Emotional Health: How To Ride The Emotional Roller Coaster of Pregnancy

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Our Experts In This Episode
Dr. Alison Wilson is a psychologist whose practice focuses on women's mental health issues surrounding reproduction. Her specialty is providing women and couples counseling for infertility, prenatal and postpartum adjustment, miscarriages, pregnancy loss and grief counseling. 


Welcome to your Pea in the Podcast, I'm Bonnie Petrie with everything you need to know about your body, your baby and the big changes ahead in your life as you begin your journey as someone's mom.

This week we'll talk about your emotional health during pregnancy.
You might sometimes have some mixed feelings about this pregnancy...
"A women feels any ambivalence or I'm not quite sure if this is what I really wanted, the guilt can come in."
Or your can be feeling blue and you don't know why...
"The neurochemicals in your brain which regulate your mood are so closely interwoven with a woman's hormones."
Or maybe you're feeling ugly and fat...
"Just look what you're doing. What an amazing thing you are doing. You know you're helping to sustain a new life."
We'll talk you through the emotional mine field pregnancy can be with a psychologist who specializes in the emotional issues surrounding fertility and pregnancy. No you're not crazy and no you're not a terrible mom. That's all ahead in this Pea in the Podcast.
So you know you want a baby, maybe you've even been trying. But now as you look at that second line on the pregnancy test your heart is seized with fear, and then shame.
"For women there is a lot of expectations surrounding the role of motherhood and then a woman feels any ambivalence or I'm not quite sure if this is what I really wanted, then guilt can come in and have her second guess herself."
Dr. Alison Wilson is a psychologist whose practice focuses on women's mental health issues surrounding reproduction and she says this ambivalence is totally normal, and it even may be more intense for a woman who has been trying for months or years to get pregnant.
"And then when it finally happens it is just not believable and a lot of times that is when fear can set in of oh okay now I finally got to this point, now what do I do? A lot of women are just fearful it's not going to happen ,and that's their whole focus, and then they really haven't allowed themselves to look beyond that because they don't want to think about pregnancy actually happening until it actually does happen because they don't want to get their hopes up too high."
So if you have that moment or even several moments of 'what have I done?' Wilson says don't beat yourself up.
"It is very normal. I think again we put so much expectation surrounding it that for some women who are let's say struggling with infertility that they dwell maybe on not getting pregnant because deep, deep down I don't really want this. And that's not the case but a lot of women can interpret that as something must be wrong with me and then that guilt can come in and just wreak havoc for some but really it's very normal, it's natural, it's change."
And if your pregnancy is a surprise, even a surprise that you're very excited about, the prospect of change, change in your body, change in your life...well, it can make you feel anxious and even resentful sometimes. Now, that doesn't make you a horrible person, it doesn't make you a horrible mother and it doesn't mean you hate your baby.
It means you are a human being.
It also means you're a human being dealing with a hormonal upheaval of epic proportions.
"Your body is so busy and all of the levels of your hormones are just at their highest, as they should be, but I agree 100% looking at research we find that the neurochemicals in your brain which regulate your mood are so closely interwoven with a women's hormones and that is true for the landscape of her entire life, from the beginning and when she starts her period and then all during reproductive years and then menopause. We're constantly influenced by our hormones and how they just kind of interact with the nuerochemicals in our brain."
And those mood regulating neurochemicals will be all over map during pregnancy, beginning at the beginning when the surge of progesterone makes you weepy and exhausted, and you cannot underestimate fatigue as a factor in your emotional vulnerability right now.
"During pregnancy, a woman in her first few months of pregnancy, internally her body is making the placenta and nourishing the developing fetus and it is equivalent to her climbing a very high mountain. Her heartbeat, all of her body for a normal woman that would just be walking down the street but for a pregnancy woman she's just constantly working at it and it's just such a stark difference."
