Being in control of your life and having realistic expectations of your day-to-day challenges are the key to stress management, which is perhaps the most important to living a healthy, happy and rewarding life...Marilu Henner.

“Stress arises when individuals perceive they cannot adequately cope with the demands being made on them or with threats with their well-being”…Lazarus, R.S. (1966). 

Anxiety is the composite psycho-physiological outcomes and signals triggered by stress response. Anxiety is the psychological consequence of exposure to a real or imagined stress. This response is multidimensional, as result of the psycho-biological variables, interactions of the stress responses and the overwhelming impacts of life events. Understanding the influence of these variables could have profound effects on how to deal with stress and anxiety in pregnancy.

According to a 2009 poll of Anxiety and Depression Association of America:

  • 52% of previously pregnant women experienced more stress, anxiety and depression during pregnancy
  • 16% experienced no significant difference
  • 32% reported a reduction in anxiety-related symptoms

Most parents and their families will experience significant amount of stress and anxiety during the unavoidable transition to parenthood. The entire family will feel the full brunt of these effects, ultimately then, the eventual interventions that will be required to provide support and care such as nutrition services, psychologists, mental health specialists and social services must all adopt a family-centred approach.

Causes of Anxiety Attacks in Pregnancy

  • Hormonal changes in pregnancy
  • Previous Anxiety attacks
  • Stress and anxiety of Pregnancy
  • Age during which anxiety attacks are common

Stress and Anxiety Psychosocial Variables in Pregnancy

The dimension, quality and longevity of a woman’s transition to motherhood, and by implication how she deals with stress, anxiety and other emotional disorders in pregnancy can be influenced by well-known psychosocial factors like:

  • Her age during the index pregnancy
  • Her parity
  • Preparation and acceptance of the pregnancy
  • Identification and attachment with a motherhood role
  • Relationship with her spouse and mother
  • Quality of family cohesion and support
  • Preparation for Labour
  • Quality of Antenatal care
  • How prenatal and labour fears are handled

It’s important to note that stress, anxiety and other mood disorders are common in pregnancies, but its diagnosis and prompt management are often ignored or missed. This portend grave consequences for the unborn child and family. The calibre of physiological responses in pregnancy is intricately linked to the gravity of the stress and anxiety.

Depression and Anxiety during Pregnancy

Just a little video about prenatal depression and feelings of uncertainty,etc. while pregnant. I apologize for being a little out of it in this video. I just…

How To Recognise Stress and Anxiety in Pregnancy

  • Insomnia
  • Excessive eating or chronic loss of appetite
  • Current alcohol abuse or past history of alcohol or substance abuse
  • Abnormal behaviour
  • Shortness of breath
  • Rapid heart rates
  • Suicidal thoughts or unusual aggression towards self and/or others
  • Current or past history of mental ill health and/or medications
  • Previous history of psychotherapy and/or counselling sessions
  • Excessive concern about body changes
  • Distorted relationship or poor compliance with family members and support system
  • Labile moods, tearfulness and irritability
  • Chronic fatigue
  • Headaches, chest pain
  • Excessive worry
  • Fainting attacks
  • Dizziness
  • Risk Factors For Stress and Anxiety in Pregnancy
  • Severe family, gestational and baby blues
  • Persistent guilt, perfectionist
  • Low self-esteem
  • Antenatal anxiety
  • Family or past history of anxiety, mood swings and depression
  • Child support  or care stress
  • Expecting first baby or having many babies already
  • Concomitant stressful life events
  • Co-morbidities
  • Domestic violence or aggression
  • Emotional or physical abuse or assault/ childhood abuse
  • Low socio economic status/Joblessness
  • Poor or lack of emotional and tangible support from spouse and family members
  • Poor drug compliance
  • Coexisting illnesses with pregnancy like Diabetes, Hypertension, depression etc.
  • History of difficult labour, poor antenatal care, birth complications, poor physical health, premenstrual syndrome
Other Psychosocial Stress Factors:
  • Recurring thoughts of hopelessness and/or dying
  • Poor or limited communication
  • Social isolation or withdrawal
  • Frequent conflicts and strife in relationships
  • Single parenthood, separation, divorce

It goes without saying that the presence of multiple risk and predisposing factors worsens the recognition and management of anxiety disorders in pregnancy.

Risk Factors For Untreated Anxiety and Chronic Stress in Pregnancy

According to Dr Healy Smith, a reproductive psychiatrist at the Women’s Mental Health Clinic at New York-Presbyterian Hospital in New York City, the risks to growing babies whose mothers have untreated anxiety disorders and chronic stress include:

  • Poor APGAR Score
  • Poor or failure to thrive post post-partum
  • Low birth weight
  • Pre-term birth

Risks to The Mother:

  • Pre-term labour
  • Post-partum depression and anxiety
  • Alcohol, drug and substance abuse
  • Suicidal ideation
  • Pre-eclampsia
  • suicide
  • Termination of pregnancy
  • Delivery by Caesarean section
  • Self neglect
  • child neglect
  • Poor mother-child bonding

Prevention of Anxiety and Chronic Stress in Pregnancy

A recent national study reported that stress management counselling by primary care physicians was accounted only in 3% of office visits, while 76% of health care professionals seem to lack the requisite skills and confidence in their ability to counsel patients about stress.

A person-centred approach has been proven to be very effective, since it grants autonomy, freedom of choice and respect for difference. Underlying the highly trusted care provided by skilled professionals is the basic element of having someone for a pregnant woman to talk to and confide. Reports from multiple studies have consistently shown that the comments and conducts of family members, partners and professionals caring for vulnerable pregnant go a long way to determine their overall well-being. Hence, adequate communication must be recognised as one of the most effective ways to successfully with anxiety and depression in pregnancy.

Interventions for Stress and Anxiety in Pregnancy

It is important to note that the following abused and ineffective strategies must be avoided: “Stop worrying”, “You will be okay”, “Try to remain hopeful and positive”, anxiolytics and sedatives. Suggestions like these are passive, and sound like relics of antiquity. Rather, let’s adopt proven and tested strategies that work and evidence based.

Cognitive Behavioural Therapy: This is an effective tool to deal with depression and panic attacks, even in pregnancy because it is brief, structured and time-limited. Using CBT, skilled therapist introduces and teaches new techniques for effective management of thoughts and emotions. Though it primarily focuses on current behaviour, Cognitive behavioural Therapy has found space in major depressive illness, Anxiety disorders, chronic insomnia and fatigue.

Specialist Intervention: Assessment by a qualified specialist is key for proper diagnosis and treatment protocols. This is more so when it comes to taking medications to beat anxiety in pregnancy. Research cautions on the use of anxiolytics during pregnancy, but untreated anxiety and chronic stress in pregnancy have grave risks for mother, foetus and child. An overriding consensus is that, medications should be a personal choice after weighing all the options and benefits against the risks with your Doctor.

Support Network: Join the local support group in your community, profession or faith community for collaboration. Local congregations embrace members without judgement.

Practice Meditation or Prayer: People who pray or meditate report fewer instances of uncontrollable stress and anxiety, simply because of their calmer approach to stressful situations and more confident connections to their spiritual selves. Meditation or prayer as an act can help slow your body’s physiological response to fear and stress, resulting in more calmer reaction to situations and a feeling of being in control. This boost morale and confidence, ultimately resulting in lesser stress and anxiety.

How To Deal With Stress and Anxiety in Pregnancy is an important health concern of every mother or mother-to-be. Dr Andrew Okpetu provides tips on how To avail yourself of some of the most tested and proven tips to manage stressors and live healthily. To find out more, CLICK HERE.