Rebekah Shallcross @mamafeminologist
👂🏼 Clinical Psychologist & Researcher
Talking all things Women’s Mental Health
Mum to Arfie
Lover of second hand bargains, leopard print and cake 🍰
Anxiety in pregnancy is common – so if you are experiencing feelings of anxiety, you are most certainly not alone. It is characterised by feelings of worry or dread or a feeling in the pit of your stomach. It can include restlessness, difficulty relaxing, difficulty falling or staying asleep, being on edge and difficulty focusing or concentrating on tasks. You may also feel angry or irritable.
As with all difficulties we may experience with our mental health, there are lots of things that contribute to feeling anxious, particularly in pregnancy, a few of which I will list below. Experiencing anxiety is an uncomfortable yet normal and natural part of life. There is nothing ‘wrong’ with you if you are experiencing anxiety. Experiencing anxiety is normal AND there are ways to help alleviate the symptoms. I will cover both the experience of anxiety, when you might want to seek help and sources of help and support in this article.
Things that contribute to the experiences of anxiety, particularly in pregnancy
Our own experiences of being parented
Think back to when you were little. Were you taught how to manage difficult emotions like anxiety or panic? Were your feelings of anxiety contained for you (i.e. you were listened to, understood and validated in your experience of anxiety)? Were you taught or modelled ways of grounding yourself, such as deep belly breathing, mindful present moment attention, challenging unhelpful catastrophizing thoughts? Or were your parents themselves anxious? Were your experiences of anxiety met with ‘don’t be silly’ or ‘just get on with it’? If it was the latter then you may struggle in managing your own experiences of anxiety as an adult.
Similarly, experiences of emotional or physical abuse growing up may also leave us at greater risk of experiencing anxiety as adults – in particular, if our own experiences growing up left us feeling unsafe and anxious.
Being brought up in households where either there was a constant source of threat (perhaps in a household where domestic violence was experienced, where you experienced abuse, or where parents often argued), means that we ourselves are much more likely to 1.) Perceive the world as threatening and 2.) Be less likely to know how to contain and soothe those feelings of anxiety.
Another things that may contribute to your experience of anxiety is pregnancy is society’s (and perhaps therefore your own) expectation that you should be SO happy! “You’re pregnant! – You must be soooo happy right? RIGHT?!”
Of course, lots of people are happy to be pregnant. But for others, they may feel happy and anxious or solely anxious. I don’t know who needs to hear this…but you can experience opposing emotions at the same time! We are complex human beings after all!
Perhaps a baby was not part of the plan now… or ever. Perhaps you may be dealing with concerns around maternity rights, implications for your career, or how you may manage another child if this isn’t your first. The expectation that becoming a mother is THE thing that will make women happy is often not the complex reality of motherhood for some people. Not only this, but pregnancy is a time of momentous change – we are no longer responsible only for ourselves, but for our baby. And parenthood, whilst coming with many joys, comes also with many challenges. And so of course, feelings of anxiety are completely normal.
Your current circumstances may also be another thing that contributes to your feelings of anxiety. Perhaps this wasn’t a planned pregnancy. Instead, perhaps it is a shock and a big adjustment to the idea of parenthood? Perhaps this is a longed for pregnancy that hasn’t come easily and you don’t feel as elated as you anticipated? Perhaps you have experienced previous baby loss and you’re fearful of what the future holds? Perhaps you have recently experienced other losses in your life; the loss of a parent, the loss of a job, the loss of a relationship and you find yourself pregnant at a time when you are already processing difficult emotions. Maybe you have previously had a difficult or traumatic pregnancy or birth and you have concerns around carrying a baby or giving birth again? Perhaps you are in a relationship that doesn’t feel right? Or isn’t safe? In ALL of these circumstances, feelings of anxiety are a natural, ‘in context’ reaction to the circumstances around you.
Finally, the physical symptoms of pregnancy often mimic the body’s natural response to threat that are experienced during anxiety – for example, exhaustion, sickness, increase in blood and heart rate, shortness of breath. Seeking support from your GP with any physical symptoms you are struggling with may also help with feelings of anxiety.
Things you can do to help manage anxiety
So whilst anxiety is a completely normal human emotion, we are not supposed to experience anxious feelings all the time. It can be exhausting and very distressing and can sometimes feel uncontrollable. However, there are several things that you can do to help manage anxiety.
Learning to regulate our nervous system
When the body perceives threat, it activates the sympathetic nervous system also known as ‘fight or flight’. The sympathetic nervous system is designed to be activated when our lives are in danger. However, in modern society we are often encouraged to perpetually be in this fight or flight state: being told to ‘strive’, ‘achieve’, ‘consume’, ‘be busy’; never giving ourselves a break, always being hyper vigilant to possible danger in the future, and never taking time to bring ourselves into the parasympathetic nervous system which is where we are designed to operate from most of the time: the rest and digest system. In order to bring ourselves into this rest and digest (parasympathethic) nervous system we can practice the following things:
Progressive muscle relaxation
When we are anxious we often hold tension in our bodies that we are unaware of (often the shoulders or the jaw). Using a full body relaxation technique can help to relax our body countering the effects of tension caused by anxiety. Try lying down, taking a few deep, slow breaths and moving your attention to your right foot. Purposively and slowly tense the muscles in your right foot, hold for a few seconds, then slowly and purposively relax those same muscles. Take a deep breath in and notice how the relaxed muscles feel. Next move onto your left foot and do the same. You can slowly move up the body: right leg, left leg, right arm, left arm, stomach, back, chest, shoulders, neck, jaw and muscles around the eyes. Each time notice the feeling of relaxation in the muscles and each time breathing deeply into the belly. At the end of the practice, notice the feeling of relaxation in the entire body.
