Travelling in pregnancy

 

'I wish I could just enjoy my pregnancy, but I can't turn off my brain,' Paula said at her first therapy session. While she'd been a 'worrier' her whole life, it had never interfered like this before. In fact, she used to find her ability to predict and plan for obstacles an asset in her work as an office manager. But five months into her pregnancy, her anxiety was out of control.

Spending her days worrying was taking its toll, leaving her distracted and unfocused. She spent her nights awake, reviewing her to-do list or thinking about things that could go wrong with the baby. Paula created elaborate plans for avoiding imagined future catastrophes, and became exhausted and irritable in the process. This then caused mistakes and oversights, leading to even more worries. All of this was beginning to affect her relationship with her partner, and was understandably interfering with her enjoyment of the pregnancy she’d been so excited to experience.

Anxiety in pregnancy runs the gamut from obsessive intrusive thoughts, to panic attacks, to fear of childbirth. But the generalised anxiety and worry experienced by Paula is one of the most frequent complaints in mothers-to-be. These worries tend to fall into a few broad categories: labour and delivery; the baby's health or viability; the mother's own competence as a parent; and the negative impact the baby might have on her life or marriage.

Many mothers-to-be have such worries, falling prey to the 'what ifs' of anxiety. In fact, it would be unusual not to feel at least a little nervous about such a big change. For some pregnant women, however, this anxiety becomes highly distressing or interferes with life – it becomes a generalised anxiety disorder (GAD). A person with GAD finds it incredibly hard to control worry, and these thoughts often disrupt sleep and make it hard to relax. Irritability, fatigue and overthinking make it hard to stay present in the moment, and it can seem impossible to concentrate or make decisions.

Up to one in five women meets criteria for GAD or another anxiety disorder during pregnancy or postpartum, and these numbers are higher when it's a medically difficult or high-risk pregnancy. For some women, anxiety will be an escalation of existing symptoms – as it was with Paula – but, for others, pregnancy will be their first experience of such problematic anxiety.

Whether you have milder levels of worry or a full-blown anxiety disorder such as GAD, cognitive behavioural strategies might be helpful in managing your symptoms. These are practical steps you can take to navigate these worries, which will help you enjoy the more positive aspects of pregnancy. These strategies specifically target the catastrophic thoughts, unpleasant physical sensations and unhelpful behaviours – such as over-preparation and avoidance – that characterise and maintain generalised anxiety.