Anxiety during pregnancy doesn’t have a perfect formula. Discover ways to reduce your stress naturally with these tips from Dr. Jill Sullivan.
How to Reduce Anxiety During Pregnancy
Anxiety during pregnancy doesn’t have a perfect formula. There are different worries for all the stages and let’s be real here, our emotions are all over the place.
If you are just finding out you are pregnant you may be experiencing a rollercoaster of emotions. This post with cover how to deal with anxiety in all the trimesters of pregnancy. If you missed it, you can check out how to deal with pregnancy anxiety while you’re trying to get pregnant.
1. Anxiety During the First Trimester of Pregnancy
Once you become pregnant, it’s normal to have occasional worries about maintaining your pregnancy. The risk of miscarriage is highest early in the first trimester. The risk drops with each week that goes by, declining to 4-5% after the fetal heartbeat has been confirmed, and to less than 1% by week 14. Your own personal risk might be higher or lower depending on several other factors, including your age, lifestyle, and past pregnancy history.
What if you have had a positive pregnancy test and have seen and heard the heartbeat, but are still worried? It is particularly difficult during the first trimester to feel confident that your body is doing everything it needs to do to sustain your pregnancy. And it’s hard to wait when you are anxious. As a result, some women begin to scan their bodies to see whether they still “feel pregnant.”
The problem is that pregnancy symptoms ebb and flow. It’s healthy and normal for symptoms to begin to dissipate. However, if you are anxious, you might not take the alleviation of these symptoms as a sign that your pregnancy is progressing. Rather, you will jump to the conclusion that you are miscarrying or no longer pregnant.
This is called catastrophic thinking. When you catastrophize, you expect the worst possible outcome, usually involving loss (e.g. loss of health, loss of job, loss of love, loss of life, etc.). Catastrophic thinking can have a dramatic impact on your mood.
The fantasies of something bad happening can inject as much stress and anxiety in your life as if those possibilities were really occurring. Because of the mind-body connection, your body has a very difficult time understanding that you are just thinking about a loss, but not actually experiencing one. We live through many more negative and anxiety-provoking experiences in our minds than real life actually brings. This leaves you feeling so bad that you become more convinced that something bad is happening, and the spiral continues.
Next, you will want to do something to reassure yourself; you may even feel like you have to have this reassurance. Seeking medical reassurance is tricky. One the one hand, you want to get the input of your doctor; on the other, you may fear that you’re becoming annoying. You might worry about calling too often. Some patients begin to fear that their doctor might “fire” them.
While I have never known a patient to be fired for asking too many questions, I have seen the relationship with their doctors become tense. I have also known patients to switch doctors if they cannot convince their OBGyn to order tests or see them as often as they would like to be seen.
The question is not whether your doctor provides the medical care you would like, but whether they provide the care you need. If you think you need more tests and appointments than are typically recommended, that might not be a good sign. Don’t let your vision or medical choices become blurred by anxiety.
Steps to Manage Worries about Miscarriage:
- Ask yourself: “Where did this worry come from?” Were you experiencing physical symptoms that caught your attention? Did you suddenly begin cramping? Did you find blood in your underwear? If so, a call to your doctor might be reasonable. BUT, if you were pushing on your side to see if it hurt, or if you just heard a story about miscarriage that prompted a worry, or if the worry came to your mind “from out of nowhere,” recognize that this is anxiety, not a medical emergency.
- Do not purchase additional pregnancy tests or special equipment to monitor the heartbeat to reassure yourself.
- Do not call your doctor with slightly different versions of the same question. One of my favorite responses from an OBGyn with whom I work closely is: “Asked and answered.” Asking repeatedly, or in slightly different ways, is a form of reassurance seeking. Reassurance seeking is a difficult pattern to break, and it will only make you feel better in the short run. In the long run, you will need more and more of it, and still never be satisfied.
- Begin to look for resources that will help you manage your anxiety more effectively. You could probably benefit from learning relaxation strategies to reduce physical tension and anxiety symptoms within your body. You might also want to learn more about how to manage the thought patterns that create or maintain anxiety. Cognitive behavioral therapy (CBT) is the most effective form of therapy available for managing anxiety. Read, view Ted Talks, explore credible videos on YouTube, and perhaps set up a consultation with CBT therapist.
- Do not emotionally disconnect from your pregnancy. Some women decide that they will not allow themselves to think about their baby or begin to brainstorm names or think about baby gear. This is most common for women who have experienced loss previously and who do not want to get “too attached.” This strategy does not work. No one has experienced less pain because they tried not to be attached, and this can set the stage for difficulties with attachment once your baby arrives.
For many women, anxiety about pregnancy loss diminishes once they’re publicly pregnant. This typically occurs near the end of the first trimester: the time when risk for miscarriage decreases, when you have heard the heartbeat at a few appointments, and likely had an ultrasound. When you share your news, you open yourself to celebration and cheer and the hope of others. The positive reactions they share help to balance your worries. Until then, don’t wish to feel worse than you do. Try to feel confident that your body is doing what it needs to do to support the well-being of your child. Check out 15 Expert Tips for Surviving Your First Trimester.
