Anxiety disorder and pregnancy - help the mother, do not harm the baby

Pregnancy is a time of happy troubles while waiting for a miracle. But fear for the future baby sometimes darkens this bright period. “Can I stand it? Will he be born healthy? Will the birth go smoothly? Will I be able to bear the pain? Did such and such harm my baby (a glass of champagne at a party before the news of motherhood, a quarrel at work, a smoking neighbor...).”

Important

If a woman is suspicious, prone to worry, if this is her first child, or especially if she had miscarriages before this pregnancy, an anxiety state may develop during pregnancy.

Inexplicable anxieties that a woman cannot cope with worsen the course of pregnancy, because these are not only subjective experiences and thoughts, but also very real symptoms of fear: heartbeat and rapid breathing, sweating, dizziness, nervous tremors, worsening symptoms of toxicosis in pregnant women. All this, of course, harms the child. Therefore, a pregnant woman with an anxiety disorder needs the help of a doctor.

Anxiety disorder and pregnancy are common neighbors

The woman’s entire nervous system is tense and aimed at maximizing the preservation of the child. But sometimes the hyperactivity of this natural mechanism has the opposite effect. Therefore, it is important to monitor the condition of the expectant mother. If she worries more often than she is happy, her worries do not have a specific reason (pregnancy is proceeding smoothly), and she cannot distract herself from them - perhaps this is already a disease.

Often, a pregnant woman, even realizing that something is wrong with her, is afraid to seek help because she may be advised to terminate the pregnancy or be prescribed medications that will harm the baby. There is a way out of this situation!

Treatment for a pregnant woman differs from therapy for ordinary patients, because it is important not only to help the mother, but also to protect the baby.

Psychological assistance to pregnant women in situations of reproductive choice

You should not refuse the help of a specialist if you are experiencing difficulties during pregnancy. Especially if there is a fact of pregnancy, but a decision about its fate has not yet been made. Psychotherapy for pregnant women in situations of reproductive choice is based on unconditional acceptance and non-judgmental attitude towards the client. The psychologist’s task is to help a woman formulate her concerns, compile a list of arguments “for” and “against” so that obstacles and difficulties can be clearly identified.

It is important to give the client the opportunity to talk about her problem. Legalize it. Admit your doubts, give them the right to be. React to accumulated tension. After all, the situation when you need to make a choice – to continue the pregnancy or not – is one of the most difficult in a woman’s life. By keeping a secret, a woman becomes isolated in her experiences. And then the task is to help unravel the tangle of unbearable feelings, help them manifest, bring them to light.

Sometimes even this is enough for a woman to feel supported, realize the right to make any decision and not experience toxic guilt.

Most women who seek psychological help in a situation of reproductive choice decide to continue the pregnancy. Abortion is sometimes an act of despair and a demonstration of powerlessness.

The path to happy motherhood

Anxiety disorder after childbirth, especially against the background of postpartum depression, is a frequent visitor to a young family, especially where the child is the first and long-awaited.

For both pregnant and nursing mothers, treating anxiety disorder without antidepressants and anti-anxiety medications is a priority. And this is not at all a reason to stop breastfeeding - the best thing that has been created for the baby’s health.

Psychotherapy, auto-training and self-relaxation training, work with significance, in special cases - hypnosis - this is the arsenal of a psychotherapist in the case when there are two patients.

Doctors at the Mental Health Center have extensive experience working with pregnant women and women after childbirth. A full-fledged arsenal of modern psychotherapy tools makes it possible to carry out treatment without drugs, avoiding harmful effects on the child and giving the mother the opportunity to fully enjoy the joy of motherhood.

The main “pregnant” fears: how to stop being afraid

During pregnancy, a woman becomes especially vulnerable psychologically. Often, something that previously did not bother her at all or that she did not even think about becomes an obsessive and frightening thought during this period. In the first of a series of columns, journalist and mother of four children Anna Kudryavskaya-Panina discusses “pregnant” fears and whether they are justified.

