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Anxiety in pregnancy: what expecting mums should know

Section: Pregnancy
Anxiety in pregnancy: what expecting mums should know

Anxiety can affect us all, pregnant or not: work dramas, relationship problems or family issues can sneak up and impact our lives from one moment to the next.

It’s thought that more than one in ten women struggle with symptoms of anxiety during pregnancy. 

But when you’re pregnant, your life is about to change dramatically: so how do you know when worries or anxious thoughts go from being routine to becoming more problematic?

It’s thought that more than one in ten women struggle with symptoms of anxiety during pregnancy. But is it affecting you? Here’s what you need to know about anxiety in pregnancy…

Can you get anxiety while pregnant?

It probably would be impossible to go through a whole nine months, a drastically changing body and thoughts of a painful childbirth without experiencing some stress and worry. With all the changes and adjustments happening in your body and in your life, it’s natural to feel nervous, scared or fearful, and hormonal changes can also make you vulnerable to volatile emotions.

With all the changes and adjustments happening in your body and in your life, it’s natural to feel nervous, scared or fearful, and hormonal changes can also make you vulnerable to volatile emotions.

Dr Genevieve von Lob, Clinical Psychologist and the author of Five Deep Breaths: The Power of Mindful Parenting, say there are plenty of normal anxious thoughts that expectant mums may experience.

“Some of the normal worries during pregnancy may include experiencing pregnancy symptoms and wondering what they mean, antenatal appointments and scans, the baby’s development especially if you are a first-time mum or have had a miscarriage or fertility issues in the past, how you will cope with labour, whether you will be a good mother or know what to do, whether your relationship with partner might change, whether you will have enough support, how siblings will respond to the new baby, and other practical financial concerns,” she says. “Also if you have had experienced anxiety in the past, then you may worry it may return and you won’t be able to cope.”

However, Dr von Lob warns, there’s a difference between normal worries and anxiety.

“If you start to find that you’re constantly feeling stressed, panicky and your worries and negative thoughts are spiralling out of control, then it may be that you have anxiety,” she says.

“When anxiety becomes so severe and distressing that you are unable to function normally in your day-to-day life, then it may be that you need to seek help.”


What are the signs of anxiety during pregnancy?

According to Dr von Lob, it can often be difficult to diagnose anxiety in expecting mums, because some signs overlap with symptoms of pregnancy, such as changes in concentration, sleep, appetite or energy levels.

“You may find that you’re worrying about many different things that seem out of proportion to the situation and you may be unable to control your racing thoughts or obsessive thinking,” she says.

“You may find that you’re increasingly restless and on edge, and finding it difficult to relax. You may be irritable and snapping at others. You may have a constant sense of impending doom, as if something bad is going to happen.

“All of these symptoms may affect your ability to concentrate on your usual daily tasks. You may even find that you lose your appetite or overeat or have difficulties with sleeping.”

There are also physiological and physical signs to watch out for, including heart palpitations, a tight chest, muscle tension, irritability, headaches, an upset tummy, dizziness, feeling faint, excessive sweating, blushing, and rapid, shallow breathing or even panic attacks.

Dr von Lob also warns that worrying about being anxious can become a vicious circle. “Often, pregnant women who are anxious feel guilty because they feel they should be full of joy, ‘blooming’ and enjoying this precious time and they beat themselves up because they feel should be grateful that they are having a baby,” she says.

“All this guilt and self-criticism can serve to increase levels of stress and anxiety. You may also start to have anxiety about anxiety and worry about your unborn baby and the effects of stress.”

She adds that pregnant women with anxiety may start avoiding situations which stress them out, but that while this make them feel better, it’s only ever a short term solution.

“We know that the more we avoid a situation which makes us uncomfortable, the more difficult it becomes to face similar situations in the future,” Dr von Lob says.

“A pregnant women with anxiety may start avoiding social situations because she is feeling unsociable, hopeless or irritable, but in the long term this may lead to more fear and avoidance of other social situations, leaving her isolated and more withdrawn.”

 

Can anxiety in pregnancy harm my baby?

