Emotional Health During Pregnancy

Pregnant women are known for their emotional fragility. Crying at television advertisements, becoming weepy at the very sight of a newborn’s jumpsuit...the list goes on.

But at what point do “normal” up and down emotions become something else entirely?

Read on to learn more about your emotional health during pregnancy and why it’s so important.

EEEK, I’m going to be Someone’s Mother!

Transitioning the mind to being a parent can take years. Don’t expect yourself to develop acceptance before you’ve had a chance to live it. The sense of responsibility for what’s to come can be almost overwhelming.

Common Emotions when Pregnancy is Confirmed

• Joy and true elation.
• Fear and anxiety.
• Worry about own health and survival. This isn’t talked about very much but for many women, these concerns are very real.
• Remorse/regret for trying to get pregnant.
• Guilt, if friends and family are having problems conceiving.
• Anger and frustration if using contraception and not wanting to conceive.
• Feelings of betrayal and guilt towards older children who will now need to share you.
• Ambivalence and not really feeling much at all.
• Feelings of resentment and lack of emotional connection to the baby.
• Anger to partner for their role in conception.

How do I get my Head around Having a Baby?

It takes time for the reality to filter through. There’s no other way to say it. It’s one thing to see a clear blue line on a pregnancy test and another coming to terms with having a baby.

The reality is big because it’s meant to be.

It doesn’t really matter if this is going to be your first baby or your tenth, bringing a new little human into the world and raising them for almost 20 years is significant.

And the number one predictor that babies will grow into reasonable adults? Is if their primary caregiver/s is healthy and stable themselves.

In other words, if you want your baby to be OK you need to look after yourself.

But I Still just can’t Believe it!

Give yourself time and space to become accustomed to the fact you’re going to be a mother. This process of adjustment can take longer for some women than others; there is no one exact moment when it all makes perfect sense.

If you’ve been trying to conceive then you’re likely to feel at least some degree of joy. But perhaps also relief.

There can be a feeling of “at last” when pregnancy is confirmed, feelings of release that now it’s possible to actually start planning for the baby, rather than the pregnancy. The two are very different concepts.

Top Ten Tips:

1. Speak with your partner about how you feel. Sharing emotions makes a huge difference.
2. Speak honestly with your family and close friends. Hopefully they’ll provide you with emotional support.
3. Prioritise your emotional as well as your physical health.
4. Chat with other parents and see what they’re experiencing.
5. Join blogs and chat groups so you can share with other expectant parents.
6. Go for long walks, practice some mindfulness, exercise and allow yourself time to think about what’s in your future.
7. Quarantine periods of time in your busy week to rest and reflect on your baby.
8. Chat with your line manger about your entitlements to maternity leave. Planning is part of the pregnancy joy.
9. Look at all of your options for maternity care. You have choices – public/private/shared care.
10. Read what you can about pregnancy and childbirth. Knowledge is power and can really help with reducing feelings of anxiety.

How common are Emotional Issues?

Experts estimate that depression is the number one cause for disability. This applies throughout the world. And in any year, around 1 million Australian adults will have some form of depression and over 2 million will experience anxiety.[1]

Pregnancy can be a time of increased risk for both because of hormonal influence and change. Having a baby means needing to make really big life changes, which can be very scary.

Even in the most supportive and stable relationships, bringing a new baby into the mix can be stressful. It’s completely normal for expectant parents to worry about how they will cope.

Are some Women more Prone to Emotional Problems?

There is no one predictable set of pregnancy emotions. All of us are unique and have our own personality, genetics and history that have combined to make us the people we are.

However, there are some risk factors which add to the chances of experiencing emotional distress:

• Women who have a previous history of anxiety, depression or other mental health issues.
• Women who generally like to feel they are in control and love to create order in their life.
• Women with a family history of mental health issues.
• Unsupportive partner and/or family.
• Relationship problems.
• Financial insecurity.
• An unplanned baby.
• Difficulty conceiving. Needing assisted reproductive technology e.g. IVF.
• Having a multiple birth.
• Problems during pregnancy including threatened miscarriage.
• Feeling anxious about the labour and birth. Some women are genuinely terrified of the prospect and need professional support.
• Needing medical support because of a complicated pregnancy.
• Expecting a baby with health problems.
• Housing instability. Moving house, renovations, mortgage or rent costs.
• Drug and alcohol use.
• Being very young.

How will I know if my Emotions are Normal?

The best guide is if you are worried about yourself. Be mindful though that sometimes we can’t be the best judge of how low we have become. That’s when it’s wise to listen to people who love and know us.

Many women have a sense of just not feeling “right” and very different to how they normally feel.

• Your partner is worried about you.
• Your family and close friends say they are concerned.
• Your GP or maternity care provider suggests you see a mental health professional.
• You feel unhappy or cry most days.
• You have insomnia or other sleep changes.
• You feel a sense of overwhelming anxiety about nothing much really.
• You wake up in the morning and feel a sense of dread for the day ahead.
• The usual things which bring you joy just leave you feeling flat.
• You want to sleep a lot and don’t have your usual reserves of energy.
• There is a change in your eating pattern, a lack of appetite or at the extreme, weight changes.
• You feel a lack of connection with your baby or the pregnancy.
• You feel a sense of foreboding or dread about the labour and birth.

Signs of Needing to get Help

• If you can’t tolerate food and are losing weight.
• If you are thinking about or are harming yourself.
• When all you can do is sleep or think about when you can go back to bed.
• If you have feelings of resentment to the baby.
• If you are hearing voices or seeing images which aren’t real.
• If you aren’t feeling happiness or joy.
• Feelings of being very alone and isolated.

A commonly used screening tool called the Edinburgh Postnatal Depression Scale (EPDS) is used to help diagnose depression. The EPDS can be used during pregnancy and up to a year after childbirth. Check here to take the test. But remember, this is just a guide. It’s important to speak with your healthcare professional to get support.

For More Information

• Edinburgh Postnatal Depression Scale (EPDS)
• Black Dog Institute

About the Author:

Jane has qualifications in general, paediatric, immunisation, midwifery and child health nursing. She holds a Bachelor Degree in Applied Science (Nursing) and has almost 30 years specialist experience in child health nursing. She is a member of a number of professionally affiliated organisations including AHPRA, The Australasian Medical Writer’s Association, Health Writer Hub and Australian College of Children and Young People’s Nurses.