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How can you manage anxiety during pregnancy?

Pregnancy is an exciting time. You will soon become a parent to an adorable, tiny human. You may expect to experience the rollercoaster of emotions during pregnancy, or emotions may catch you off guard. Some women feel joy at every flutter or kick, marveling at their changing bodies. For other women, pregnancy is hard, giving no reprieve as it brings severe fatigue, mood changes, and constant worries. You may notice that with every passing month, your thoughts are spiraling out of control, affecting your performance at work and your relationships at home. But how do you manage your anxiety, and should you treat it?

What causes anxiety during pregnancy?

Worries during pregnancy are universal. Hormonal changes of pregnancy, prior heartbreaking miscarriages, and sleep difficulties may all contribute to anxiety for mothers-to-be. You may worry about how a baby will affect your relationships with friends or family members, the health of your future child, the delivery experience, or the financial burden of an additional family member. All of these worries are completely normal. For humans, a certain amount of anxiety is protective; how else could we motivate ourselves to complete our work or run away from a bear?

What are the symptoms of anxiety disorders during pregnancy?

Although it’s normal to be worried about the health of your baby, in some cases this worry becomes debilitating and may require further attention. Thoughts about the health of the baby may become obsessive, even when doctors are reassuring. Worries may also appear as physical symptoms, such as a rapid heartbeat, difficulty breathing, or panic attacks. If this is the first time you experience a high level of anxiety, this may be frightening in itself. When anxiety starts to interfere with your day-to-day functioning, relationships, or job performance, it may be classified as an anxiety disorder — if your doctor picks up on it.

Anxiety can occur at any time during pregnancy, or it may first appear after delivery (perinatal anxiety is the term used for anxiety during pregnancy and after delivery). The rates of generalized anxiety disorder appear to be highest in the first trimester, likely due to hormonal changes. The most common symptoms of anxiety include constant worrying, restlessness, muscle tension, irritability, feeling dread, an inability to concentrate, and difficulties falling asleep due to worries. Some women also experience symptoms as a result of other anxiety disorders, including panic disorder, obsessive-compulsive disorder, or post-traumatic stress disorder.

Unfortunately, two of the most common mental health screening tools in pregnancy (the Edinburgh Postnatal Depression Screen and Generalized Anxiety Disorder 7-item Scale) are not great at detecting anxiety in pregnancy. Although underdiagnosed, anxiety disorders during pregnancy and in the postpartum period are common, and may affect up to one in five women. Many women suffer in silence.

What are the effects of untreated anxiety on the fetus?

When thinking about management of anxiety, it is important to consider both the risks of treatment as well as the harms of untreated anxiety. Although less studied than depression, research suggests that anxiety may negatively affect both the mother and the fetus. Anxiety increases the risk for preterm birth, low birthweight, earlier gestational age, and a smaller head circumference (which is related to brain size).

What are some treatments for anxiety during pregnancy?

Fortunately, there are many treatments that can reduce anxiety during pregnancy and help you feel better. For many women, anti-anxiety medication is not an option during pregnancy, as there is little information on the safety of such medication on the fetus. Some women who had previously taken medications for anxiety may wish to discontinue medications during pregnancy for personal reasons.

Therapies such as cognitive behavior therapy (CBT) demonstrate promise in the peripartum period (the period shortly before, during, and after giving birth). CBT focuses on challenging maladaptive thoughts, emotions, and actions, and it uses anxiety management strategies such as diaphragmatic breathing (adapted to pregnancy).

If your anxiety is severe, medications may be an option for you. Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed for depression and anxiety during pregnancy and after delivery. It does not appear that SSRIs are associated with an increased risk of major congenital malformations. However, SSRIs may be associated with transient neonatal symptoms such as jitteriness, tremor, crying, and trouble feeding, which resolve on their own in a few days.

The use of benzodiazepines such as lorazepam (Ativan) and alprazolam (Xanax) during pregnancy has long been a controversial topic. Although older studies showed an association between their use and an increased risk for cleft lip and palate, a more recent study looking at benzodiazepine use during pregnancy did not show this link when these medications were used alone (although there may be an increased risk when combined with antidepressants).

What else helps anxiety during pregnancy?

