What You Need to Know About Anxiety During Pregnancy & Postpartum
When we talk about perinatal anxiety, we're referring to a type of anxiety that can occur at any point from the beginning of pregnancy to the end of the baby's first year. It encompasses a range of anxiety disorders, and it's not just a one-time show during pregnancy; it’s more like a series that continues into the unpredictable world of early parenthood. In a nutshell: perinatal anxiety isn't satisfied with just the pregnancy plotline; it's got its eyes on the sequel too. Perinatal anxiety affects approximately 10-20% of women.
During pregnancy, this anxiety can manifest as excessive worries about the baby's health, your health, and the impending birth. It's normal to have some concerns, but perinatal anxiety can amplify these to an intense level, making it hard to find joy in the anticipation of growing a tiny human.
After the baby arrives, the anxiety can persist, often refocusing on concerns about the baby's well-being or your capabilities as a parent. This could involve worries over the baby's feeding and sleeping, fearing for their safety to an extreme degree, or struggling with intrusive thoughts about potential harm coming to your child.
What are the symptoms of anxiety during pregnancy and postpartum?
When does 'normal' new mom worry tip into 'hey, let’s pay attention to this'?
I like to conceptualize more "normative" new mom worry as being like the background noise of a coffee shop—it's there, it's constant, but you can still carry on a conversation. It can be annoying and sometimes distracting, but overall, it's manageable. It can look like:
"I'm trying to eat healthy while I'm pregnant, but I had fast food twice this week—hope that's okay."
"Will I bond with my baby right away, or will it take time?"
"Should we try the cry-it-out method, or is another sleep method better?"
"I need a night off, but does thinking that make me selfish?"
"I miss wearing my pre-pregnancy clothes."
On the flip side, perinatal anxiety is the equivalent of that coffee shop turning into a heavy metal concert when you’re trying to study. It’s intense, it’s overwhelming, and it's all-consuming. It looks like:
"I had fast food twice this week. I’ve already ruined my baby's health, and they’re not even born yet. I’m a terrible mother."
"If I don’t feel an instant bond with my baby, it means I'm a bad mom and our relationship will be damaged forever."
"If we choose the wrong sleep method, our baby will have lifelong sleep problems."
"Wanting time for myself is a sign I’m not cut out for motherhood."
"My body will never be the same again, and I’m no longer attractive."
Other symptoms of perinatal anxiety that might join the party include:
Rapid Heartbeat and Breathing: Think less 'strolled through the park' and more 'escaped from a haunted house.'
Excessive Worrying: Beyond the normal concerns, it’s when your mind becomes a 24/7 loop of worst-case scenarios.
Sleep Disturbances: If you're tossing and turning and it's not just because you can't find a comfortable position, it might be anxiety knocking on your door.
Muscle Tension: Sure, pregnancy can make your back feel like you’ve been carrying a piano instead of a baby, but if your muscles are wound tighter than a jack-in-the-box on overdrive, that’s a red flag.
Irritability: If your partner’s chewing has gone from mildly annoying to the sound of a thousand chalkboards being scratched at once, it might be more than just typical irritability.
Concentration Problems: Like trying to thread a needle on a roller coaster – it’s a challenge to say the least.
Appetite Changes: When your stomach is in knots, and eating becomes just another chore.
Are any of these symptoms sounding a little too familiar? The Edinburg Postnatal Depression Scale (EPDS) can be a helpful tool in identifying both depression and anxiety symptoms during pregnancy and the postpartum period. Additionally, the Generalized Anxiety Disorder 7-item scale (GAD-7) is another assessment validated for use in perinatal populations. These screening tools can be a good jumping off point to determine appropriate interventions.
Recognizing these symptoms is crucial for navigating not just the pregnancy, but the rollercoaster of the first year with your new tag-along human. If you’re currently nursing a baby with one arm and Googling “how to stop worrying” with the other, it’s probably time to hit the pause button. Here at Hive Wellness Collective, we get that anxiety doesn’t have a 9-month expiration date, and our team is ready to support you. Get connected with an anxiety therapist in Michigan today.
Evidence-based self-help strategies for anxiety during pregnancy & postpartum
Let's explore some of our favorite evidence-based strategies that can help you cope with perinatal anxiety.
1. BREATHING TECHNIQUES FOR RELAXATION
Because oxygen is our friend. Breathing might sound elementary, but during bouts of perinatal anxiety, it can feel like a forgotten art.
Practicing diaphragmatic breathing, which involves taking deep breaths to calm your racing heart, can be incredibly effective. This technique is rooted in science and has been shown to lower cortisol levels, the notorious stress hormone.
