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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.

10 tips for coping with insomnia during pregnancy

At least two thirds of pregnant women suffer from sleep problems ¹ . In some women, they occur periodically and do not affect daily life, while others spend every night without sleep and live for many months in sleep-deprived mode.

Doctors warn that insomnia during pregnancy is normal. It is difficult for a woman to fall asleep due to a large belly, baby movements, heartburn, nausea, tingling and leg cramps. One of the causes of insomnia is considered to be a lack of oxygen: the uterus presses on the diaphragm and reduces the volume of the lungs, and the respiratory mucosa swells against the background of hormonal changes. Even if you manage to fall asleep, frequent trips to the toilet at night do not give you a normal rest. nine0005

What if you are already desperate to get a good sleep, and taking medication while carrying a baby is not an option? We offer 10 life hacks that will help to cope with insomnia in a future mother.

#1: Use Pillows

They say that a pregnant woman can't have too many pillows, and it's true. Try different positions: wrap your legs around a pillow, put it under your lower back, support your back to lie comfortably on your side.

Ideally, if you buy a special pillow for pregnant women, which gives a lot of space for imagination and makes life easier. It is indispensable for insomnia in the last 10-12 weeks of pregnancy. Choose options from holofiber, granules, swan or artificial down - they will provide maximum comfort. nine0005

#2: Sleep on your left side

In this position, the enlarged uterus does not compress the inferior vena cava and does not restrict blood flow to the placenta. Sleeping on your left side is an excellent prevention of edema and restless legs syndrome.

#3: Eat a Light Dinner

Heavy meals put a load on the stomach and prevent the body from resting properly at night. For dinner, it is better to eat lean meat or fish, salad, boiled or baked vegetables. We recommend giving up black bread and legumes, which can cause flatulence. nine0005

#4: Don't lie awake

If you can't fall asleep, don't stare at the ceiling for hours and drive your thoughts around. It is better to get up and walk around the room, open a window for ventilation, turn on relaxing music. When you switch your attention and calm down, the long-awaited dream will come faster.

#5: Meditate

Meditation is a great solution for pregnant women who suffer from insomnia. It relaxes the muscles of the body, copes with anxiety and helps clear the mind of unnecessary thoughts. nine0005

#6: Don't drink a lot of water at night

To avoid running all night to the toilet, drink from a small cup and don't drink too much green tea - it has a diuretic effect. If you feel thirsty before bed, take a couple of sips of water.

No. 7: Take a bath

If you have no contraindications, you should lie down for 15-20 minutes in warm (not hot!) water to relax your muscles and relax. A few drops of lavender essential oil will enhance the soothing effect of the bath.

#8: Listen to the sounds of nature

Download the app on your phone with relaxing sounds to fall asleep quickly. Perhaps, after 10-15 minutes of listening to the sound of the sea or the sounds of the forest, you will be sound asleep.

#9: Don't touch your phone before bed

Blue light from the screen reduces the production of melatonin ² , which is needed for sound sleep and maintaining circadian rhythms. Therefore, 1 hour before bedtime, it is worth postponing all gadgets. If you want to pass the time, take a book or do needlework, listen to music. nine0005

No. 10: Create a comfortable microclimate in the bedroom

Ideal conditions for sleep are fresh air and a temperature of 20-22 °C. If you are hot, leave the window open or turn on the air conditioner, as long as it does not blow directly on the bed. During the heating season, use humidifiers - they make breathing easier and help to cope with nasal congestion in pregnant women.

¹ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4935047/
² https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5703049/

Restless pregnancy - restless child? — 34 answers

Recently, I often come across posts and comments related to children's anxiety, allegedly because of the stomach, sometimes because of other problems. Once, when I was writing a post about our dysbacteriosis (which, by the way, I treated for quite a long time), I was advised to pay attention to my psychological state. Allegedly, the child is restless not from dysbacteriosis, which is not a disease at all, but from my nerves. I did not agree with this then, because. I didn't have any nerves. But then the thought woke up in me that everything that I experienced during pregnancy could affect the child. I will not write here either about dysbacteriosis, or about colic, or about my opinion about all this. Since this opinion has changed a long time ago, and will be the topic of a completely different post. nine0005

I am now interested in your experience. How was your pregnancy - calm or not. And what kind of child do you have? I would like to reveal the connection between the intrauterine and extrauterine life of the baby. And is there any connection at all?