2. Anxiety During the Second Trimester of Pregnancy
You told yourself that things would be better in the second trimester, but they aren’t. Everyone said you’d be feeling better physically, which is somewhat true. And, you hoped you’d feel less anxious when fears of miscarrying decreased. But you still feel bad. You’re worried that this is a sign that you will be a bad mother.
This is called emotional reasoning. You assume that your negative emotions reflect the way things are. “Someone who is going to be a good mother wouldn’t feel this bad. A good mother would be happy and enjoying her pregnancy.” Intellectually you know that this probably isn’t true, but it feels true at times. This is because of the mind-body connection.
Pregnancy can be a happy time, but it can also be stressful. The longer you’re pregnant, the better you might feel physically, but you are also getting closer to the changes ahead. What will you do about work? What will you do about childcare? Can you afford a baby? Will your relationships change? Will you love your child enough? Contemplating these questions can be stressful.
“Stress” has become synonymous with distress. Thus, stress has become “bad” and its positive effects are ignored. To a certain extent, stress can be helpful. When you are stressed, cortisol is released. Cortisol prompts you to take action. This promotes your problem-solving system. Stress protects, energizes, and motivates you. Stress can be helpful when it motivates you to take action, pursue change, or strive to achieve.
The stress you are experiencing may be a sign that there are important things to begin thinking about and planning for. These might be things that, while important, are not yet urgent. And, you do not want to wait for them to become urgent. This is your opportunity to be proactive and prepared in advance (which, most anxious people prefer).
What action can you take to reduce your anxiety and stress?
- Maintain your social activities. Social activities will help you build support.
- Surround yourself with those who can offer support, share information, listen to you when you share your thoughts and feelings, and help you feel less alone. A strong network of supportive friends and family members is an enormous buffer against life’s stressors.
- Begin reading about parenting. Is there a parenting style that resonates with you? Learn about a variety of approaches and begin to discuss them with your partner.
- Start to research baby gear. Talk to moms who will give you the scoop on which products you really need. Think about where you might want to register. And while you’re at it…
- Explore new moms’ groups in your area. Find out how to join. See if you can connect with women who are due around the same time as you. Do your research now and see if you can begin to build new connections that will provide support in the postpartum period. Lack of social support is a well-established risk factor for postpartum depression. Action you take now might protect you in the future.
- Maintain confidence in yourself and your ability to persevere through challenges. Recall other stressful situations that you have managed well. What did you do then? Can you use any of the same skills now?
- Learn how to calm and soothe yourself when you’re feeling sad, angry, or afraid. The ability to bring your emotions into balance helps you bounce back from adversity. People who know how to manage their stress use active coping techniques, including tension reduction activities, relaxation techniques, self-care, and strategies to examine and change negative thought patterns.
- Stress-hardy people have an optimistic attitude. They tend to embrace challenges, have a strong sense of humor, accept that change is a part of life, and believe in a higher power or purpose. You are doing one of the most important things we as humans can do: you are making a whole new person! It’s not easy, but there are few things in life as important as this.
Stress is a fundamental part of being alive and cannot and should not be avoided! The trick is to ensure that the degree of stress we experience is tolerable and that we develop the skills to manage stress when it becomes painful. By working to build support, increasing your confidence in your ability, improving your outlook and ability to manage emotion, and seeking information that allows you to prepare and engage in problem-solving, you can learn to tolerate stress effectively.
Your identity as a mother begins during pregnancy. If you do not have a positive view of yourself as a mother, you are less likely to develop positive feelings about your baby and the demands of mothering. When you take appropriate action–to gather your resources, educate yourself, and prepare–the stress you are feeling will begin to resolve.
3. Anxiety During the Third Trimester of Pregnancy
Worried about delivery? These tips will help you reduce anxiety as you prepare for your final weeks of pregnancy. The most common worries in the third trimester involve labor and delivery.
- How badly will it hurt?
- What if something goes wrong?
- Should you have an epidural?
- What effects will that have on the baby?
- Will people judge you if you decide to have one?
- What if you need a C-section?
- What if your water breaks and you are alone?
- Will you make it to the hospital in time?
- If your labor stops progressing, will they send you home?
- What if your favorite doctor isn’t on that night?
If you are already facing anxiety, adding these worries to your existing list may seem overwhelming. One approach that often helps people cope with anxiety is planning ahead. If you are pondering some of the questions above, you may be beginning to develop a birth plan. The American Pregnancy Association defines a birth plan as “a simple, clear, one-page statement of your preferences for the birth of your child.” Note the page length! The inside joke on birth plans is that the longer they are, the more likely it is that things will not go as planned.
Birth Plan to Reduce Anxiety During Pregnancy
1. Decide who you want to have in the delivery room with you? For some people, this is a family affair. For some women, it is a time to bond with other generations of women. This is an important opportunity to advocate for yourself; please utilize your partner to help you navigate these conversations.
2. Trust your team. Your healthcare provider is highly trained. S/he may be receptive to some of your ideas, but may view others as too risky to implement.
3. Prepare to be flexible. You may be thinking that you cannot possibly limit your plan to one page. Mine was one statement: “I plan to show up and do what the people who do this all day, every day, advise me to do.”
Remember that part of what you feel is excited! Excitement can feel very similar to anxiety. And, you feel motivated to make this transition well. Put some of the time and energy that would be wasted on worry into preparing, but also remember that soon your pregnancy will be over and motherhood begins!
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