To practice diaphragmatic breathing, follow these simple steps:
Find a comfortable, quiet spot where you can sit or lie down.
Place one hand on your chest and the other on your belly.
Inhale slowly through your nose, allowing your belly to rise and expand while keeping your chest relatively still.
Exhale slowly through your mouth, gently contracting your abdominal muscles to help expel the air.
Repeat this process for several minutes, focusing on the sensation of your breath and the gentle rise and fall of your belly.
Apart from diaphragmatic breathing, other techniques like equal breathing, box breathing, and 4-7-8 breathing can also help. Here’s a quick rundown of each:
Equal Breathing: Inhale and exhale for an equal count (for example, inhale for a count of four, exhale for a count of four). This can help bring balance to your breath and mind.
Box Breathing: Inhale deeply for a count of four, hold your breath for a count of four, exhale for a count of four, and hold again for a count of four. Visualize tracing a box with your breath.
4-7-8 Breathing: Inhale for a count of four, hold your breath for a count of seven, and exhale for a count of eight. This technique can be particularly effective in promoting relaxation and reducing anxiety.
The beauty of these techniques lies in their simplicity and accessibility. I mean, you take your breath with you literally everywhere you go, right? So whether anxiety hits at a prenatal checkup or a mommy and me music class or at 3am in the dead of night -- your breath is available. Remember, the key to effective breathing techniques is consistency. Set an alarm to remind you to be intentional with your breath at different points throughout the day, especially during moments of increased stress or heightened anxiety.
2. MINDFULNESS AND MEDITATION PRACTICES
Mindfulness isn't about carving out hours of silence; it's about finding pockets of peace in your everyday hustle—yes, even with a baby in tow. It’s the art of living in the now, savoring the little moments, and releasing the grip on your yesterdays and tomorrows.
Here are simple ways to weave mindfulness into your mom life:
Stroller Sessions: Transform your daily walks into a meditative experience. Feel the handle’s grip, listen to the rhythmic roll of the wheels, sync your breath with your strides. It’s a moving meditation that fits right into your schedule.
Mindful Diaper Duties: Turn the routine diaper change into a moment of mindfulness. Be present with the sensory details—the texture of the diapers and wipes, the patterns, the sounds of your baby. Even amidst the less glamorous tasks, there's room for a mental reset.
Synchronized Breathing: Feeding times are perfect for syncing your breath with your baby’s. As they breathe in, you do the same; as they breathe out, follow suit. It's a shared ritual that brings serenity to you both.
Supporting Evidence:
Brief mindfulness sessions can significantly cut down stress and the APA also reports that mindfulness meditation can meaningfully decrease anxiety levels.
Don't worry, you don't need to be a meditation guru to benefit. Studies have shown stress relief in meditation novices after just a few tries.
So keep in mind: a minute here, five there—every bit contributes to a stronger, calmer you.
3. USING COGNITIVE-BEHAVIORAL TECHNIQUES
Cognitive-Behavioral Therapy (CBT) is a powerful tool to challenge and reframe negative thought patterns. It's like having a personal trainer for your mind, helping you question those catastrophic thoughts and replace them with healthier perspectives.
HOW CBT HELPS WITH PERINATAL ANXIETY:
CBT works by identifying negative thought patterns that often contribute to anxiety. During pregnancy and the first year of motherhood, your mind might be teeming with "what ifs" and doomsday scenarios. CBT steps in to help you recognize these thoughts, understand how they affect your emotions and behaviors, and then challenge and reframe them into more balanced thoughts.
FOR PREGNANT MOMS:
Imagine you're lying in bed, and the thought pops into your head, "What if I'm not a good mom?" CBT would have you examine this thought critically—what evidence do you have for this? Are you perhaps comparing yourself to an impossibly perfect standard? Then, you'd work on reframing that thought to something more balanced like, "I'm learning and preparing every day to be the best mother I can be."
FOR MOMS IN THE FIRST YEAR POSTPARTUM:
Let's say you're constantly worrying about your baby's milestones, thinking, "My baby isn't rolling over yet; something must be wrong." CBT would encourage you to look at the full picture—recognizing the range of normal development and the dangers of comparison. A reframe might be, "Babies develop at their own pace, and my baby is showing growth in their unique way."
CBT TECHNIQUES TO TRY AT HOME:
Thought Records: Keep a journal where you write down anxious thoughts, then challenge them by writing out evidence for and against the thought. Finish by writing a more balanced thought.
