Guest post: Managing anxiety in pregnancy

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A guest article by Dr Natasha Bijlani

Managing anxiety during pregnancy and early motherhood

If you have an anxiety disorder, or have had one in the past, it is likely that you’ve thought about the influence it could have on yourself and your baby during pregnancy and motherhood.

Dr Natasha Bijlani, a consultant psychiatrist at Priory Hospital Roehampton with a specialist interest in women’s mental health issues and pregnancy-related mood disorders, has put together advice for women who are uncertain of the impact that their anxiety disorder will have on themselves and their baby during pregnancy. From her expert information, you can find out what to do and where to turn to manage your anxiety during this important stage in your life.

Will my anxiety affect my baby?

Babies and children are impressionable and learn by example, so there is a chance that an untreated anxious mother will raise an anxious child. If you have never spoken to your doctor about your anxieties, book an appointment so that you can start taking the steps to better manage it, reducing the possible impact it could have on you and your baby in the future.

Even if you have previously spoken to a doctor about your excessive anxiety, it might be a good idea to re-book an appointment when you are planning your pregnancy or are in the early stages of pregnancy. Making sure you update your doctor can ensure that you and your baby have access to the right level of support and treatment going forward.

What should I do about my anxiety medication?

If you are taking medication for anxiety, always seek your doctor’s advice before making any decisions to stop, continue or cut down during pregnancy. While it is best to have this discussion when you are planning your pregnancy, don’t worry if you become unexpectedly pregnant. Doctors are usually careful about not prescribing potentially harmful medications to women of childbearing age and you should have been warned if there are likely to be any contraindications of your medication with future pregnancy. 

Your doctor will be able to give you updated information on the effects of your medication during pregnancy, and talk you through the risks of continuing or discontinuing your treatment so that you can both agree on the best course of action.

Depending on your circumstances, your doctor may advise you to gradually discontinue your medication, or recommend that you continue with your medication if you have a significant anxiety disorder. If you are advised to do so, this will be for the benefit of you and your child.

Disregarding medical advice – or choosing to abruptly stop your medication without speaking to your doctor – could lead to unpleasant discontinuation symptoms as well as your original anxiety symptoms reappearing or worsening. It could also contribute to an increase in stress hormones and the development of unhealthy coping behaviours as you attempt to deal with excessive anxiety once again. Untreated anxiety can also lead to depressive symptoms or to the development of a formal depressive disorder, so it is highly recommended that medical advice is sought and taken.

How can I manage my anxiety during pregnancy?

When pregnant, try to focus on maintaining a relaxed and healthy lifestyle. Taking the time to look after your physical and emotional wellbeing can help to lift your energy, act as a distraction from your worries and help you to feel calmer and more in control, giving you the opportunity to keep your anxiety in check.

Eat a balanced diet, maintain a good sleep routine, engage in appropriate physical exercise and drink adequate amounts of non-alcoholic fluids. Also take the time to unwind everyday by doing something that you enjoy or find relaxing, whether that is taking a walk in the park, reading a book, or meeting up with friends.

It’s also a good idea to spend time reading about pregnancy, birth and early motherhood, as being better informed can help you to feel more in control and worry less about the unknown. (See below for information on classes you can attend locally which may also help.) If you do have concerns, speak to your partner or a knowledgeable person you trust, as this can give you the opportunity to release any pent-up feelings you might have been harbouring. Also, ask any questions you have to your midwife or doctor. Giving yourself the opportunity to talk with a trained and knowledgeable professional can provide you with reassurance as well as solutions and treatment you may not have previously thought about. 

If your anxiety disorder is severe, you could be referred to a perinatal mental health service. These services specialise in caring for women who have mental health problems in pregnancy and after birth, so will be able to provide you with the right level of care that you need during this time. 

Further information, help and support

  • Tommys – information about anxiety and panic attacks in pregnancy
  • Netmums – information about anxiety and peer supporters offering advice and support online
  • Maternal OCD – information and peer support for women with perinatal OCD. Peer support via phone, skype and email
  • PANDAS Foundation – information and support, including a helpline and email support, for women experiencing anxiety and depression in pregnancy or the postnatal period
  • Mind – information about perinatal anxiety
  • Birth Trauma Association – information and support for women who have PTSD due to a traumatic birth
  • Best Beginnings – videos of women describing their experience of antenatal and postnatal mental health, and treatment. Also available on the Baby Buddy App
  • Headspace – meditation and mindfulness information and guidance

Further information from Suffolk Babies

Antenatal classes

Attending antenatal classes can be a great way to allay any fears around birth and having a new baby. If you have had a baby before, antenatal classes are just as important as first time around, as they can help you see your previous experiences in a new light and every pregnancy and birth is different, just as every baby is different.

There are a huge range of classes out there, and it’s important to find the right one for you and a teacher you trust. Here in the Ipswich Hospital area we have three different free antenatal classes on offer:

Hypnobirthing
Ipswich Hospital midwives offer a 10-hour Hypnobirthing course for women and their birth partner, around 24-28 weeks of pregnancy. The course uses tried and tested hypnotherapy techniques together with evidence-based midwifery antenatal training.
The classes run on a variety of days and at various destinations. There may be a charge for the course, but please speak to your midwife if this is difficult for you.
For further details, or to book your place on a hypnobirthing course please email:
hypnobirths.midwife@ipswichhospital.nhs.uk
 
Infant Feeding
Ipswich Hospital midwives offer a Preparing to Feed Your Baby Workshop. Feeding workshops can help you make a decision about how to feed your baby. You can discuss your options and have your questions answered in a relaxed atmosphere. Partners can attend too. Details of venues & how to book are in your booking pack (or ask your community midwife).
 
Essential Preparation for Birth
The Essential Preparation for Birth Workshop is offered by Suffolk Babies to all couples from around 26 weeks of pregnancy. Book online for your nearest workshop.
In the workshop we cover everything you need to know about labour, birth, and the early days with a new baby.
It is a free, 4 hour workshop, run at evenings and weekends: www.suffolkbabies.co.uk/essential-preparation-for-birth-workshop

Suffolk Babies also offer a women-only 6 week antenatal course:

Practical Preparation for Birth
Preparing your body to give birth is about practising your breathing and how to move your body to maximise the effectiveness of your contractions, keeping calm and feeling in control. This women-only movement-based class will allow you to practise with an experienced teacher and give you some wonderful relaxation time.
Visit www.suffolkbabies.co.uk/practical-preparation-for-birth.
Cost £60 for a 6 week term

If you are feeling anxious because of a previous birth experience, you can seek support from Birth Reflections:

Birth Reflections

Are you left with unanswered questions after your birth experience? The birth reflections service is a confidential way to understand your birthing experience and perhaps better understand any niggling questions that may be tucked away at the back of your mind.

At any point after your birth experience you may call a designated phone line, leaving your name and contact number. A midwife will get back to you to arrange a meeting at a mutually convenient time and venue.

Your partner can be involved too, and it does not matter how long ago your baby was born. Of course, you don’t have to wait until you get home to ask any questions, the midwives on the postnatal wards are happy to go through events of your birth with you and answer any questions you may have.

To use this service you must have given birth under the care of the Ipswich Hospital NHS Trust.

To access Birth Reflections please phone 01473 703000.

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