I don't know about you, but when I am exhausted my fuse becomes very short and I might cry at any moment. When I am tired, I'm touchy.  Add to that moms-to-be often get very anxious. Will I be a good mom, will I be able to handle the demands of a newborn on no sleep, can we even afford this? Will my partner expect me to do all of this all by myself?
"About your marriage and expectations I think it is very helpful during the pregnancy for the couple to really talk about what is your vision of my role once we have the baby. And it's very helpful to, say, in a traditional relationship, the man might expect for you to do the childcare 24/7 or he may not, but it is helpful to talk about it beforehand. Preferably before you get pregnant of what is your view and some sort of agreement or something that, a loose plan. 'Well I think I am going to stay at home for the first 4 or 6 weeks.' Or 'I really would expect for you to help me with this, this, and this' or just have some sort of idea in discussing it and hopefully coming to some sort of agreement, because I think too often what kind of catches women off-guard is once they are in the role of mother, some just assume they have to do it all and it gets overwhelming in a hurry of just taking care of this little one and the house and running errands and doing all of the domestic things and resentment can really build. Where if you kind of have some idea of 'you know honey I'm going to need your help in this area or you need to do this that could help.' But having said that I have met many, many women where they are very career oriented and their intentions are to go right back to work and the husband is thinking that and they give birth and then they are just enamored with that role and they decide 'you know I don't really want to go back to work' and that can just throw it all off. But if you can have some loose plan ahead of time that is very, very helpful."
So communication can ease some of your anxiety, but don't be surprised to find yourself having vivid dreams in which you leave the baby somewhere or drop the baby or even hurt the baby. This, too, does not mean you hate your baby. These are all manifestations of normal anxiety. If they scare you talk to your doctor and they can recommend a therapist to talk you through this anxiety. It's no fun and you don't have to suffer.  There are people who can help you.
Dr. Wilson says some of you may face the added struggle with being unhappy with the way you look as your pregnancy progresses and your body grows and changes.
"Some women, they are just completely content with oh my body is nourishing another little being and you see that glow and they just relish every moment of it and their pregnancy is smooth sailing for them. But other women, sometimes it catches them off-guard that, especially if they have always been fit or really in tune with their body and then all of the sudden it is changing in areas that she just did not anticipate at all, and that can be rather upsetting for some. For lots of women there is a concern of a figure after having had the baby and wanting to get back to that. Hoping that they will be able to lose the pregnancy weight and then for some discovering that that is not always easy to do because you're incredibly busy taking care of the newborn."
Dr. Wilson says this can be difficult for women who have struggled with weight in their lives and it can be particularly painful for women who have or have overcome eating disorders.
"I've worked with women who are terrified with 'what if I get fat?' and it is really an issue around control, and previous to getting pregnant some aspect of their life felt really, really out of control so they will focus on what is in their control and that is eating and what they choose to go into their body. Then once they become pregnant you get concerned, is that behavior still going to be present?  But it's been my experience that a lot of women are able to recognize okay it's not just me, I have to nourish this little one. And going to a yoga class I think can be very empowering.  You can still do amazing things with your body and you can still be healthy and eat what is healthy for you, for the baby and for a lot of women they will find okay it's not just about me anymore and that can be a very helpful journey. And I'm not saying for all but I think it is empowering."
If you've had an eating disorder and you're pregnant make sure you talk honestly about this with maybe an OB, and maybe a therapist too.
"Surround yourself with supportive people but really it is finding a loving relationship be it with your spouse or your partner or with a good friend. Just look what you're doing; you want somebody to lift you up instead of putting you down of what an amazing thing you are doing. You're helping to sustain a new life and that can be very, very helpful. I prefer to talk to older women who've been there and done that and they can really help you and go you know what this is temporary, you're alright and this will pass. Just finding things intergenerational relationships can be immensely helpful. And I hate to sound so cliche-ish but it really does take a village to raise a child and I think that is true for the mother as well. Women need support from other women."
