Pregnancy is an exciting time, but you may also be experiencing stress and anxiety around this life-changing event. Here, we look at some of your most common pregnancy worries and how to best address them.
‘I will miscarry’
This is a common pregnancy fear and is the main reason why your doctor advises you to wait for 12 weeks before announcing your pregnancy.
Around 50% of pregnancies end in miscarriage, according to the March of Dimes, a non-profit organisation based in the US, which advocates good health for moms and babies. These include miscarriages that may occur before the woman knows she is pregnant or has missed a period.
According to Dr Martin Puzey, a gynaecologist and obstetrician at Mediclinic Cape Town, around 15% of known pregnancies end in miscarriage, and more than 80% of all miscarriages occur within the first three months of pregnancy. Over half of these miscarriages are due to chromosomal abnormalities, so while devastating, this is nature’s way of ending a pregnancy in which the foetus is not developing as it should. At six to eight weeks, your chance of having a miscarriage drops to 5% and less than 3% of women will have a second miscarriage.
Miscarriages due to chromosomal abnormalities are unavoidable and not due to anything the woman has done, or not done. However, you can lower your risk of miscarriage by not smoking, avoiding alcohol and reducing your caffeine intake to 200mg or less a day.
‘I will develop a complication’
You may be concerned about developing a complication, such as pre-eclampsia or gestational diabetes.
Research shows that the risk of developing extremely high blood pressure (that may result in pre-eclampsia) is between 5% and 8%, although this is more common in mothers over the age of 35, as well as those who are predisposed to high blood pressure. According to the Mayo Clinic, it isn’t clear why some women get gestational diabetes while others don’t. There are, however, certain risk factors such as being an older mother, a family or personal history of prediabetes or excess weight pre- or during pregnancy.
If your blood pressure is elevated, your healthcare provider will monitor it and take the necessary action. Pre-eclampsia usually only develops in the second half of pregnancy, but if you are experiencing other symptoms, like swelling of your hands or face, blurred vision or headaches, speak to your doctor or gynae immediately.
Reduce your risk of gestational diabetes by eating a healthy diet, maintaining low to moderate activity, and keeping an eye on your blood sugar levels. If necessary, reduce your intake of starchy foods.
‘I don’t think I can cope with labour’
It’s time to plan for your baby’s exit strategy and you are suddenly fraught with fear: how much will it hurt, how long will it take?
Labour is one of the most challenging, exciting and even embarrassing times of your life. You will feel your most exposed and vulnerable, but you’ll also be at your most powerful.
Two things happen at this time − the muscles in your womb and abdominal wall will contract, and your cervix will soften to allow the birth of your baby. During the labour process, your body releases the hormones oxytocin, also known as the love hormone, and prolactin. As your contractions become more intense, these natural pain-relief hormones promote feelings of elation and happiness. As you get closer to pushing, your body releases adrenaline and noradrenaline, which give you that much-needed surge of energy.
Talk to your gynae or midwife about the labour process and attend antenatal classes. The best way to be prepared is to empower yourself. It’s important to have a doctor and/or midwife you can trust and who can talk you through what you can expect as this will go a long way in helping put your mind at ease.
‘My baby will have a birth defect’
Every visit to the doctor and test that is done will bring some fear as you wait to be reassured that your baby is developing normally.
This concern is completely normal. However, according to research conducted by the Centers for Disease Control and Prevention, only 3% of babies are born with birth defects. Regular medical check-ups and scans will help pick up any irregularities and reassure you.
To minimise the risk of brain or spinal defects, take your prenatal vitamins and folic acid daily. Other tips to help minimise the risk are to avoid alcohol and cigarettes; only use medication that has been approved by your healthcare provider, gynae or doctor; stay away from toxic chemicals and maintain a healthy weight. If you have a family history of defects, speak to your doctor about what you can do to reduce your risk.
‘I will need an emergency C-section’
Regardless of how prepared you (and your body) are for birth, the reality is that you do need to be open-minded and adaptable to potential changes in your birth plan.
South Africa has one of the highest C-section rates in the world, with estimates sitting at 70%, while the international rate is around 15 to 18%.
The good news is that these are, in general, elective C-sections, which usually take place 10 to 14 days prior to the due date. Apart from birth complications that may require an emergency C-section, your gynaecologist may recommend an elective C-section for the following reasons that can be picked up before the birth: transverse or breach-lying baby; the baby’s head is considered too large to pass through your pelvis (known as cephalopelvic disproportion) or, a previous C-section birth.
Have an idea of how you would like things to go, but be open to the fact that this may change. The most important thing is that you and your baby remain safe and healthy. Ensure that you have included the possibility of an emergency C-section in your birth plan and state that you want skin-to-skin contact with your baby immediately after the birth as long as no emergency procedures are required on your baby.