Photo: depositphotos/fabianaponzi

Being a girl is not easy - all girls know this. And being a pregnant girl is also a little scary. And sometimes not even a little. Thanks to hormones, talkative experienced friends and relatives, with special voluptuousness, telling pregnant women a variety of horror stories and terrors that await them, starting from the moment of childbirth.

What is true and what is not is difficult for a girl to figure out, even if this is not her first time giving birth. Because you never know what actually awaits you when you “become +1”, and then another “+1”, and so on. You'll never guess what's behind that door. At first you weren’t a mother at all and you can’t imagine what it’s like to raise a child, then you were the mother of only one child and you can’t imagine what it’s like to be a mother of two...

There have been four of these “+1s” in my life. I dare to think that at least a little, at least a little, I now know about these fears. And I know what I will answer to a pregnant girl who will ask me in fear, is it true?.. Yes, baby, yes. This is all true. Yes. But no.

Let's just initially agree that everything I am talking about and will talk about is not exceptional and extraordinary stories and turns of events (which, of course, also happen), but what happens within the framework of the norm. The way it happens for most people. And let’s also remember that the scope of the norm is very wide. And therefore, even within this framework, everything will happen specially, individually for each of us.

The first group of fears are somehow related to the process of childbirth.

Fear first. Terrible pain.

Photo: depositphotos/AndreyBezuglov

Well, yes. That's right. It will hurt. Very painful. Or maybe not very much. Or maybe it won't hurt. What is certain is that it will be hard work. And the pain that accompanies it will subside as soon as the child leaves your body. This is the most euphoric state in a woman’s life – the first moments after childbirth, when you want to cry and laugh at the same time.

But it's still scary. Of course it's scary. What fool would rejoice in the intense pain that lies ahead? Who can be consoled by the fact that billions of women go through this pain? Thank God and progress, nowadays it is much easier to help yourself cope first with fear, and then with pain, than before. At courses for pregnant women, they teach proper behavior during childbirth: relaxation, breathing. And it really works! You can also give birth with a partner - a friend, a doula, a psychologist, a husband - who will help, including withstand the pain, on whom you can lean in the literal sense of the word, who will be a real helper or even a lightning rod (for example, in the case of childbirth with a husband - Believe me, he will understand and forgive).

May God grant health and a Nobel Prize to the one who invented the “epidural” (yes, I know that he was not alone, and they all died long ago), and to the one who decided to use it in childbirth - eternal honor and glory. I had the opportunity to give birth under an epidural twice, but on the third, alas, according to indications, it had to be turned off at the most difficult and painful moment. And only the last – fourth – time I learned how easy and almost painless childbirth can be. When even 10 minutes before pushing you can listen to music and laugh at your husband’s jokes. And then you don’t feel as if a tank drove over you, and later a concrete slab fell for good measure. And just a couple of hours after you were transferred to the ward, you run to the children's department to take the baby to you, so as not to be separated from him.

It’s surprising that the “epidural” still has so many opponents. There is some absolutely fantastic side-effect attached to this method, although if you read evidence-based sources, everything will turn out to be not so scary at all. And his opponents also like to talk about “naturalness,” which has now become so fashionable that sometimes the noise around it can drown out the arguments of reason. So, in the 21st century, giving birth using pain relief is normal and natural. By the way, most often epidural anesthesia is used not just to make the process easier for the mother in labor, but for medical reasons: it lowers blood pressure, helps dilate the cervix, and so on.

Naturalness in the sense of something happening without outside interference, under the influence of the laws of nature, also implies natural selection. But that’s not what we’re talking about, is it? We mean that any woman wants to remain in good health after childbirth and with a healthy child in her arms.

Therefore, I will say again: you should not refuse or doubt the achievements of modern medicine. A reasonable and attentive doctor will do everything to ensure that your birth is as natural and safe as possible for you and the baby.

And even if you give birth alone, even if you are still in unbearable pain and nothing helps, remember the main thing: this pain is finite, it lasts no longer than a few hours, and the more you endure, the sooner relief will come. And not just deliverance, but the main meeting in your life.

