Anxiety During Pregnancy: Strategies for Coping


pregnant woman outside

Laura Berlinsky-Schine
Laura Berlinsky-Schine
When you are pregnant, everything may feel out of whack. You may be having health issues, morning sickness, and anxiety about what is happening to your body—and about giving birth and becoming a mother.
A little maternal anxiety is normal, of course. This is a big change, and you are bound to feel some anxiety during pregnancy. However, some women experience mental health issues that extend beyond the typical fears about your baby-to-be and motherhood in general. Women already prone to anxiety may feel an upsurge in symptoms due to new concerns, as well as hormonal changes.
According to research, 33 percent of women experience clinical depression or an anxiety disorder during their pregnancy. Despite this startling statistic, fewer than 20 percent of them actually seek treatment.
So first, take a step back and think about whether your anxiety is the typical stress during pregnancy many women experience or whether it might be the symptom of a larger anxiety and depression disorder.
Everybody experiences some degree of anxiety and stress a various points in their lives. It is not limited to pregnant women. And given that you are gearing up for perhaps the biggest life transition you will ever make, it is normal to be a more anxious than usual. Add that to your hormones going wonky, and it is a recipe for some serious maternal anxiety. You might be worrying about whether your baby will be healthy, if you will be a good mother, how you will support your child, and how your life is about to change. You may also be thinking about how your relationship with your parent and other children (if you have them) might change. That is all normal. In fact, you would be hard-pressed to find a mother-to-be who doesn't worry about at least some of those issues during her pregnancy.
However, if you experience an overwhelming form of anxiety and depression that leaves you unable concentrate on your daily life or function at work because you are so consumed with fears and worries and filled with panic, you may be experiencing what is known as antenatal anxiety.
Antenatal anxiety is essentially anxiety and depression women experience during their pregnancies. It is characterized by more intense depression and anxiety than the typical worries of a mother-to-be.
Women who suffer from antenatal anxiety may not only have mental health symptoms such as depression, obsessive thoughts, and anxiety—they often also experience physical symptoms, such as heat palpitations, appetite changes, low energy, and muscle aches, among other health and physical problems. If you are experiencing these or other anxiety symptoms, such as panic attacks, you should seek the help of a mental health professional. Note that the risk factors for anxiety and depression during pregnancy are increased by some factors, including:

• A history or previous diagnosis of an anxiety disorder or panic disorder
• Previous fertility issues or the loss of pregnancy in the past
• Pregnancy complications or a high-risk pregnancy
• Work or home stress during pregnancy
• A history of generalized anxiety disorder or other depression or anxiety disorders in the family
• A history of premenstrual dysphoric disorder (PMDD)
Living alone or being single, divorced, or separated
• Having a low income

Having these risk factors doesn't necessarily mean you will definitely suffer from antenatal anxiety, and not having these risk factors doesn't mean you can't suffer from it. Anyone can experience severe anxiety and depression during pregnancy. The most important part is that you get help if you do have symptoms that are overwhelming you or interfering with your life detrimentally.
It is very important to seek the help of a professional, because if left untreated, you and your baby could suffer long-term effects from your anxiety problems. According to one study, maternal anxiety during pregnancy can lead to complications in child behavior, such as ADHD, later on.
Your baby could also suffer from:
• Premature birth (before 37 weeks) or preterm labor
• Low birth weight
• Low APGAR score
• Colic
You could experience:
Preeclampsia (an condition that affects pregnant women and results in high blood pressure, water retention, and protein in the urine, among other potential complications)
• Substance abuse problems
• Postpartum or postnatal depression