• Engage in regular physical activity. In general, it is safe to engage in physical activity during pregnancy. However, if you are at risk for preterm labor or have pregnancy complications, consult with your doctor first.
• Ensure adequate sleep. Whether it’s a calming bedtime routine, pregnancy pillow, or a few nights in a bed away from your snoring partner, now is the time to learn what works for your sleep.
• Practice mindfulness. Research shows that mindfulness may reduce worries about labor, and it may even prevent postpartum depression.
• Journaling. Writing about your worries may help you brainstorm potential solutions, and it allows you to reflect on your concerns.
• Schedule worry time. We often worry because we do not want to forget something. Setting aside 30 minutes toward the end of the day provides you with a time to worry productively, but it frees you from holding onto your worries the rest of the day (practice reminding yourself "I’ll get to these thoughts later").
• Yoga, massage, meditation, and acupuncture. Finding relaxation techniques that work for you may take some experimentation — but their benefits will continue even after the baby arrives.

Fears of pregnant women are overcome - nine useful tips :: Clinician

25 10. 2017

• Unfounded fears

• Unnecessary alarms

• Worries unsupported by arguments

• Natural doubts

The time of pregnancy is nine months of happy expectation of a miracle, but sometimes the same number of months of fears and worries about the unborn child. In order to find joy and avoid unnecessary worries, to enjoy the gestation period, the necessary task is to get rid of the complexes, having determined the cause of the anxieties, to “quench” them. Mothers, husbands, relatives, of course, will help you (psychologically and physically), but the main mission to overcome your own anxieties lies with the pregnant woman.

The cause of anxiety is most often the physiological restructuring of the body, which leads to overwork, a weakened physical condition. This means that the expectant mother from the very beginning is predisposed to anxiety precisely in terms of physiological indicators. But understanding this phenomenon does not make it easier. The attending physician prescribes vitamins, trace elements, and in some cases hormones. It seems to be competent and according to plan, but ... it's still scary!

But what are these very fears and how to overcome them? How many pregnant women, so many fears. Not all have a logical background, some are based on myths and superstitions, and some are based on elementary ignorance.

Unfounded fears

A woman does not always plan pregnancy while leading a normal life. And when she finds out about an accidental pregnancy, she begins to count with horror the number of glasses of wine drunk, cigarettes smoked, what harmful food she ate during conception. Of course, the correctness of the recommendations indicating the need for timely planning of pregnancy sounds reasonable. But if everything has already happened, a decision has been made to give birth, then it is important to clearly understand that the wisest thing is to bring your psychological state into harmony and create favorable conditions for the development of the fetus.

Fear of miscarriage is an understandable concern. To identify the problem as early as possible, take tests every other day. The best arguments for well-being in this matter are indicators and numbers.

To drink coffee or not to drink - fans of aromatic grain drink exhaust themselves with this question, who cannot live a day without this drink. But every morning to tremble at this thought is definitely harmful to the unborn child. Let's look for an alternative. Is it better to spend the whole day at work sluggish and sleepy than to still dare to drink a cup of coffee with milk to cheer up?

Recent scientific studies have shown that a cup of coffee a day does not harm the baby. Pregnant women are allowed to drink, but it is recommended to use it less often, in addition, use sparing options: instant coffee or no caffeine at all.

Taking medicine or suffering pain (discomfort)? Pregnant women are usually extremely distrustful when even doctors prescribe pills to them. Even after the time spent at the consultation with a specialist, some “pregnant women” discuss the medicines prescribed by the doctor on women's forums for greater reliability. In order not to panic and not look on the Internet for advice from pregnant alarmists whose competence you are not sure, it is wiser to find a doctor who you can trust 100%! The field of gynecology in our clinic is one of the most developed and intensive areas of work.

Does it seem to you that your belly is growing slowly or, conversely, is it too big? This is not a serious cause for concern. The main thing is that the ultrasound confirmed that the fetus develops according to the deadline. Also, pregnant women worry that they are gaining weight rapidly or are malnourished. Eat a balanced diet and get enough (again, with the permission of your doctor) to move, then the weight will be within the normal range.