And, if possible, one piece of advice - try not to shout. During my first birth, my roommate screamed heart-rendingly next to me; I puffed and moaned, but then I thought: what if you scream, it’s easier. I tried it. It became not only not easier, but much more painful, as if all the strength that I had previously concentrated on the process had dissolved in a scream.

The second fear. Something is bound to go wrong during childbirth.

Photo: depositphotos/ mathom

Certainly! Something is bound to go wrong. Not the way you imagined it to be during the long pregnant evenings. And it’s far from a fact that what will seem “wrong” and frightening to you will not turn out to be complete nonsense for your obstetrician-gynecologist. Well, for example, you planned to lie in a jacuzzi or jump on a fitball during contractions, but according to indications, you were chained to a bed and a CTG machine that monitors the baby’s heartbeat.

Like, for example, in my third birth. I had a perfect pregnancy, and for the birth I signed a contract with a doctor whom I had been choosing for a long time (and never regretted later, I gave birth to my fourth child with her). And, of course, I was going to come to the maternity hospital during labor with my husband, to give birth myself, without stimulation and quite quickly - my third birth. Of these, only “with my husband” and “myself” came true, although the latter remained in question until attempts were made.

There is no point in fighting this fear. You just need to philosophically accept what you cannot influence. The only thing you can do to calm yourself down a little is to give birth with a doctor whose professionalism you do not doubt and whom you trust unconditionally. Only complete trust in the doctor saved me from panic in my third birth, when everything that could possibly go wrong. Not so for me. Because the process is an important thing, but relative. And as a result, on the third day I left the maternity hospital healthy with a healthy daughter. Which means everything is as it should be.

The third fear. My husband won't want me anymore if he sees me in labor.

Photo: depositphotos/SimpleFoto

I was extremely surprised when I learned that many women refuse partner childbirth precisely because of this fear. The following set of stereotypes is tightly attached to it: a man is superfluous at childbirth, this is a sacrament (poor word, which is now being dragged into everything), men are weak, they faint there themselves. Well, let’s say only a few faint.

About “whether he wants or not” - this postulate seems to me as ridiculous and ridiculous as a similar idea about men, which humiliates them, in my opinion, seems ridiculous and ridiculous to me. And this is the beautiful thing: he shouldn’t see me “there”! Seriously? And he really never saw you “there”?

Childbirth is pain and blood and generally a terrible sight. Come on! So, a man can go to war, but not to the delivery room?

Extra father at birth! Well, yes, several strangers, it is possible that men are not superfluous, but the father is superfluous. And excuse me, he seemed to be present at the conception, unlike everyone else. So why shouldn't he see the result of this process?

Look, if all you care about is this “sexual” fear, after all, no one is asking a man to stand at your crotch and stare there for several hours. He can be with you during contractions, be a mediator between you and the doctors, give water and massage your back, help you get to the toilet, roll over or get out of bed, just be there just in case. And during pushing, if it bothers you, he can come out or hold your hand. My friend, who gave birth with her husband, said that he was shocked by what a woman has to go through when giving birth to a child, and after the birth he became especially gentle with her, including in intimate relationships, which took on something completely new, according to her, the level.

My husband is one of those “perverted naturalists” who cannot be scared by childbirth. We gave birth to both daughters together, he cut the umbilical cord for both of them and watched the process of their birth from beginning to end. All these fears about “he won’t want to” were ridiculed by us more than once during pregnancy, but I still asked my husband immediately after the birth of my eldest daughter: “Well, you don’t want me anymore, right?” “March to bed!” – he burst out laughing.

Miscarriage at 6 to 12 weeks

A miscarriage in this period is also considered early. Its most common causes are:

Endocrine disorders

Endocrine disorders, when the ovaries do not synthesize enough hormones to keep the fetus in the womb, or the amount of male sex hormones is increased, is one of the most common causes of miscarriage and miscarriage.

An imbalance of hormones in a woman’s body can most likely lead to early termination of pregnancy. With a lack of the main hormone progesterone produced by the ovaries, this happens most often. Another hormonal problem is an increase in uterine tone, which provokes expulsion of the fetus.