‘I am stressed and worried my baby will be affected’
Your life is changing and it’s natural to experience some anxiety. Between the influx of hormones, exhaustion and everything else, a bit of stress in your life is understandable.
The good news is that small, everyday stressors will not impact the health of your baby. The concern is when this becomes chronic stress and anxiety, or leads to depression.
Take things down a notch and find a way to relax. Reclaim your calm by having a bath, writing in a journal, sharing your anxiety with your partner, chatting to a friend or having some fun.
‘I will eat the wrong thing’
Beyond the basics of healthy eating and drinking, there is the concern that what you have, or haven’t, eaten is unsafe for your baby.
Risks associated with accidentally eating unpasteurised cheese, high mercury fish or other no-no foods are relatively small, the experts say.
Ask your doctor for a list of foods you should avoid. If your doctor says you need to limit your intake of a particular food, ask how much, if any, is safe.
‘My body will never be the same again’
Some women are concerned that they won’t lose the extra weight they gained during pregnancy and that they will be left with stretch marks or sagging skin.
Research shows that 14 to 20% of women will keep some of their pregnancy weight. Remember, it took you nine months to gain the weight, so you won’t lose it overnight.
You can guess if you’ll have stretch marks as they are genetic − if your mom had them you are more likely to get them too and 90% of pregnant women get stretch marks as they are caused by rapid weight gain and loss.
Try to maintain a healthy weight during your pregnancy, within the parameters set out by your gynae or midwife, and allow yourself time to lose the weight after the birth. Start with low to moderate exercise once your healthcare provider gives you the go-ahead.
Tissue oils have been proven to help prevent stretch marks and assist your skin in springing back after the birth. Keep your skin hydrated by applying tissue oils from at least your second trimester.
‘My partner won’t be attracted to me’
Weight gain, swollen body parts and sensitivity mean that you may not be feeling your most attractive before or after the birth.
You are having his baby and he likely appreciates the changes you are experiencing. He may also have his own anxieties, such as hurting you or the baby.
Realise that feeling unattractive may be more about how you feel and less about how he feels. Communicate your concerns to him and find out if he has any concerns. Your partner will most likely reassure you and give you that confidence boost you both need.
Alleviate your fears
Pregnancy fears and anxiety are completely natural and expected. Dr Bavi Vythilingum, a specialist psychiatrist at Akeso Kenilworth Clinic, shares that the best way to help alleviate these concerns is to ensure that you are empowered with the right information. “Anxiety is always worse when we are overworked and emotionally depleted. Just like a car can’t run on an empty tank, you can’t run on an empty emotional tank.”
The best way to refuel this reserve is to:
- Speak to your gynae or healthcare provider about any concerns or questions you may have
- Have a small notebook in your handbag and write down any questions you may have when they pop into your mind
- Take time out to have fun
- Relax and meditate
- Stay active and get regular exercise (speak to your healthcare provider before embarking on any new exercise regime)
- Learn breathing techniques as deep breathing can be calming
- By sharing your anxieties you and your partner can help calm each other
- Speak to other moms so you feel less alone.
If you feel completely overwhelmed and you aren’t able to cope, Dr Vythilingum says it’s important that you seek professional help. “Don’t wait until you are really struggling – rather get help early.” Your gynae or GP is the best place to start as they will refer you to a mental health professional if necessary.
When it’s more than the blues
Perinatal depression (PD) refers to depression that starts during pregnancy, and may persist for up to 12 months post birth. Dr Lavinia Lumu, a specialist psychiatrist at Akeso Randburg – Crescent Clinic, explains that in the past, the focus was more on postnatal depression. However, research reveals that, quite often, depression starts during pregnancy. The term encompasses both antenatal and postnatal depression. Dr Lumu adds that women who have experienced PD in their past pregnancies are at risk in their next pregnancies. “If a mother has had a previous history of PD, it is essential that she informs her healthcare provider. This will ensure close monitoring and early intervention in the next pregnancy.”
Symptoms include the inability or lack of desire to take care of yourself and/or your baby, low appetite, extreme fatigue, memory problems, persistent feelings of sadness, hopelessness, helplessness, insomnia and feelings of panic. In severe cases, there may even be suicidal thoughts. “Psychotic features and thoughts of infanticide can also occur in severe cases,” explains Dr Lumu.
Did you know?
A 1997 study conducted by B Sjögren, and published in the Journal of Psychosomatic Obstetrics & Gynecology, looked at the conscious reasons for anxiety about childbirth. These included anxiety over delivery due to lack of trust in the obstetrical staff (73%), fear of own incompetence (65%), fear of death of their baby, themselves or both (55%), intolerable pain (44%) and loss of control (43%).
Kim Bell is a wife, mother of two teenagers and a lover of research and the way words flow and meld together. She has been in the media industry for over 20 years, and yet still learns more about life from her children everyday.