If you think you might be experiencing antenatal anxiety, seek the help of a mental health professional immediately. A therapist who practices cognitive-behavioral therapy (CBT) can help you manage your disorder and find non-medicinal approaches to managing your depression or anxious thoughts and emotions.
If you have been taking antidepressants or other anti-anxiety medications before your pregnancy, talk to your psychiatrist or ob-gyn before stopping; otherwise, you could experience many difficuld withdrawal side effects that could put you and your pregnancy at risk. It is a good idea to have this conversation before you get pregnant, so you will have time to discuss your options and strategies for coping with anxiety and stress during your pregnancy or wean yourself from the medication if you and your doctor decide it is the best option for you. (Note that some medications may not be harmful to your pregnancy and baby, but be sure to discuss your particular situation with a medical practitioner to determine what the best course of treatment is for you.)
Managing less serious or severe forms of stress and anxiety during pregnancy
But what if you are experiencing a less severe form of stress and anxiety during your pregnancy? Is there anything you can do to deal with the daily worries and anxiety symptoms that are par for the course for many pregnant women?
There certainly is!
You don't need to suffer. Here are some ways to cope with anxiety issues and other difficult mental health side effects of your pregnancy:
1. Get regular exercise.
Exercise is always important for you, but it is even more so during your pregnancy. In general, people who exercise regularly are 25 percent less likely to develop anxiety or depression than those who don't, according to the Anxiety and Depression Association of America.
Exercise should be low-impact during pregnancy, especially if you are not used to high-impact forms of exercise like running and jumping; high-impact exercise may result in injury or put physical stress on you. If you are use to this type of exercise, consult your ob-gyn to discuss whether or not you should continue your program. You may be able to do so for at least the first trimester—but again, your doctor is the best person to advise you on how to proceed with your exercise regimen.
You can continue lower-impact forms of exercise, such as walking, swimming, yoga, and spinning (stationary cycling). These types of low-impact exercise can have enormous benefits in addition to boosting your mood, including:
• A lower risk of gestational diabetes
• A lower risk of excess weight gain
• Preparing your muscles for childbirth, resulting in an easier delivery
Better sleep
• Improved stamina
Exercise can also improve the health of your newborn.
If you don't exercise regularly, now is a good time to start. However, make sure you ease into an exercise schedule, and discuss it with your ob-gyn first. It is important to work up to an exercise program gradually, especially if your body isn't used it.
2. Sleep!
Sleep is essential for your physical and mental health. Lack of sleep during pregnancy can result in irritability, exhaustion, and lack of concentration at work and home. According to one study, women who got less than six hours of sleep per night during their pregnancies were 4.5 times more likely to have a c-section and experienced labors lasting 10 hours or longer compared with those who got 7 hours of sleep or more.
So, how do you make sure your getting the recommended seven or eight hours every night?
Unfortunately, many women experience pregnancy insomnia—an inability to catch those zzzzs while pregant—because of issues like frequent urination, fluctuating body temperature, leg cramps and other body aches, and, of course, anxiety. So getting a good night's sleep while you are pregnant is easier said than done. However, there are some steps you can take to help you sleep better.
Since it is a good idea to avoid sleep medications during your pregnancy (some may be safe for you and your baby-to-be, but be sure to consult your ob-gyn before taking anything), there are plenty of DIY strategies for naturally getting better sleep. Start by establishing a a night time routine, listening to a relaxing meditation, trying a breathing exercise, practicing yoga, or journaling.
Since you may be experiencing high levels of exhaustion during your pregnancy, you may need and want more sleep while you are pregnant. That's totally fine! You may need more sleep than usual, so do it!
3. Rest.
While you may be trying to get as much done as possible before the baby comes—staying late at the office to get ahead on work projects before maternity leave, taking care of household chores, and so on—it's important to take it easy during your pregnancy. Rest is essential to maintaining your energy and keeping yourself from getting overly stressed.
If you have sick days or vacation days saved up, use them when you need a break or are feeling particularly stressed. It is also a good idea to schedule in breaks throughout your day to just put your feet up and take some time for yourself.
Your support system—your partner, friends, family, neighbors, and other people you know you can count on—will come in handy. It is okay to ask for help with your responsibilities so you can take a break. Have a conversation with your partner to discuss how he or she can take on more of the load and household chores while your pregnant. Your other friends and family members can help out, too. If you have other children, for instance, you might ask someone to watch them on occasion while you're resting and your partner is working.
Resting doesn't just mean taking a nap, although a nap can certainly help you out. You could also just lie down or put your feet up and drink some herbal tea while watching TV, listening to soothing music, or reading a good book. Take some time to take care of yourself. You deserve it!
4. Practice relaxation exercises.
On a similar note, relaxation exercises can help you recuperate and mange your stress and anxiety as well.
One great relaxation exercise is deep breathing. Get into a comfortable position, sitting upright in a chair or lying down. Breathe in through your nose, allowing your belly to fill with air. Place one hand on your belly so you can feel it rise and expand. Then exhale through your nose or mouth. Repeat this process for several minutes.
Meditiation is another useful way to relax and combat stress. Getting started with meditation can be a little difficult—you may feel your mind wandering and be unable to focus—so you may want to try a guided meditation to start out. It can help you acclimate yourself to the practice.
Progressive muscle relaxation is a great way to get you body to relax physically. Starting from your toes, tense individual muscle groups one at a time for 30 seconds each before relaxing them. Work your way up your body to your neck and head.
There are many other relaxation techniques that can help you reduce physical symptoms of stress and help ease the tension in your body. If a particular technique doesn't seem to work for you after trying it out a few times, try a new one.
5. Maintain a well-balanced, nutritious diet.
Healthy eating is essential to maintaining a healthy pregnancy, as well as keeping stress and anxiety at bay.
So what is a healthy diet?
Well, to start, it means eating more than you usually do. The American Pregnancy Association recommends consuming around 300 more calories per day.
It also suggests eating foods thatare high in Vitamic C and Folic Acid, which are generally found in fruits and vegetables. Vitamin C is found in fruits and vegetables like oranges, grapefruits, honeydew, broccoli, tomatoes, and brussel sprouts. Dark, leafy greens a good source of folic acid. It can also be found in foods like legumes and veal.
Eating whole grains, such as fortified breads and cereals, is also important, because these foords tend to be high in iron, B Vitamins, and fiber.
Protein is also essential to your mental health and growing baby. Beans, meat, fish, and eggs are good sources of protein and also contain B vitamins and iron.
The American Pregnancy Association also suggests getting at least 1000 mg per day of calcium, generally found in milk, cheese, yogurt, and some soups. It can also be found in some green vegetables, seafood, and dried peas.
If your diet needs an extra boost, you can also look into taking a prenatal vitamin. Discuss the best options for prenatal vitamins the complement your diet with your ob-gyn.
Taking care of your mental well-being is very important during your pregnancy—as it is all the time, of course! Try these strategies to keep your stress in control. Not only will they help you, but they will help your baby and your baby's health as well.
If you are experiencing anxiety and/or depression symptoms that extend beyond minor, everyday fears and worries, it is important to seek help immediately. Discuss your problems with your ob-gyn or another medical professional. She can refer you to a mental health professional for support. Remember: You don't have to do this alone!