How to Manage Stress During Pregnancy

“Wow, I’m having a baby!” can quickly become “Wow. I am the one having a baby.”

The initial excitement of getting pregnant can sometimes turn into stress for expectant mothers. Concerns about your own health, your baby’s health, finances, and relationships can turn an otherwise hopeful, happy time to one of excessive worry. Don’t let that happen. Take a preventive approach to managing stress during pregnancy to calm worry and make your experience a more positive one.

Let’s face it: Pregnancy is uncomfortable. But with people on all sides telling you how wonderful it is to be pregnant, you may feel guilty admitting you feel stressed about all the physical changes involved. If you feel this way, you’re not alone. Many women admit to feeling deeply ambivalent about the changes in their lives during pregnancy. Often these concerns yield to happiness when the baby arrives, but until then, some women feel like their lives and bodies are suddenly out of their control.

From morning sickness (or sometimes all-day nausea) to hemorrhoids, major mood swings, intense fatigue, and dozens of pounds of weight gain, pregnancy changes let you know that you’re no longer the boss of your body. And each new symptom may trigger a certain anxiety: “Is this normal? Is my baby safe? Will I ever go back to the way I used to be?”

Pregnancy also can trigger stressful relationship and family issues. Having a baby brings a third person into your romantic relationship—a third person whose needs take priority over everyone else’s. In addition, a new baby invites more frequent visits from family, which may prompt discussions surrounding religion, finances, and even where to live.

It’s completely normal to have mixed feelings about these life changes. Many people feel lovingly about a child, but also scared and unhappy about the changes involved. Take heart, though—there are ways to make the time during pregnancy easier. Two keys to managing stress and worry during pregnancy are:

1. Accept the fact you’ll need to develop different coping skills and routines both during pregnancy and after the baby arrives.
2. Organize your life to accommodate pregnancy and the new reality of family life.

It can be startling to confront your reality and realize many aspects of your current lifestyle will need to change during and after pregnancy. Ask yourself:

• What do I currently do to manage my stress? Can you do those same things during pregnancy? If not, how can you improve your everyday coping skills? For example, if you used to go shopping for new clothes and get a cocktail with girlfriends, perhaps meeting for tea and going for a walk is a more pregnancy-friendly choice.
• What aspects of my daily life will need to change? For example, if you live in a fifth-floor walk-up, consider whether it will be manageable while lugging a stroller, diaper bag, and sleeping baby. If you commute by bicycle and need to stop, be prepared to plan an alternative method of getting to work.
• Will I need to set boundaries with family? Think about whether you’ll welcome intimate involvement from your parents and in-laws regarding your pregnancy, or if you’ll need to set some boundaries around certain topics such as breastfeeding advice and staying with you after the birth, and how you’ll do that.
• How can my partner and I continue to communicate productively? Good communication is especially important, and some sensitive topics—such as religious beliefs, sex, money, and parents—can become even more so during pregnancy and afterward.
• Are we financially prepared? Determine how financially prepared you are for your pregnancy and your child, how you might need to adjust the household budget, and who’s responsible for adjusting what.

If you need help navigating the choppy waters of change, don’t hesitate to talk to a therapist. In fact, many people seek out couples’ therapy before they have their child to address these sensitive topics.

My best tip for stress management during pregnancy: Get organized, and start as early as you can. Here are some suggestions for getting started:

• Establish new routines early. Begin now to establish the routines you’ll use after the baby comes home, such as meal planning for the week ahead, creating grocery lists, and making plans to see friends rather than relying on spontaneous get-togethers.
• Write it down. Hormonal changes often cause pregnant women to become forgetful. If you didn’t write to-do lists or use a calendar to remember important dates before pregnancy, now is the time to start.
• Know your go-to stress relievers. Develop a list of stress-relief practices that work for you before you get stressed, so you have ideas at your disposal when you need them, such as meditating, going for a walk, or deep breathing.
• Find an objective sounding board. Find someone to talk to who has no emotional investment in your pregnancy, such as a therapist or an online community. Being able to talk openly about what’s going on in your life and receive feedback from an objective party can provide stress relief and reassurance. Ask your therapist if he or she will be available for phone sessions after the baby is born, since leaving the house with a newborn can be challenging.
• Prepare to employ new coping strategies for late pregnancy and postpartum. For example, you won’t be able to exercise for several weeks after delivery, and your health care provider may recommend against intense exercise at the end of pregnancy. If you use exercise as a key coping strategy, how will you replace it?

Depression doesn’t always just sneak up after the baby arrives. Expectant mothers sometimes fit full criteria for depression during pregnancy. If you have persistently low mood or apathy most of the day every day, for at least two weeks, and several of the following symptoms, you should talk to a mental health care provider:

• Trouble sleeping because of emotional distress (trouble falling asleep; waking up and being unable to get back to sleep for more than 20 minutes at night; waking up early and being unable to fall back asleep because of worry)
• Feelings of guilt that you can’t let go
• Loss of interest in things that used to bring you joy, and lack of excitement for the future
• Low energy beyond what your health care provider tells you is normal (e.g., if showering or feeding yourself seems like too much of an effort)
• Poor concentration and trouble making decisions
• Loss of appetite beyond what your health care provider says is normal

If you’re having thoughts that life is not worth living or thoughts of harming yourself or your child, contact a mental health provider immediately or call the National Suicide Hotline at 1-800-273-8255. There is also the National Postpartum Depression Hotline at 1-800-PPD-MOMS.

Managing stress and worry during pregnancy will only help after the baby arrives. Many women have the “baby blues” after they deliver due to changes in hormones and lifestyle. Preparing for and being realistic about these life changes will assist in keeping you feel grounded after your little one arrives.