When the baby pushes hard, it is scary at first, and if the pushes are weak, perhaps even more scary. Indeed, both may indicate hypoxia. Share your concerns with your doctor, a toned uterus is a solvable problem. Just in case, study the so-called "method 10", based on the calculation of the fetal heart rate. So you will participate in the process not passively, but meaningfully. By the way, it is in your power to actively help the cub: walk daily in the fresh air, sign up for an oxygen cocktail course. Most likely, this is how the child simply shows temperament. But if the reason is more complicated, remember that medicine can cope with such problems. Hypoxia (if it is not chronic) is amenable to medical adjustment, as a result of which the tension of the walls of the uterus decreases, and blood circulation improves.

Childbirth is delayed, and this is fraught with the fact that a woman is daily absorbed in listening to herself and looking out for harbingers in fear of missing the start of the long-awaited process. On the one hand, vigilance does not seem to interfere, but one thing is clear - it is impossible to miss childbirth, there is no turning back. Perhaps the day of birth is simply incorrectly determined, because pregnant women do not always know the day of conception exactly.

Are you afraid of natural childbirth, scary and surgical intervention? Remember that most panic plans (not related to pregnancy) are implemented in a completely different way than your imagination draws, so fantasizing, winding yourself up is not a good idea. Even if the child is born as a result of a caesarean section, this sometimes happens. The main thing is that the birth is safe for the baby and the mother. To give confidence in this matter, it is useful to attend childbirth preparation groups with your husband.

The fear of not being able to cope with a new role is familiar to everyone who has “passed through” pregnancy. Long before the birth of a child, a woman begins to "try on" motherly cares. And a common misconception here is to make demands on yourself based on the image of your own mother. After all, you are unique, you have your own ideas about care and upbringing, dreams and dreams. Anxiety is unproductive, they take away strength, depress energy, instead read a book about the development of the baby. When he is born, there will be much less time for reading.

In preparing for childbirth, it is important not only to follow the doctor's recommendations, but also to overcome fears. Psychologists believe that awareness of the causes of fears and knowledge help to cope with problems, especially for women - “courageous”, thinking and hardy beings.

Sex during pregnancy

Author: obstetrician-gynecologist Viktoria Shpachenko

Tips and opinions from leading child professionals: https://www. instagram.com/emc.child/

Sex is one of the main components of a strong relationship in a couple. When there is no child, a man and a woman live in their own pleasure and intimacy usually attaches great importance.

With the onset of pregnancy, in couples, sex often fades into the background. Mostly the initiators of this are women. Why?

1. A woman worries if intimate life will interfere with the development of the fetus. The most common questions of patients to gynecologists are: “Will the baby suffer?”, “Will sex provoke a miscarriage?”, “Will there be complications?”.

2. A woman does not feel well during pregnancy.

3. No desire.

Obstetrician-gynecologist Viktoria Shpachenko helped to sort out these issues.

In a normal physiological pregnancy, intimacy is not dangerous. The fetus is securely protected in the mother's tummy, so it cannot be harmed during sex. Intimate life does not provoke a missed pregnancy. This is usually caused by a chromosomal pathology or hereditary thrombophilia.

Contraindications

However, there are a number of contraindications in which it is better to abstain from sex. Among absolute:

• bleeding at any time;

• placenta previa;

• isthmic-cervical insufficiency.

Relative contraindications include inflammatory diseases. With such diseases, the vaginal mucosa is especially vulnerable. Even the most harmless bacteria can provoke the development of an infection that is dangerous not only for the mother, but also for the baby. Therefore, it is better to postpone sex until recovery.

Feeling unwell

Indeed, during pregnancy, a woman can often feel unwell. Toxicosis or just a general malaise. Of course, in such cases, intimacy should be postponed until the condition normalizes.

Lack of desire

Lack of desire is a fairly common occurrence in a woman during pregnancy due to hormonal changes. Especially in the first trimester. In the second trimester, on the contrary, desire may intensify. During this period, especially a lot of progesterone is released in the body, the woman becomes more sensitive, and orgasms become brighter. In the third trimester, the expectant mother greatly increases her stomach, shortness of breath appears. Sex during this period can be uncomfortable and not cause desire. But, of course, every woman is unique. And it is impossible to predict how pregnancy will affect her body and attraction to a partner.

Therefore, there are no arguments in favor of not having sex from a medical point of view. Moreover, sex during pregnancy is even beneficial.

Firstly, it improves blood flow, and secondly, it gives the expectant mother positive emotions. Both are good for the baby.

How to explain to a partner if you don't want sex?

Another common question for pregnant women.

Pregnancy doesn't change anything for a man.

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