Often, worrying about worrying can lead to more worrying - and when we think of our unborn child being affected by these nerves, it can make the anxiety even worse.

But Dr von Lob says that having normal stresses and worry is not going to harm your baby.

“A pregnant woman can expect her cortisol levels - one of the key stress hormones - to naturally increase by two to four times during pregnancy,” she says.

“In fact, cortisol plays a useful, and important role in regulating the maturation of the foetus, including lung development.”

However, more serious anxiety could have an adverse effect.

“Studies have shown that long-term, chronic anxiety in pregnancy can affect a developing foetus, since cortisol can cross the placenta and influence the building blocks of the baby’s emotional development,” she says. 

“Research also shows that chronic anxiety increases the odds of a preterm birth, a low birth weight and make it more likely that child may have emotional or behavioural challenges in the long term.”


How can I reduce anxiety in pregnancy?

Feeling anxious is perfectly common, and seeking help should be the first step if stress and worry is beginning to take over your life.

“Many pregnant women feel embarrassed or ashamed about having negative thoughts and feelings during pregnancy, or worry that they will be perceived as being an unfit mother, but having anxiety is nothing to be ashamed of and it is not your fault,” says Dr von Lob.

“It happens to many women at some point in their lives and you are not alone in feeling like this.nIt’s really important that you recognise if you are struggling, and reach out for help. You can talk to your midwife or GP if your stress levels have risen to a point that you are so overwhelmed that you are finding it difficult to cope or function.

“Your GP may be able to refer you to a psychologist or counsellor who can provide a non- judgmental, confidential space for you to talk about how you are feeling.”

 

It’s also important to reach out to family and friends who can support you and offer you help during this exciting but challenging time.

“Build up your support networks,” adds Dr von Lob. “Talk to understanding, compassionate partners, friends or family who you know support and love you, who you can be totally honest with and who you know you won’t judge you. You may also wish to seek out groups in your community or supportive online communities.

“It’s also good to take care of your mental health by continuing to do the activities you normally enjoy such as seeing friends.

“Eating a healthy, balanced diet of whole fresh foods can really have a big effect on your mental health and help your growing baby. Also getting plenty of sleep and doing gentle exercise such as walking or pregnancy yoga is also helpful.”

 

Preparation for each pregnancy stage, for the birth and for parenting is also important - but make sure you’re picking your sources wisely.

“You may want to increase your knowledge by reading up on the ins and outs of pregnancy and parenting to help you feel prepared,” advises Dr von Lob.

“However, be selective in the books or internet forums you choose, as many women report that some resources have made them feel even more anxious and fearful, so trust your intuition on this one. Select the information which provides you with the informative and practical advice which feels healthy and helpful.”

Mindfulness and breathing exercises can also help bring calm to anxious minds and bodies. “When we take conscious, deep breaths, our heart rate slows, our blood pressure falls, and we reduce production of the hormone cortisol,” says Dr von Lob. “We also strengthen the pathways in the brain associated with a sense of calm.  So the next time you are feel anxious, take five deep breaths and feel your entire body soften and your frazzled feelings start to fade. 

“When we are anxious, our thoughts are often chattering away and can suck up much of our attention. One of the simplest ways to come back to the here and now is by taking a moment to focus on what you can see, hear or feel. Schedule time for relaxation every day, or even a few times a day if you can. Look for guided meditations or mindfulness apps such as Headspace.”

 

Dr von Lob also says pregnant mums with anxiety must watch the way they speak to themselves, and take care to try and control any negative thoughts.

“If you notice your mind is full of harsh or self-sabotaging thoughts and beating yourself up for feeling like this or not being able to snap out of it, try and see if you can learn to cultivate some kindness and compassion for yourself,” she says.

“This may feel a bit strange or even impossible at first, but it’s worth persisting. For example, think about what you would say to a friend in a similar situation. Kindness and giving ourselves permission to look after ourselves and our needs without feeling guilty or selfish is so important, particularly in our role as parents, and it’s a wonderful thing to be able to teach our children,” she adds.

 
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