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Stress in pregnancy

Section: Pregnancy
Stress in pregnancy

Work, relationships, bills, office politics, family pressures… all the things that stress you out in a normal world can seem magnified once you’re pregnant.

With hormones floating around, the growing realisation that your life is about to be drastically different, and coming to terms with your changing body, even seemingly small problems can appear overwhelming at times. Worst of all, worrying about being stressed inevitably leads to more stress, which is an unpleasant vicious cycle that can keep you up at night.

But is it abnormal to feel stressed when pregnant? And how can you spot the warning signs?

We spoke to Dinesh Bhugra from the World Psychiatric Association, who is also a professor of mental health and diversity at the Institute of Psychiatry at King's College London, to get the lowdown on stress in pregnancy.

Although the stigma around talking about mental health has broken down in recent years, with the general public having an increased awareness of stress and the challenges it brings, when we experience it for ourselves, we can feel incredibly isolated.

Is it normal to feel stressed when pregnant?

Although the stigma around talking about mental health has broken down in recent years, with the general public having an increased awareness of stress and the challenges it brings, when we experience it for ourselves, we can feel incredibly isolated.

Bhugra says it’s a normal feeling - and that it can be magnified once you’re expecting for myriad reasons.

“Almost everyone feels stressed at times,” he says. “Stress during pregnancy is not uncommon. Pregnancy can lead you to feel stressed about the baby’s health and wellbeing, the capability to be a good parent, or the ability to cope after birth.”

Plus, he adds, if you’re a first-time parent, or have had a difficult birth experience previously, the feelings could be even more overwhelming - not to mention other problematic circumstances that could magnify any normal worries.

“It’s possible that your first pregnancy may be more stressful, or if there have been previous miscarriages or difficult births, that could also lead to stress,” he says.

“Lack of social support, not having your partner, overcrowding and poverty could also make stress worse.

“Some people may worry whether the arrival of the baby will affect their relationship with their partner, or be concerned about childbirth, pain and the ability to cope with the baby.

“A history of difficult childbirth as well as previous experiences of stress, anxiety and depression may also add to a sense of worry - and potential changes in roles, such as taking time off or giving up your job altogether may be yet another source of worry.”

What are the signs of stress in pregnancy?

It’s normal to feel stressed when we have a big deadline coming up or have had an argument with our partner. But how do we know when the stress has gone too far and could be detrimental to our mental health? Watching out for signs can be key to getting help fast, before the feelings of stress become overwhelming.

“Some of the signs include not being able to sleep, worrying a lot and constantly about trivial matters and worrying out of proportion, which could affect mood, sleep, appetite and concentration,” says Bhugra.

“People may feel that their mood changes with the time of the day, or feel unhappy, sad, not interested, and unable to enjoy things that were once enjoyable. Pregnant mums can also feel that they’re not able to cope, that they sleep too much or too little, that they lose their appetite or overeat. They may feel inadequate, irritable or hopeless, and that they want to avoid others.”

Often, during pregnancy, mums who feel stressed may also feel guilty and frustrated because they feel they should be on cloud nine - and those feelings of guilt, of course, often lead to more stress. 

“Thoughts of self-harm may make one feel even more inadequate, especially because pregnancy is supposed to be a joyful time,” adds Bhugra. “In addition, individuals may experience physical symptoms like palpitations, racing heart, sweating, heavy breathing, sweating, shakes and so on. Rarely, individuals may develop panic disorder leading to rapid breathing and sense of panic.”

Can stress in pregnancy harm my baby?

While it would be impossible to go a whole nine months without feeling some levels of stress, the occasional moment of worry will most likely not hurt your baby.

However, Bhugra says, continued levels of stress may well affect the baby’s immune system and could create problems.

“Prolonged stress may well affect the baby’s brain, so care must be taken to manage stress in the best way possible,” he says. "Chronic heavy stress with poor coping skills could add to creating differences in brain development. Under stress, it’s well recognised that the body goes into flight or flight mode leading to a surge in your levels of cortisol, chronic stress may keep these levels high which could cross the placenta and affect the baby. Continuing high levels of stress are problematic and every effort should be made to reduce these.”

Bhugra also notes that once you’re pregnant, you must be careful with any medication you take to manage stress, as some forms of medicine could cross the placenta barrier and could possibly affect the foetus.

If you’re feeling that you need medicine to manage your stress levels, it’s best to seek advice from your GP or obstetrician to help identify a safe form of medication that’s right for you.

How can I reduce stress during my pregnancy?

The most important thing to realise if you’re feeling stressed during your pregnancy is that you’re not alone. You’re not the first woman to feel like this, and you won’t be the last: so it’s important to tackle the stress early and not let it build up over time.

“Share your concerns and worries,” says Bhugra. “Talk to friends and others in whom you are able to confide.”

Talking to family or friends who have been through a pregnancy before can not only be cathartic, but can also lead to actionable and helpful suggestions you may not have though of yourself. Although we may be used to grabbing a glass of wine whenever we’ve had a bad day, or reaching for the caffeine whenever we’re exhausted, these aren’t advisable when pregnant. Instead, Bhugra says it’s important to keep in good physical shape, which will translate to good mental health.

“Do small bursts of physical activity if possible - like short walks - in order to reduce tension and help you relax,” he says. “Try to also do some relaxing activities, like listening to music, which will help you sleep. Eat healthily, too: even if you don’t feel like eating, try to have small portions of food with regular fresh fruit and vegetables. If you can't sleep, try not to worry about it,” he says. “Settle down with some relaxing music or reading.”

Don’t be afraid to ask for help too: if you’re too exhausted to cook dinner, or wish someone else would take the dog for a walk so you can put your feet up, ask a friend or family member who you know wants to make your life easier.

If you can get into the habit of accepting or asking for help while pregnant, it will only make it easier to delegate responsibilities to others once the baby arrives and you’re desperate for some shut-eye. 

 
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