Behavioral Experiments: If you're avoiding certain activities due to anxiety, design small experiments to test the reality of your fears. For example, if you're worried about going for a walk with your baby, try a short one around the block and note how it goes. Spoiler alert: often you'll find you're much more capable and the outcome is much more positive than you expected.
Mindfulness-Based CBT: This involves staying present and fully engaging in a task without judgment. When bathing your baby, instead of letting your mind race with worries, focus on the present moment—the warmth of the water, the softness of the soap suds, the joy of your baby's splashes.
Graded Exposure: Gradually and repeatedly expose yourself to the source of your anxiety in a controlled way. If you're anxious about your baby catching germs, start by going to a less crowded place like a park, and gradually work your way up to more populated areas as you become more comfortable.
Relaxation Techniques: Incorporate relaxation strategies like progressive muscle relaxation—tensing and then relaxing each muscle group—which can help reduce the physical symptoms of anxiety.
Remember, CBT isn't about invalidating your concerns as a new mom; it's about helping you manage them in a healthy, productive way. If you find that these self-help strategies aren't enough, our virtual anxiety therapists at Hive Wellness Collective are awesome with CBT. They bring a wealth of expertise and compassion to each session, helping you to untangle the web of anxious thoughts that may be cluttering your mind. With CBT, they can guide you through exercises that pinpoint the core beliefs fueling your anxiety, dismantle unhelpful thought patterns, and rebuild with a foundation of thoughts rooted in reality and self-compassion. But it's not just about talk; we'll equip you with practical tools and strategies that you can apply in real-time, when those middle-of-the-night worries hit, or when you're feeling overwhelmed by the weight of mom life. Get started with one of our anxiety therapists today.
4. THE ROLE OF PHYSICAL EXERCISE IN REDUCING PERINATAL ANXIETY
Exercise is anxiety's nemesis. Even a short stroll with your baby can trigger the release of endorphins, the body's natural stress relievers. You don't need a vigorous workout; a gentle yoga session or a brisk walk can significantly improve your mental well-being.
THE BENEFITS OF EXERCISE FOR PERINATAL ANXIETY:
When you engage in any form of physical activity, whether it's a leisurely stroll with your little one or a brief yoga session, your body releases a flood of endorphins. These natural mood lifters work wonders, helping to reduce stress, improve sleep, and boost your overall sense of well-being. Plus, regular exercise can enhance your self-esteem, leaving you feeling more empowered and capable in your role as a mother.
TIPS FOR INCORPORATING EXERCISE INTO YOUR ROUTINE:
Stroller Strides: Take your baby for a walk in the stroller. It's a win-win—your little one gets some fresh air, and you get those endorphins flowing.
Mom and Baby Yoga: Look for local classes or follow online tutorials. Yoga is not only a physical exercise but also a practice in mindfulness, allowing you to be fully present in the moment.
Dance Party for Two: Crank up your favorite tunes and have a mini dance party with your baby. Not only will it be a delightful bonding experience, but it'll also get your heart pumping.
Park Playdates: Organize meetups with other moms at the park. While the little ones play, you can engage in some light stretching or even a few squats and lunges. No gym required! Stroller Strides is a great way to move your body and connect with other moms.
Home Workout Circuit: Invest in some simple exercise equipment or use your body weight for resistance. Dedicate a few minutes each day to squats, push-ups, and planks, building up your strength and resilience over time.
Let’s get real: some days, the biggest workout you’ll manage is lifting your coffee to your lips. And that’s okay. The point is, exercise is about more than just sculpting your mom-bod; it’s a legit tool in your “deal with it” kit for anxiety. When anxiety strikes, get moving. Your brain will thank you, even if your muscles have a few choice words the next day.
5. SLEEP HYGIENE AND ITS IMPACT ON PERINATAL ANXIETY
Sleep is your ally against anxiety. Sleep hygiene refers to the set of practices and habits that are conducive to sleeping well on a regular basis. Good sleep hygiene is crucial for everyone, but it's especially important for new moms who may be experiencing perinatal anxiety. Anxiety can disrupt sleep, and poor sleep can exacerbate anxiety, creating a vicious cycle. Here’s how you can establish a sleep-friendly environment and routine:
Set the Stage for Sleep: Make your bedroom a sanctuary for sleep. This means a comfortable mattress, a cool temperature, and darkness. Consider using blackout curtains and perhaps some white noise to drown out any disruptive sounds.
Consistent Sleep Schedule: Try to go to bed and wake up at the same time every day, even on weekends. This helps regulate your body's clock and can help you fall asleep and stay asleep for the night.