Progesterone ensures the preparation of the uterine mucosa for implantation, and is the hormone that maintains pregnancy in the first months. If conception occurs, the embryo cannot properly attach to the uterus. As a result, the fertilized egg is rejected. But pregnancy can be saved with the help of progesterone drugs if this problem is detected early.

Also, the cause of early miscarriage may be an excess of male sex hormones that suppress the production of estrogen and progesterone. Often, the cause of repeated miscarriages is androgens, which affect the formation and development of pregnancy; as well as thyroid and adrenal hormones. Consequently, changes in the function of these glands can lead to miscarriage.

Untreated sexually transmitted infections

This problem must be solved even before conception. Often the cause of miscarriage is sexually transmitted infections: syphilis, trichomoniasis, toxoplasmosis, chlamydia, cytomegalovirus and herpetic infections. Their effect on the fetus and the course of pregnancy is different for each woman and depends on the timing of infection, the activity of the microorganism, the degree of immune protection and the presence of other unfavorable factors. Depending on the situation, they can lead to the formation of fetal malformations, intrauterine infection, feto-placental insufficiency, early miscarriage or premature birth. Infection of the fetus and damage to the fetal membrane leads to miscarriage. To avoid this, treatment of infections should be carried out before pregnancy. The use of therapy is also possible during pregnancy as prescribed by a doctor.

Viral infections and other diseases

Any disease accompanied by intoxication and a temperature rise above 38°C can lead to miscarriage. Rubella, influenza and viral hepatitis occupy a leading position on this list. At 4-10 weeks of pregnancy, a simple sore throat can also become tragic; pneumonia carries a more serious risk. Pyelonephritis and appendicitis can cause early labor. When planning a pregnancy, you must undergo a medical examination to identify and treat foci of infections.

Rubella is extremely dangerous during pregnancy - it leads to severe malformations of the fetus, so infection with it during pregnancy is an indication for medical abortion.

Any disease during pregnancy can lead to the non-viability of the embryo. And the body, through miscarriage, insures you against unwanted offspring. With such a miscarriage, the next pregnancy has every chance of going well.

Immune causes of miscarriage

Sometimes antibodies that are hostile to the fetus are formed in the blood of a pregnant woman. This reason can be predicted and eliminated in advance. Most often, a conflict arises when an embryo inherits the father’s positive Rh factor, and the mother’s negative Rh factor rejects the embryo’s tissues that are foreign to it. Constant monitoring of antibody titers and the administration of anti-Rhesus immunoglobulins allows you to support and maintain pregnancy. In case of immune conflict, progesterone preparations are also used to prevent miscarriage, which in this case has an immunomodulatory effect.

Reduced immunity

Reduced immunity of a pregnant woman also refers to immune causes. The body is simply unable to grow new life within itself. You need to take care of yourself and recover before your next pregnancy.

Anatomical causes of miscarriage

Anatomical causes of miscarriage are the most difficult to resolve. Malformations of the uterus are a serious reason for miscarriage. Sometimes you just have to deal with it.

Signs of behavioral deviation after pregnancy loss

Deviation, as a rule, begins as a defense against too strong emotions in the form of masking or denial of grief and loss. It may occur daily or periodically. Exacerbations may be due to dates (anniversary of loss, planned date of birth, etc.).

Deviation can manifest itself in the form of:

• prolonged groundless anxiety;
• self-flagellation;
• eating disorders (starvation or constant overeating);
• refusal of marital relationships and communication with loved ones;
• formation of addiction (games, medications, alcohol, etc.);
• workaholia or any phobia;
• sexual dysfunction or violent relationships, etc.

All these conditions are associated with a complicated experience of loss and require qualified help. Do not give up! Look for an opportunity to restore the resource!

Unfounded fears

A woman does not always plan a pregnancy while leading her usual lifestyle. And when she learns about an accidental pregnancy, she begins with horror to count the number of glasses of wine she drank, the cigarettes she smoked, and what she ate unhealthy during the period of conception. Of course, the correctness of the recommendations indicating the need for timely pregnancy planning sounds reasonable. But if everything has already happened, the decision has been made to give birth, then it is important to clearly understand that the wisest thing is to bring your psychological state into harmony and create favorable conditions for the development of the fetus.

