sad looking pregnant woman sitting on sofa

Four months ago Riya discovered that she was pregnant. She and her husband were not prepared yet to start a family. However, Riya’s husband quickly accepted the situation and was in fact looking forward to the arrival of the baby. Though Riya has tried to do the same and put on a happy face, her world inside is in complete turmoil. Throughout the four months so far, she has been plagued with severe anxiety and refuses to let her husband leave her side.

This story is one of the many that I encounter. Even with a healthy pregnancy, many expectant mothers experience anxiety bordering on panic. She could be overjoyed and looking forward to the arrival of her newborn and yet be riddled with doubt about her ability as a mother. The timing of the pregnancy may have an impact, too. It could mean cutting down on work or even resigning, financial setbacks and not to mention the frustration of lagging behind in your career.

It is natural that pregnant women will be concerned about the safety of their unborn child. And we would think that cutting edge medical imagery should help calm the nerves. Yet, paradoxically, in many cases the aggressive and often mandatory testing throws up more doubts about the health of the child. Ultrasounds and 3D imaging have an important role to play in managing the complications of pregnancy. But, they also increase the stress in parents. I often come across pregnant women who have whipped themselves into a panic over test results which showed only a modicum of deviation from normal. No amount of explanation will calm them down. One woman repeatedly ran to her obstetrician the moment she felt that she could not sense the baby’s movements.

In many cases the aggressive and often mandatory testing throws up more doubts about the health of the child

Otherwise stable and intelligent women seem to become puddles of anxious anticipation during pregnancy. I don’t blame them. Being responsible for a little being within you without having consistent and continuous access to what’s happening inside can be scary. However if this is not addressed during pregnancy, the depression may continue even after delivery and take the form of post partum depression.

Do we blame it on the hormones?

A lot of these emotional reactions are often a result of increasing levels of oestrogen and progesterone. Pregnancy is a hormonal circus. Hormones work their magic to help us conceive, keep the baby healthy, aid in labour, delivery and in nursing our child. The downside is that they also make us moody… very moody. A pregnant woman could wake up happy and, in a matter of minutes, could get downright cranky because the tea that was lovingly made by her partner did not turn out to her liking. Hormones can make us more prone to anxiety and panic.

Hormonal changes during pregnancy may also cause fluid retention, weight gain and hyperpigmentation of the face, neck and inner thighs. These unsightly changes can further have a depressing effect on a woman’s mood. To add to it, if the husband is unaware of what changes to expect and how to respond to his wife, she could wrongly perceive it as lack of support. Pregnancy jokes made by insensitive friends don’t help matters either—and the expectant mother ends up with the perfect recipe for depression.

Otherwise stable and intelligent women seem to become puddles of anxious anticipation during pregnancy

Feeling overwhelmed

Depression could be physiological, brought on by the hormonal variations or could be a result of feeling overwhelmed with the whole gamut of changes brought on by the pregnancy with no access to coping techniques. Some of the other precipitating factors could be complications in the previous pregnancy or even a previous miscarriage, physical or emotional abuse, infertility, low income, stressful life events such as death, moving homes, work pressure or divorce.

Whatever the cause, depression during pregnancy is common and unfortunately very easily dismissed by doctors and family members alike. Often, the pregnant lady is told that it will go away after she takes one look at the baby. The truth is far from it. If the depression is not managed well, it can continue even after the baby arrives. Depression during pregnancy is characterised by crying spells, restlessness, preoccupation with negative thoughts, mood swings, trouble concentrating, poor or excessive sleep and appetite and constant and extreme fatigue which may continue well after the baby is born.

If the depression is not managed well, it can continue even after the baby arrives

So what can you do?

Here are nine tips that can help you prevent or manage the emotional upheavals associated with pregnancy.

  1. Assess your readiness as a couple to have the child. Is your marriage on sound footing? Have both of you spoken about and found a resolution/compromise to the issues you have with each other? Are you having a baby because you want one or is it family pressure that you are yielding to? Having this conversation with yourself and with your spouse can clarify the thoughts behind you seeking or going ahead with parenthood. The more ready you are, the more accepting you will be of the changes involved and the more motivated you will be to seek solutions to the accompanying emotional upheaval.
  2. Become part of a pre-natal class. It will make you more aware about the different issues involved in pregnancy—physical, emotional and medical. The pre-natal class will also equip you with skills to cope with the changes during gestation.
  3. Make sure you plan your day in a way that allows you to get adequate sleep and rest. Packing your day from daybreak till bedtime will only tire you physically and mentally. Remember that ‘You come first’.
  4. Exercise regularly. Not only does it keep you physically fit but also releases endorphins which are happy hormones that work to elevate your mood. Meditate regularly.
  5. Plan at least one activity every day that gives you pleasure. It could be gardening, reading, going for a drive, watching a favourite show or listening to your favourite music. Or some music specially suited to pregnancy.
  6. Avoid seeking information about pregnancy related complications on the Internet. Have minimal contact with people who foster negativity in you.
  7. Do household chores as a couple. Doing things together with the father of your child can be an enjoyable and wonderful bonding process.
  8. Share your feelings of anxiety, fear or sadness with a trusted friend or family member. Join a support group. It helps to spend time with other expecting moms who might be going through feelings similar to yours. The solutions that come out of these discussions can help calm you down.
  9. Do not hesitate to seek professional help to ascertain how serious your depression is and if it will require medication and/or counselling support.

This was first published in the October 2015 issue of Complete Wellbeing.
Gaurai Uddanwadikar
Gaurai Uddanwadiker is a psychologist with a Harvard Medical School Health Counseling certification. ​She is the Clinical and Administrative Head of Counseling India, a mental health organization in Bangalore. Gaurai works from the Pacific Northwest in a virtual capacity with her team and is currently enrolled in the MHA program at the University of Washington.


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