- Practice big belly breaths
When we are anxious and in fight or flight mode, we often breathe from our chest, short sharp breathes that make us feel pumped (and ready to fight or flee!) Practicing deep breathing slowly and into our belly can help to activate the rest and digest system instead, helping us to alleviate anxious feelings. Try lying on the floor, placing your hands on your belly, and breathing a nice deep breath into your belly, feeling your hands rise, for a count of 4. Hold your breath here for 7 (or as long as is comfortable) and then slowly breath out for a count of 8 (or as long as is comfortable). Repeat 4 or 5 times or as many times as feels comfortable. This is a lovely one to do at night before sleep.
- Practice present moment focus
When we are anxious, we often spend a lot of time and energy worrying about the future. Practicing mindfulness (or present moment focussed attention), helps us purposively chose to instead bring our focus to the here and now. It sounds so simple, right? But of course, when we have spent a lot of our lives with our minds in the future, bring our attention to the present moment can feel really difficult. There are several apps that can help in the practice of this including Headspace and Mindful. It is important to also try to be really kind to yourself as you begin this practice. Another way to bring yourself into the moment is by noticing 5 things you can see, 4 things you can touch or feel, 3 things you can hear, 2 things you can smell or taste and then taking 1 big deep belly breath.
Learning to challenge unhelpful thoughts
Often when we are anxious, we can think in a way that exacerbates our anxiety without really noticing. Some of these unhelpful patterns include catastrophic thinking, black and white thinking, being self-critical, comparing ourselves to others and creating rigid rules for ourselves (i.e. shoulds and musts). Learning to recognise and challenge these unhelpful thinking styles can be beneficial, especially when it comes to anxiety. A great pdf work sheet on this can be found here: https://www.getselfhelp.co.uk/docs/UnhelpfulThinkingHabitsWithAlternatives.pdf
Support from others
Finally, seek support from those around you. Trusted friends and family you know will listen to your concerns supportively.
If you don’t have friends you feel you can speak to in trust, there are support groups for parents online, including The Village – Parenting group, run by @mumologist and supported by several trained and registered Clinical and Counselling Psychologists https://www.facebook.com/groups/visforvillage/.
Think about putting boundaries in place with people who make you feel more anxious, limiting or stopping contact. Also think about what media you are consuming, again putting boundaries in place with anything that increases your anxiety unnecessarily. For example, stopping news notifications, or scrolling through news websites.
When to seek help
If you are experiencing anxious symptoms most of the time for more than two weeks, it is worth visiting your GP to discuss this. Similarly, if you are experiencing symptoms related to OCD (obsessive thoughts around contamination, fear of losing control, intrusive sexual or violent thoughts or images and/or compulsive behaviours or rituals to compensate for these thoughts such as hand washing, compulsive checking etc.) or panic attacks (sudden onset of shortness of breath, feeling faint, chest pain, trembling and dizziness, usually accompanied by thoughts you are having a heart attack or are going to die) you should also speak with your GP or midwife. If you have experienced a previous traumatic birth or if you have a fear of giving birth (known as tokophobia) then you can also seek support again from your GP or midwives.
There are a variety of treatments that your GP may recommend including self-directed Cognitive Behavioural Therapy (CBT), talking therapies, medication or a combination of treatments. Try and speak to a GP you trust and if you are not happy with the advice you are given, you can always request to speak to a different GP.
You may also decide to seek the support of a Psychologist or Counsellor. You can self-refer for talking therapy here: https://www.nhs.uk/service-search/find-a-psychological-therapies-service/ or, if finances allow you can self-fund.
- Domestic violence: https://www.refuge.org.uk/get-help-now/phone-the-helpline/
- Tokophobia: https://www.tommys.org/pregnancy-information/im-pregnant/mental-wellbeing/specific-mental-health-conditions/tokophobia-fear-giving-birth
- Anxiety in pregnancy: https://www.tommys.org/pregnancy-information/im-pregnant/mental-wellbeing/specific-mental-health-conditions/anxiety-and-panic-attacks-pregnancy
- Self-help book: ‘Mind Over Mother’ by Anna Mathur, Psychotherapist
Let me know how you get on by heading over to my Instagram page @mamafeminology and commenting under the post: Anxiety during pregnancy: Signs and Support. Here you can find more resources from me. And if you would like to work with me therapeutically 1-1 you can email me directly firstname.lastname@example.org or visit The Psychology Collective website to find out more: https://www.mumologist.com/the-collective
With love and #mamasolidarity