Fear of miscarriage is an understandable worry. To identify the problem as early as possible, get tested every other day. The best argument for well-being in this matter is indicators and numbers.

Fears of pregnant women

Pregnant women come to therapy at different stages. And the reasons for applying are also different. But in first place in the ranking are the fears of pregnant women:

• fear of miscarriage
• fear of having a sick child
• fear of not surviving childbirth
• fear of mental inferiority of the unborn baby
• fear of loss of sexuality
• fear that my husband will leave me
• fear of losing control over one's weight
• fear of not being able to cope with caring for the baby

This is far from a complete list of fears that pregnant women talk about when they see a psychologist. Psychotherapy of fears consists of their legalization. By bringing them into the light and speaking, the woman separates them from herself. Fear ceases to be part of it and becomes an independent phenomenon that can be worked with.

By talking through and processing her fears, a woman becomes free from them and does not experience the horror that accompanies experiencing this uncomfortable state.

General recommendations of a psychologist

In any situation, you cannot escape reality and not allow your emotions to come out. If a person experiences a traumatic situation alone, then he needs to talk through it, writing down thoughts in a diary or on a voice recorder. After recording, it is important to review what has been stated several times and, when you decide that everything has been said, destroy what you have written.

You can write several symbolic letters and talk about the feelings and experiences that you experience. Remember: this is not for publication anywhere. After creation, these letters are subject to mandatory destruction (burn, tear into small pieces, etc.). The purpose of these activities is to release pain and relieve suffering.

If you have a social circle that helps you survive the loss, you need to talk through all the memories associated with the circumstances of what happened (from the moment you decided to have a child or learned about pregnancy to the very fact of the loss).

When forming a circle of support - loved ones who will live with you during this difficult period, it is necessary to exclude people who are dishonest, prone to gossip, distortion of information or manipulation.

If you are in doubt about whom exactly you can trust, then the ideal solution would be to contact a specialist.

The help of a psychologist specializing in such conditions is necessary if:

• the period has not been overcome in 3-4 weeks;
• there is no trusted person with whom you could talk through absolutely all stages of the situation;
• there is a feeling that the experience has been prolonged and there is no way out;
• there is a feeling that you are not able to cope with the problem on your own;
• there are signs of destructive behavior;
• there is a need for support and understanding.

Your main task is not just to survive the loss, but to completely restore resources for future life and new projects.

Dealing with destructive thoughts and feelings

Destructive thoughts and feelings that a woman experiences after pregnancy loss can be directed both at herself and at others.

In relation to oneself, a feeling of guilt is formed, a feeling of being inferior, broken, empty, pathetic and even dirty.

In relation to others, a complex of reducing oneself develops, a false impression of condemnation from others, a lack of sympathy and understanding.

To overcome this condition it is necessary:

• communication with friends and acquaintances;
• expressing your emotions and feelings through painting, poetry, letters, journaling;
• forming a support group of people you trust (this could be close friends, relatives, professional psychologists).

It is very important not to ignore or hide these emotions from yourself, but to live through them and let them go. Be patient, give yourself as much time as you need.

What is important to know after pregnancy loss

To avoid complications associated with pregnancy loss and move on with the belief that everything will be fine, it is very important to understand the following:

• The possibility of healing is as real as the fact of loss. The experience itself contains the potential for restoration.
• There is no predictable bereavement experience. Every person is unhappy in their own way. The only thing that is predictable is the presence of a way out and a constructive solution.
• Even very close and empathetic relatives or friends are not always able and able to provide adequate support. You need to understand this and contact specialists in time.
• You have the right to the support of others and the time and space to heal. Each path of overcoming is unique.

Misunderstanding.