Pre-Sleep Rituals: Develop a pre-sleep ritual to signal your body it’s time to wind down. This could include reading, a warm bath, or some gentle stretches. The key is to find something that tells your body, "Hey, it's time to relax."
Tech Timeout: Screen time right before bed can be the thief of sleep. The blue light emitted by phones, tablets, and computers can interfere with the production of melatonin, the hormone that regulates sleep. Try to disconnect from all screens at least an hour before bed.
Mindfulness and Relaxation: Incorporate mindfulness or relaxation techniques such as deep breathing exercises or progressive muscle relaxation. These can reduce anxiety and promote a deeper sense of calm, making it easier to drift off to sleep.
Watch Your Diet: Avoid heavy or large meals within a couple of hours of bedtime. Nicotine, caffeine, and alcohol deserve caution, too. The stimulating effects of nicotine and caffeine take hours to wear off and can wreak havoc on quality sleep. And even though alcohol might make you feel sleepy, it can disrupt sleep later in the night.
Managing Night Feeds: For new moms, night feeds can disrupt sleep patterns. To cope, try to keep the lights dim and activities to a minimum during these interactions to promote a quick return to sleep for both you and your baby.
Navigating Sleep Challenges: It’s normal for sleep to be interrupted during the first year of motherhood. Instead of stressing about a perfect sleep schedule, focus on the quality of the sleep you do get. Short naps during the day can be helpful in catching up on missed sleep and if possible, consider seeking help from a partner or family member to take shifts during the night.
Botton line: ensuring you catch those Zs isn't just a luxury—it's a necessity, especially when you're dealing with perinatal anxiety.
Resources and apps to support your mental health during pregnancy & postpartum
Building a sturdy toolbox of resources and skills is the name of our game because ultimately, at Hive Wellness Collective, our goal is to encourage and empower you to prioritize your well-being for the long-term. Here are a few of our tech-friendly and more traditional tools to put in your mental health toolkit to keep your well-being on track.
TECH COMPANIONS FOR MODERN MOMS
Zen in Your Pocket: Look for an app that’s like a mini-spa for your brain. Headspace could be your go-to for a quick mindfulness or meditation session.
Mood-ometrics: Grab an app like MindDoc that acts like your daily mood ring—tracking your emotional ebbs and flows, giving you insights into what’s up with your inner world.
Lullaby for Grownups: Sleep is precious. An app with white noise or calming stories—think Noisli or Slumber—might just help you drift off when it’s finally quiet.
Nutrition Sidekick: Nourishly or similar apps can be your cheerleader for balanced eating, minus the toxic "diet culture."
GOOD OLD ANALOG ANCHORS
Pen and Paper Power: A journal doesn’t need batteries. Jot down your thoughts, make lists, or doodle away stress. It’s low-tech and always there for you.
Inspiration Library: Keep a book or two that offer guidance without the digital glow. "Feeling Good" by David D. Burns is a classic pick for CBT-based self-help and we also love
The Human Connection: Sometimes you just need a real voice. Have your go-to people on speed dial for when you need a pep talk or a virtual hug.
Breathing Blueprint: Print or jot down a cheat sheet of breathing exercises. Tack it on the fridge for a quick glance when you need a quick reset.
Affirmation Arsenal: Write down positive affirmations on sticky notes. Plaster them where you’ll see them—like on your bathroom mirror for a pep talk during teeth brushing.
Your mental health toolkit should be as unique as you are. Fill it with the things that make sense for your life and your mental health needs. Remember, these tools are here to serve you, not to add another “should” to your day. Keep them handy, use them when you need them, and give yourself credit for taking steps to maintain your mental wellness.
Dealing with anxiety on top of motherhood can feel like a bit much some days, right?
That's where we step in. At Hive Wellness Collective, we get it, and we've got your back. Our hive is your go-to place to grab some peace of mind and strategies that work as our clinicians are experts at providing compassionate and effective support tailored to the unique challenges of navigating anxiety in motherhood.
And because we love a good affirmation moment in our hive: you're doing the toughest job in the world, and you're nailing it. We're here to offer a virtual high-five for your victories, a listening ear for those tough moments, and a gentle push forward when you need it. Together, we'll work to manage and minimize that anxiety, creating a more peaceful and fulfilling motherhood experience for you. Because you deserve more than just getting by—you deserve to thrive, and at Hive Wellness Collective, we're committed to making that your reality. Get started with one of our anxiety therapists and start thriving today.