Anxiety in Early Pregnancy

Early pregnancy is often the most stressful time of a pregnancy. Many women find that their anxiety is highest during the first trimester. It’s no surprise because early pregnancy presents a major life change, your hormones change dramatically and you become physically exhausted.

On a cultural level, there is also a dismissive attitude in our western world towards women’s experience during the first trimester. You might be told to just “deal with it” and get on with life, but you are in the process of going through a major mental, emotional and physical transformation. Your body is telling you to rest, but there are still many demands on your energy.

Below are some common worries and practical ideas on how to increase your sense of well-being.

Anxiety about feeling out of control, being too emotional:

In early pregnancy, your belly is barely noticeable. Your baby has yet to make their presence known yet you might be noticing all kinds of new symptoms (sometimes daily!). All of these changes might make you wonder whether your experience is normal. Combine all of this with the tremendous fatigue or nausea you might be experiencing, and it can feel like you cannot cope in your normal way. You might not be used to the roller-coaster of feelings, fuzzy thinking, the forgetfulness, and the lack of motivation. It can be scary to feel like your old, competent self is fading.

Ironically, the first trimester can also be a time when a woman feels a sense of loss. We often think about what we gain in pregnancy –  a baby, a family, motherhood, but there is loss as well. Think about what you have lost in becoming pregnant? It is ok to admit the loss as well as the gain. You might have lost your sense of control, energy, freedom to eat and drink what you enjoy etc.

Anxiety about losing the baby or the baby being healthy:

Virtually every woman has this fear, but just because your fear is normal, doesn’t make it any easier. Your baby might have been a long time coming, a blessed surprise, or even the result of many years of treatments. Either way, once you find you are pregnant, you begin to create a new world that includes this baby. You might be thinking about how your body will change, how your baby will look, what kind of father your partner will be, etc.  You might try to keep yourself from bonding “just in case”. You might even have a history of miscarriage and be watching intensively for signs of things going wrong. Sometimes women feel like they are holding their breath, just waiting for the first trimester to pass and then breathe a sigh of relief.

Practical things that might help cope with anxiety:

• Making peace with “uncertainty” and cultivating contentment: The first trimester is a time of uncertainty. Intuitively, you know that you cannot control things. At the same time, you might wish that someone would give you a crystal ball to know that everything will be ok. With reassurance, you might feel more at ease to go about the business of growing your baby.

But without this absolute reassurance, we can try to make peace with uncertainty. Making peace with our feelings or cultivating contentment is associated with a balanced Autonomic Nervous System which means more energy, fewer unpleasant symptoms and more balanced hormones. A great article for those of you who love the science behind the information is http://drlwilson.com/Articles/NERVOUS%20SYSTEM.htm .

In the article, Dr. Wilson explains the difference between happiness and contentment: “ Contentment is different from feeling you need to be happy all the time.  Happiness, as most people know it, is often short-lived.  It is often an attempt to overcome feelings of unhappiness.  Contentment is a state in which you are at peace with yourself and the world, even if the world around you is not to your liking.  You can learn to let the world go and choose contentment rather than attempting always to control the world. “

Understanding your coping style: Take this opportunity to learn about yourself and gain mindfulness on how you cope with stress and anxiety.

• Ask yourself…how do I cope when I feel a sense of insecurity or don’t know the answers?  What do you see yourself doing?
• …Perhaps you seek out more information – proof that things will be ok, or details on how to prevent something from happening. …Maybe you disconnect from friends or family.
• Then ask yourself, is this approach helping me to increase my feelings of well-being? If not, what will?  List 2 or 3 things.

Sometimes we just need to acknowledge that there is uncertainty, and we are scared. By accepting these feelings, we can reduce the stress hormones that are created when we try to control the outcome of things. The truth is that you will have many moments of uncertainty as you progress in your pregnancy and become a mother and you can use this time as a time to grow your ability to feel love even when you are scared or worried. Sometimes it can feel impossible to find a peaceful mindset. Getting support can help. Talk with someone who is supportive and can give you tools to get through this time such as a knowledgeable friend/family member, prenatal coach or doula .

• Miscarriage prevention: 
o If you have had a hard time getting pregnant or have a history of miscarriage, you doctor might suggest progesterone.
o Another option is Acupuncture with a naturopath who has specialized training in perinatal care. Dr. Rishma Walji, a local Naturopath and Acupuncturist in Milton, Ontario uses acupuncture in early pregnancy. In her experience, “Acupuncture can help promote circulation to the uterus and throughout the body, and ensure healthy uterine lining, which improves your chances to sustain a healthy pregnancy and prevent miscarriage.” (http://rishmawalji.com/  )

• Reducing the impacts of stress: We all know that stress is bad for us. During pregnancy, there is the additional concern of the impact of stress hormones on your growing baby. The first trimester is a critical time for development, so getting support to reduce stress hormones will have a positive impact for your entire pregnancy, including reducing risks of preterm labour ( http://birthpeeps.blogspot.ca/2012/08/radical-change-35-shift-focus-of-early.html  )

We all experience stress, and we cannot eliminate it. We can, however, reduce the impacts of stress by balancing the nervous system on a regular basis with simple daily activities. Activities such as prenatal yoga (no..it’s not too early! Studies show that earlier is better!  http://www.ncbi.nlm.nih.gov/pubmed/19538619 ), slow breathing, soothing music, massage, dancing all help us settle the busy mind and get into our bodies. For some more great ideas on reducing the impacts of stress in early pregnancy visit: http://birthpeeps.blogspot.ca/2012/08/35-what-we-can-do.html. Also, here is a very simple home yoga and relaxation practice:

• Support for nausea: Nausea can increase feelings of anxiety because it is hard to feel engaged and productive when you feel like you have the flu every day!  An amazing, up to date resource with medical and non-medical options is published by Motherisk and is available for download here http://www.motherisk.org/documents/survive-morning-sickness.pdf

• Naturopathic Medicine: There is evidence to suggest that nutrition, acupuncture and homeopathy can help alleviate some of the most common problems experienced during pregnancy including: morning sickness, body pains and cramps, insomnia, edema, stress and mild to moderate depression. To find a local naturopath with special training in pregnancy visit http://www.apnd.org/

• Getting more rest: 
o You will need more rest – a lot more!  Many women find that they need 12 hours of sleep a night, and still might feel themselves nodding off in the middle of the day. Get as much rest as you can. Resting will help you recover from stress.
o Extra sleep/rest can mean that you will miss your time with friends and even your partner. You might be used to watching favorite shows together, or going for walks. Sometimes you feel a loss of closeness with your partner at this time. As you feel better, you will have more time and energy. In the meantime, let your partner know what you are experiencing and that it is temporary. As much as you are adjusting to pregnancy, so is your partner. He/she might be doing many more household tasks and might not completely understand what you are experiencing. List a 3 or 4  ways that you can each show your appreciation for each other, without words, as a way to keep a sense of closeness through this period.
o Get your iron and thyroid checked. Both conditions are very common in pregnancy and can wreak havoc on your already limited energy levels. Low iron or issues with your thyroid might also increase anxiety.

If you feel you would benefit from personalized support and coaching, please book a free session at http://www.neliadeamaral.com/connect  . I look forward to hearing more about your unique experience of pregnancy.