It’s meant to be one of the best times of your life. Creating a new human – your human. Giving life. Blossoming. Glowing. And all those other lovely-sounding words. And yet, pregnancy can be a very stressful time for many women. So stressful in fact that a US-based study found that 84 per cent of pregnant mums experience some level of stress during their pregnancy, while a different study published in the British Journal of Psychiatry in May 2017 found that the percentage of pregnant mums suffering from anxiety ranges from 18 per cent in the first trimester, rising to 25 per cent by the third.
A quarter of mums-to-be suffering from anxiety? That’s a lot of pregnant women - and that's before there was a global pandemic. With the Coronavirus restrictions in force, the number of women suffering perinatal anxiety and depression is expected to rise significantly, says Siobhan Miller, founder of The Positive Birth Company and author of Practical Ways to Make Your Birth Better, "especially with vital support groups, clinics and classes cancelled, and women often having to give birth alone due to self-isolation and social distancing.”
But this also means that if you have been experiencing something along the lines of the bump blues, you’re far from alone. And it’s not something you have to – nor should you – put up with.
Dr Rose Logan, clinical psychologist at The Lighthouse Arabia (Lighthousearabia.com), says, “Perinatal, or antenatal, anxiety is much less documented than postnatal depression and much less talked about. I think a lot of women assume it is just part of being pregnant and something they have to just deal with. But it really doesn’t have to be. Speak to your GP, or your OBGYN about it, and they may refer you to a psychologist, or a counsellor, or a psychiatrist, depending on the situation.”
However, it’s easier said than done. There is a huge expectation on pregnant mums to enjoy every second and all aspects of pregnancy, so it isn’t always easy to put your hands up and admit that you are finding it hard.
Anna Yates, psychotherapist, hypnotherapist and owner of Mind Solutions (Mindsolutions.ae), says, “The difficulty here in the UAE is that most people are far away from families, who might be the only people you feel you could open up to about something like this. Additionally, there is such a focus on the baby’s wellbeing that pregnant mums can often neglect their own needs. So, as long as the doctors are confirming that the baby is fine, the mum may simply pass off her own anxiety as being unimportant. But this isn’t the case.”
Does anxiety impact the baby?
There’s some compelling evidence showing the importance of a pregnant woman prioritising her mental wellbeing. Researchers from the University of Zurich recently released a report suggesting that long-term exposure to stress hormones may increase the baby’s chances of developing ADHD and cardiovascular disease.
Vivette Glover is professor of perinatal psychobiology at Imperial College London. She says, “Many pregnant women are anxious or depressed, and this can affect how the baby’s brain develops. This in turn leaves the child at greater risk of anxiety, depression, slow learning or behavioural problems such as ADHD later.”
She adds that there are other factors which can increase or reduce this risk, such as the support of the father, the care after birth, the child’s genes and much more. But, still, a mother’s emotional state is of utmost importance. “We know that the mother’s mood can affect the function of her placenta. If the mother is more anxious there is less of the enzyme that breaks down the stress hormone cortisol, for example; and the development of her baby’s brain can be affected by being exposed to more cortisol.” This can lead to changes in how the baby’s genes work and other biological systems.
Interestingly, this process has an evolutionary basis according to Glover. If our ancestors were in physical danger, their unborn baby being exposed to more stress hormones in the womb would make them more anxious, thereby causing them to be more vigilant and able to detect danger. She says, “Readily distracted attention, as in ADHD, may have helped to spot the danger more quickly. Rapid aggression may have helped also. But these changes, adaptive in the presence of real danger, are not advantages in our society.”
Emotional issues during pregnancy can also put the mother at a higher risk of emotional issues after pregnancy. Which in itself is a good enough reason to seek professional help during pregnancy, says Dr Rose. She says, “If you are anxious and stressed or depressed during pregnancy it increases the risk of a mental health issue postnatally. Whether that’s postnatal depression, or increased anxiety, it may affect your perceived ability to cope, which can lead to further mental health complications postpartum. A lot of people don’t link the two. They think ‘I’m pregnant. Of course, I am going to feel stressed and anxious.’ But no, if it’s actually troubling you, then definitely it is something to be addressed as it can potentially increase the chances of postnatal issues.”