I will write about us. I found out I was pregnant at 5 weeks pregnant. Then I had a loved one, not yet a husband. We lived separately. I wanted a child. But it was unrealistic. I lived with my mom, grandma and dad. Mom left and came home from work. I also worked. Grandmother had serious health problems, despite which she completely supported the whole house herself - she washed, cleaned, cooked. All this is done by hand (without any vacuum cleaners, mops and other devices), in the old fashioned way. I could vacuum the whole house and wipe the dust everywhere - the very next day my grandmother again crawled around the apartment with a rag. I think it’s not worth writing about my grandmother’s obsession with cleanliness and how all this affected her health. nine0005

My father was ill. Always. He had a micro-stroke, a heart attack, and a bunch of all sorts of thrombosis and other diseases. All this was reflected in the head, and was called dyscirculatory encephalopathy. When I was 10 years old, he underwent a bypass and was ordered to lead a healthy lifestyle. He didn't lead it. He could drink (a glass was enough for him to become inadequate), he smoked one after another. Grandma was at home with dad all day. One day, dad began to see what the rest did not see, and to talk to those whom we did not see. He could go out onto the balcony and start screaming. He called me at work, said that they wanted to kill me and that I was not allowed to come home. Once, during such an attack, I could no longer stand it, I was shaking, and I said, "Stop mocking us, I'm already shaking, and I still have children to give birth." Then I was already waiting for my Nikusha. Then there were psychiatric hospitals, discharges. At the 4th month of my pregnancy, my father died and I took care of his funeral. nine0005

At that time my boyfriend was a 5th year student at the institute. He was happy with the baby. And it could not be otherwise. We had a real love story with him. But at that time, our relationship was simply shaken due to the fact that because of my dad, I had no time for him. We kept the child and decided that we would have a family. But our parents at the joint council decided that there should be a wedding. We did not need it, and we resisted for a long time. Everything suited us anyway, and going to the registry office with a belly, all the more, did not fit into the whole romanticism of our relationship. But every evening they made a scandal to me that I would have a *** dock, because. out of wedlock. This is exactly what it said to me. Then I went to the kitchen and broke the dishes. Sometimes she was hysterical. We agreed to the wedding. They even proposed to me and gave me a ring. And I was sick of the fakeness of this whole situation. I said there would be a family wedding. But from some friends of her husband, 30 people came up. As a result, the wedding turned out to be not family at all. All I did was cross off the list of people I didn't need. And listened to lectures about it. Then there was a bunch of all sorts of organizational troubles, because of which I also often broke down. With grief in half, the wedding was arranged for 30 people and, in principle, everything about it was great, except that initially we didn’t need it. nine0005

All the time that I was burying my father and preparing for the wedding, I was also writing a diploma for my fiancé. I wrote day and night, at work and at home. Traveled to libraries. I decided that it would be better if he worked and earned money, and I wrote him a diploma. I shoveled a lot of literature. I will not write all the nuances, but in the end he was given a 3 for the diploma. Because he simply could not defend him for lack of knowledge. I worried, quarreled with him, but in the end I understood only one thing - I shouldn’t have taken on this matter. Since then, my husband's business is only his business. I do not climb into them and do not delve into. nine0005

In addition to all this, during pregnancy I could sometimes become simply unbearable. One day, my mother was driving (she was just starting to drive), and she couldn’t park, and another car was driving behind her and honking. Then that driver got out and started to be indignant, and I got out of the car and started yelling something at him, what a goat he is, etc., he can’t wait for a woman. Can you imagine a pot-bellied cursing creature? This is how I looked then. Then she came home and burst into tears.

I have accumulated a lot of negative emotions accumulated during my father's illness. And they kept pouring out all the time. I, being in principle a calm person, then seemed just a hysteric.

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