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Managing Anxiety during Pregnancy

For many women, becoming pregnant is not only a joyous experience, but also one fraught with anxiety. What’s that twinge I’m feeling? What if something goes wrong? What if I’m not a good mom? Is the baby moving enough?—Too much??—HELP!!! Anxiety during pregnancy can spiral out of control if we’re not careful, but there are things that every pregnant woman can do to help manage the anxiety she feels.

Thinking Skills. We all fall into thinking traps on occasion, often without even realizing it. These traps can keep us stuck in patterns of thought and behavior that initiate and maintain anxiety in many areas of life, pregnancy included. Some common thinking traps that arise during pregnancy are:

  • “What if…” (what if something bad happens?)
  • “Fortune-telling” (jumping to conclusions)
  • “Catastrophizing” (making a mountain out of a mole hill)

To climb out of these traps, tune into your own thought patterns and then work to free yourself from the traps by shifting your thinking to a more evidence-based approach. If you find yourself getting stuck in a pattern of “what ifs,” take a minute to examine the realistic probability of the feared event occurring. You can use a similar approach if you notice that you are jumping to conclusions. If you find yourself blowing things out of proportion, work to move from a catastrophic mindset to a coping mindset (e.g., “Even if this unlikely thing did happen, I would handle it, and this is how.”) For all of us, pregnant or not, changing our perspective can have a tremendous impact on our emotions, and employing thinking skills is a great way to reduce the amount of worry we experience.

Breathing Skills. For many people, the most salient part of anxiety is the physiological component. This can be even more true in pregnancy if a woman is already hyperfocused on the many physical changes taking place. What we feel in our bodies while anxious—the increased heart rate, rapid breathing, sweating, and muscle tension—is part of the body’s internal alarm system that sounds when we’re in danger. Of course, if we’re sitting at home on the couch or in a meeting at work (rather than running from a predator, as our ancestors were when this system developed), these physical symptoms are more of a nuisance than an aid. Taking control of our breathing is one way to short-circuit this alarm system fairly rapidly.  Practice taking slow, deep breaths, and think about the diaphragm dropping and the rib cage expanding out and down as you breathe in. You can picture your lungs as balloons filling with air on each inhale and imagine the air spilling out of the tops of the lungs on the exhale. Slow down your inhale to a count of four, and stretch the exhale to a count of six or eight. Practice this for a few minutes, and you’ll likely see at least some of your anxiety dissipate quickly. Better yet, work on breathing this way intentionally for a few minutes every day while you’re feeling calm so that when you’re having an anxious moment, this method of breathing is intuitive and reflexive.

Nonjudgmental observation and self-compassion.  It can help to know that pregnancy is marked with worry for many women and that the mind can be mischievous when left to its own devices. Practice observing when the mind is creating worries, and see if you can notice those worries without feeling carried away by them. Try not to judge your worry thoughts as they arise, and—more importantly—try not to judge yourself for having those thoughts. Be kind to yourself as you encounter pregnancy anxiety, and know that you are not alone.

While a certain amount of worry is normal during pregnancy, sometimes women experience significant levels of anxiety that can’t be managed without the help of a professional. Reproductive psychiatrists have expertise in safe and effective medication management during pregnancy, and cognitive behavioral psychologists can help provide support and instill the skills necessary to keep pregnancy anxiety in check. To learn more about reproductive mental health at Union Square Practice and meet our compassionate, capable treatment team, click here.

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