What should I do about it?
The good news is that there are lots of things pregnant women can do to take control of their emotions and reduce anxiety. Researchers in Zurich suggest that using therapy to reduce stress and anxiety while pregnant is the best way to protect both mother and child from knock-on effects. They add that it’s a good idea for support to be offered after the birth to help mother and baby bond well, as this can help counteract the impact of stress during pregnancy.
Anna from Mind Solutions agrees, saying, “We use hypnosis and other therapies to help bring the mum’s anxiety and stress levels down naturally. Many mothers are interested in using hypnobirthing for a calm, natural birth, but many don’t know that they can use hypnosis to get the most out of their pregnancy too. We can help women at all stages of pregnancy to feel calm and confident, which would benefit the baby as well as themselves. The best thing you can do for your baby is to relax and enjoy the pregnancy.”
There are many triggers for anxiety during pregnancy – some of them internal, such as the mum’s own fears of childbirth or parenthood, and some of them external, such as pressure from family, or changes to lifestyle. Another common trigger is problems during previous pregnancies. Anna says, “I often find that if a pregnant mum is suffering from anxiety, it is for a valid reason. They may have had a problem with a previous pregnancy, or a similarly distressing experience. In these situations, hypnosis really is the best thing as you can use it to tell the subconscious mind that everything will be fine, which can help your mind and body relax at a much deeper level.”
Dr Rose says, although it is easy for mums to pass off their mood swings as being down to fluctuating hormones, it might deserve a closer look. “Hormones may be playing a part but they aren’t necessarily the whole situation. This is something that can make it harder for mum and baby postnatally and is something that you can get help with. Anxiety during pregnancy is not something you should have to live with.”
Dr Rose Logan, clinical psychologist at The Lighthouse Arabia, explains how prenatal anxiety can manifest in pregnancy-specific ways: “In addition to more general anxiety symptoms, there may also be anxieties that are more specific to pregnancy. For example, a neglect or obsession with health, or hygiene, or avoiding places. That would be at the more extreme end, where women might become a bit hypervigilant. Not necessarily OCD, but perhaps a little bit obsessive or compulsive. Or there might be an increase in restlessness, irritability, the need to control other areas of life, withdrawing from people and places, insomnia, or perhaps not feeling that they can engage with their pregnancy. This may not be in the sense of bonding with the baby, but maybe in a sense of not being able to get excited about it and perhaps holding off doing things like joining an ante-natal class, or looking at cots.”
A real mum’s experience
Sophie*, from the UK, suffered from anxiety and panic attacks throughout her second pregnancy. She says that she was let down by her OBGYN who didn’t acknowledge the warning signs and that, if it wasn’t for a chance encounter with another gynaecologist, her anxiety might never have been discovered.
“I was so lucky that the anxiety just disappeared as soon as she was born. About five hours after I gave birth, it was like a dark curtain just dropped and everything was fine and wonderful. But throughout the entire pregnancy, I was in bits. I couldn’t sleep… I was miserable. I was petrified about how it would be once she was born and I was anxious about how it would affect my relationship with my eldest, with my husband. I cried through most of my appointments with my OBGYN. I knew something was wrong, but I didn’t tell anyone. I think if my mum had been here, she would have recognised it and intervened. I was given the name of another gynaecologist for sleeping tablets. She told me that the insomnia was a tell-tale sign of prenatal anxiety. We talked and talked and talked. If it wasn’t for her, I don’t know how I would have made it through. To other mums going through it, I would say, ‘Don’t keep it to yourself.’”
Read more: How to support your pregnant wife
Photos by Istock