I used to be one of those women whose friends were mostly men, and I still have a lot of men friends, but if I'd listened to this podcast before I had my own baby I would have shrugged and chuckled 'what a silly thing to say? women need other women! of course I was fine on my own!'  But you know what? When I was pregnant I did begin to seek out other women. I needed to understand what was going on in my body and in my mind, what was this ache, what was this twinge, what was this burst of joy or surge of sorrow about, and since my mother had passed away, I really needed to connect with some other women somehow.
"There are some online support groups where a lot of women connect that way. In this busy world of ours at least you can go oh gosh I feel like the Good Year Blimp. You feel like having somebody validating those feelings and doing it online sometimes it depends on the city where you live you can find a pregnancy support group."
I did find my support online; I joined pregnancy message board the day my pregnancy was confirmed. My daughter is a little girl now and almost every woman I bonded with then is still my very close friend today. I now understand the value of female friendship. So if the internet feels comfortable to you, sign up for a message board, see if you can make some connections there or join a prenatal exercise class, or take a childbirth class, or a breastfeeding class or join La Leche League.
"It doesn't matter to me how or where it is just getting that connection. You fare much better in life having connection with other people who are preferably supportive of you."
This certainly has turned out to be true in my life during my pregnancy and then as I navigate the tricky landscape of parenthood. If you still feel overwhelmed pick a good friend, a close confidant to share with, someone who will let you talk through your feelings and won't tell you to just get it together. Your concerns are real. Or talk to your OB about finding a therapist like Dr. Wilson who specializes in these kinds of things. There is nothing to be ashamed of or feel guilty about.
"It's a new adventure for women and to have a safe place to talk about it is just in my eyes very important. If that is just not possible because of time schedules or what not, I'm also a big believer in keeping a journal where you just get a regular notebook, it doesn't have to be anything fancy and it allows you that when those feelings surface you can write about it or some women like to choose to do it each day at the end of the day to kind of review and process and kind of get some of these feelings out because that is what we are looking for. The feelings are normal and natural but we don't want them to stay stuck. We want an outlet for them and I think that is very, very helpful."
We have been talking about normal feelings of sadness and anxiety and fatigue and self-esteem, but Dr. Wilson says there is something else that you just need to check your emotional pulse every now and then.
"Lot's of women are under this conception that oh the postpartum depression happens once I have the baby. It can actually surface during the last trimester of the pregnancy. So any type of mood changes, and I'm talking you're depressed for more days than not. Not just simply weepy or emotional, but you're just not feeling like yourself. And there's loss of hope. And there is this idea of I just can't do it that might come across as being very, very overwhelmed and this is like during the pregnancy. If those feelings start to surface we really want to watch you once you deliver."
If you feel this way absolutely talk to your doctor or midwife about it. If you have a history of clinical depression your health practitioner wants to know that, too. That can put you at a greater risk for postpartum depression as your hormones go haywire after pregnancy and after birth.  If you have bipolar disorder it is also very important to share that with your healthcare practitioner. That puts you at greater risk for postpartum psychosis, but if the doctor knows they can help you.
Pregnancy can be an overwhelming time for you emotionally, even though you are overjoyed about the changes to come, and can't wait to meet your baby. You're not a bad mom if you sometimes feel sad.  Dr. Wilson wants you to be gentle with yourself.
"Hey it's normal and natural to have these fluctuations and I don't have to be perfect and everything just great with this. But it's normal and if it's starting to feel any bit unusual or bothersome talk to somebody. Be very proactive in your care."
Because your baby needs you...healthy, happy and well.
We hope you've enjoyed this Pea in the Podcast: Your Emotional Health. Please visit our website PeaInThePodcast.com for more information about our experts, to find links and transcripts and to register to receive tailored week by week shows for each week and stage of your pregnancy. It's everything you need to know about your body, your baby and the big changes ahead in your life in your journey to becoming a mommy. For Pea in the Podcast, I'm Bonnie Petrie. Thanks for listening.