The pregnancy period can give a new positive impetus to family relationships, or it can give rise to misunderstanding. But the most important thing for a woman is to receive support from her loved one. However, it is much more difficult for a man to get involved in the process of his wife’s pregnancy and become a “pregnant” dad. He has a hard time imagining that there is a little man growing inside your belly (by the way, not a stranger to him). A man is more likely to be concerned about your new quirks than about the peculiarities of your pregnancy. It is a rare representative of the stronger sex who talks with inspiration to the “tummy” or is touched by the shocks from its depths. But this does not mean that men are completely indifferent to the upcoming changes. They just experience “pregnancy” in their own way.

Psychologist's answer

Take the trouble to unobtrusively educate your loved one about pregnancy issues. He needs simple, concrete information about what is happening at the moment. Ask him to go with you to the ultrasound. Some men, having seen with their own eyes their baby inside their tummy, completely change their attitude towards their wife’s pregnancy, as if convinced of the real existence of the baby. Use the pronoun “we” more often, this will be another sign that you are no longer alone. Unobtrusively tell your husband about how the baby behaved throughout the day. If at first there is no expected reaction, do not be upset and do not blame your husband for misunderstanding. It's just that many men don't express their emotions openly.

Recommendations for your inner circle

The most important thing is that at any stage a person should feel supported. It is necessary to find ways of communication that are acceptable to him. He should know that he can contact you at any time of the day, and this is convenient and allowed.

Are you having difficulty conceiving or maintaining a pregnancy? ISIDA clinic specialists have everything necessary to help you find the happiness of motherhood. We will be glad to see you among our patients. Any questions? Call 0, +38 and we will be happy to answer them. Or ask your question on our website and we will definitely answer it .

Vain worries

To drink coffee or not to drink - this is the question that fans of the aromatic grain drink exhaust themselves with, who cannot live a day without this drink. But trembling every morning from this thought is definitely harmful to the unborn child. Let's look for an alternative. Is it better to spend the whole day at work sluggish and sleepy than to still dare to drink a cup of coffee with milk to cheer yourself up?

Recent scientific studies have shown that a cup of coffee a day is not harmful to the child. The drink is allowed for pregnant women, but it is recommended to drink it less often, and also use gentle options: instant coffee or no caffeine at all.

Take medicine or endure pain (discomfort)? Pregnant women are usually extremely distrustful when even doctors prescribe pills to them. Even after spending time consulting with a specialist, some “pregnant women”, to be on the safe side, discuss the medications prescribed by the doctor on women’s forums. In order not to panic and not to look on the Internet for advice from pregnant alarmists whose competence you are not sure of, it is wiser to find a doctor who you can trust 100%! The field of gynecology in our clinic is one of the most developed and intensive areas of work.

First months of pregnancy

The first months of pregnancy are a time of revolutionary changes not only in a woman’s physiology, but also in her psychology.
In the inner, hidden space of her “I”, the space of another person appeared, whose existence must not only be taken into account, but perhaps the whole life must be rebuilt, all plans must be changed. Not everyone can accept these changes unconditionally. Even if the child is desired and long-awaited, the enormity of the accomplished event captures all the woman’s thoughts, making her worry: “How will my life develop next? How will the pregnancy proceed? What will happen to my career? Will I be able to provide my baby with a decent future? Will I be a good mother? Familiar questions, aren't they? Such mental anguish can cause not only a feeling of fatigue and irritability, but even cause toxicosis or the threat of miscarriage. Psychologist's answer

First, don't try to solve all problems at once. Set them aside for an indefinite period of time, and perhaps some of them will be resolved without your participation. And in general, pregnancy is a unique time when you can rightfully allow yourself not to react to life’s problems. And not feel guilty for such irresponsible behavior. Remember that more than all the material benefits in the world, a child needs your attention, understanding and love.

Secondly, the most important thing now is to realize and accept your new state. Give yourself permission to be pregnant. Accepting your new state means accepting the appearance of a child in your life and learning to understand his needs. Indulge your little weaknesses - be it the desire to lie down in the middle of the day or buy yourself some delicacy. Let pregnancy enter your life not as a time of prohibitions, but as a time of new opportunities. A statement like “I won’t be able to wear my favorite skinny jeans” can be replaced with: “Finally, I’m updating my wardrobe!” It is enough to change your point of view to get a taste for change.