turns into the dominant of childbirth, the body adjusts to a difficult stage, the woman is completely immersed in her own experiences. For the same reason, nervousness and tearfulness may appear, especially if family members underestimate the degree of anxiety of the pregnant woman.

Fetal movement
When the uterus becomes too tight for the growing fetus, its range of motion is reduced. This leads to hormonal changes in the mother's body before childbirth. Therefore, a week before an important event, the baby, as it were, “calms down”. This happens often, but not always. In addition, a sharp decrease in activity may indicate oxygen starvation of the child, which is the reason for an immediate visit to the doctor. A similar harbinger of childbirth before 37 weeks rarely appears.

Weight loss
Before childbirth, almost all pregnant women notice a decrease or stabilization of weight, by 0. 5-2 kg. This weight loss can be explained by the removal of excess fluid from the body under the influence of changes in the hormonal background. The mother-to-be may notice that gloves and rings are easier to put on, the shoes become less tight and it becomes easier for her to put on shoes.

Nesting instinct
If you conduct a survey among young mothers on the topic “what did you do when labor began?”, then many of you will probably give similar answers. Pasting wallpaper, dismantling the wardrobe, washing the tiles in the bathroom - these are a few of the things that a woman decides to do at the end of her pregnancy. Such "arrangement of the nest" is akin to the instincts of many animals, when before the appearance of offspring, you need to take care of the home. If such chores do not tire the expectant mother too much, then they should be treated positively. After all, homework is a little distracting from the anxieties and worries about the upcoming birth.

False contractions
The notorious Braxton-Hicks (false) contractions are a frequent occurrence in the last weeks of pregnancy, a harbinger of childbirth in most women. One they can cause discomfort, others do not even realize that there are uterine contractions. The essence of such contractions is to prepare the myometrium for childbirth and the maturation of the cervix. Such contractions do not lead to the opening of the uterine os and are felt as a hardening of the abdomen in response to movement or physical exertion. False contractions are characterized by irregularity, low intensity, painlessness and periods of rest between them up to 30 minutes or more. False contractions occur about 4-6 times a day, usually in the mornings and evenings, and last no more than two hours in a row.

Removal of the mucous plug
This harbinger of labor can occur 2 weeks before the onset of labor, and a few hours before it. In some cases, the mucous plug does not come off entirely, but in small portions. In practice, this sign looks like a discharge of vaginal discharge (sometimes mixed with a small amount of blood). A pregnant woman should inform her obstetrician-gynecologist about the discharge of the mucous plug.

When is it necessary to call an ambulance or go to the maternity hospital?
• If the waters have broken
• If a large amount of blood is excreted along with the waters or the mucous plug
• The development of regular labor 2 - 3 contractions in 10 minutes
• If the contractions are so strong that they do not allow rest
• The appearance of a headache , flies before the eyes, blurred vision
• Absence of fetal movements for 6 hours or more

Source: http://mama-super.ru/za-skol-ko-do-rodov-poyavlyayutsya-lozhnye-shvatki/

Warning signs during pregnancy — CGP on REM city polyclinic No.

We discuss the most pressing issues of pregnancy management in the classes at the Young Mother's School and invite our women to an active constructive dialogue.

Schools are held in the format of an interactive conversation, we invite you to ask questions to the doctor, get comprehensive advice on planning and managing pregnancy, contraception and women's health. Our obstetrician-gynecologists are ready to do everything possible for a comfortable pregnancy, however, we hardly get feedback from our women.

Ladies, Women's Health Schools are held every Thursday from 13.00 to 14.00.

First trimester warning signs that require medical attention:

vomiting more than 8-10 times a day
bleeding from the genital tract
severe pain in the abdomen or side.
The pain may be dull at first and then begins to increase.

Physiological changes during pregnancy that do not require special treatment:

nausea
change of taste
appearance or darkening of pigment spots on the skin
soreness of the mammary glands.

There are three trimesters during pregnancy. The first trimester corresponds to the first three months of pregnancy, the second trimester corresponds to the period from 4 to 6 months of pregnancy,

Signs that require immediate medical attention in the second trimester of pregnancy: