Pregnancy can be journey filled with joy, anticipation, and excitement. It can also be terrifying, worrisome, and anxiety provoking. This is a time of immense change, both physically, emotionally, and socially. While much attention is given to the physical well-being of expectant mothers, the importance of mental health during pregnancy cannot be overstated. As a mom-to-be, taking care of your mental well-being is just as important as taking care of your body.
Understanding the Impact
Pregnancy can bring about a whirlwind of emotions. From the initial thrill of discovering you're expecting to the anxieties and worries that may arise throughout each trimester, it's entirely normal to experience a wide range of feelings on this journey. However, for some women, pregnancy can also exacerbate or trigger mental health conditions such as anxiety and depression.
Hormonal changes, increased stress, and concerns about the future can all contribute to feelings of unease or sadness during pregnancy. Moreover, past experiences, such as previous struggles with mental health issues or traumatic events, can resurface during this time. Recognizing the signs and seeking support is essential for managing these challenges effectively.
According to the Center of Disease Control and Prevention mental health includes our emotional, psychological, and social wellness.(1) Wellness is not merely the absence of disease. Wellness is the act of practicing healthy habits daily to attain better physical and mental health outcomes.(2) It is a dynamic process, with conscious development, intentional choice making, and thoughtful actions that lead toward balance and flexibility. Wellness commonly considers seven dimensions: mental, physical, social, financial, spiritual, environmental, and vocational.(3) These dimensions are interdependent and influence each other. It is important to observe and consider each dimension and take action to build wellness-affirming habits, routines, and coping strategies.
Prioritizing Self-Care
Self-care is not just a luxury and isn’t selfish; it's a necessity, especially during pregnancy. Taking care of your mental health means making yourself a priority. This can involve engaging in activities that bring you joy, relaxation and are nourishing to your soul. Whether it's going for a walk in nature, practicing prenatal yoga, or indulging in a soothing bath, finding moments of tranquility amidst the chaos of pregnancy can work wonders for your well-being.
Studies have found that practicing mindfulness and relaxation techniques can greatly improve mental health, promote emotional positivity, and stability. Mindfulness-based treatments have been shown to reduce anxiety and depression.(4) There is also evidence that mindfulness can lower blood pressure and improve sleep. Kabat-Zinn (1994) described mindfulness as “paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally” (p. 4).(5) Mindfulness is the act and process of accepting things as they are and approaching situations with an open mind. Incorporating mindfulness and relaxation techniques into your daily routine help manage stress and promote emotional well-being. Deep breathing exercises, meditation, and guided imagery can all help you stay grounded and centered during this transformative time.
Self-care can also look like setting boundaries with friends and family, practicing saying “no”, being present with emotions that are coming up, asking for help, listening to the needs of your body, and giving yourself permission to rest when needed.
Eat, Sleep, Move
Maintaining a healthy lifestyle can positively impact your mental health. Eating a balanced diet, staying physically active (with your healthcare provider's approval), and getting enough rest are all essential components that can lead to better mental health.
Nutrition
What you eat matters, especially during pregnancy. It will come as no surprise that processed foods are correlated with negative health outcomes and have been found to increase risk of developing depression, mild cognitive impairment, and ADHD.(6) Studies have also found that nutritional deficiencies, like vitamin B12, B9 (folate), and zinc, can cause symptoms of depression and dementia such as low mood, fatigue, cognitive decline, and irritability.(7) Opt for whole clean food that are nutrient dense.
Exercise
Exercise contributes significantly to maternal and fetal wellbeing during pregnancy. Engage in appropriate exercise based on your doctor’s recommendation. This can include walking, swimming, prenatal fitness classes, Pilates, yoga, weightlifting, and much more. In particular, aerobic exercise is considered the most beneficial, as it involves the heart pumping oxygenated blood to the working muscles.(8) Increased blood flow is helpful for the baby. Additionally, exercise in pregnancy has been shown to decrease macrosomia, gestational diabetes, preeclampsia, cesarean delivery, low back pain, pelvic girdle pain, and urinary incontinence.(9) Exercise is not just helpful for the body, but it is also great for the mind. Maintaining an active lifestyle through pregnancy can help reduce stress and anxiety through the release of endorphins, which are natural mood lifters. You may need to modify your usual exercise intensity in order to prioritize safety, but women are typically encouraged to continue working out throughout their pregnancy. Be sure to work with your doctor and a fitness profession to ensure you are implementing a fitness routine that is best for you.
Sleep
Getting enough rest is crucial for your mental health during pregnancy. There are numerous studies that have connected sleep with various mental health outcomes.(10) Good sleep practices, which are sometimes referred to as “sleep hygiene”, refers to healthy habits, behaviors and environmental factors that can be adjusted to help you get the rest you need.(11) Make sleep a priority by:
- Being consistent. Go to bed at the same time each night and get up at the same time each morning, including on the weekends.
- Being intentional with your environment. This may include making your bedroom quiet, dark, relaxing, and a comfortable temperature.
- Removing electronic devices, such as TVs, computers, and smart phones, from the bedroom.
- Avoiding large meals, caffeine, and alcohol before bedtime.
- Establishing a soothing bedtime routine and practicing relaxation techniques before bed.
If pregnancy discomforts make sleeping difficult, talk to your healthcare provider for advice.
Seeking Support
No woman should feel alone on her journey through pregnancy, especially when it comes to mental health. Building a support network of trusted friends, family members, and healthcare professionals can provide invaluable encouragement and guidance during this time. Don't hesitate to reach out for support when you need it.
For women experiencing significant challenges with their mental health during pregnancy, seeking professional help is crucial. Therapists specializing in perinatal mental health can offer tailored support and strategies for coping with the unique stressors of pregnancy. In some cases, medication may be recommended under the guidance of a healthcare provider to manage severe symptoms safely.
Share your feelings and experiences with trusted friends, family members, or fellow expectant mothers. Joining a prenatal support group or online community can provide a valuable source of encouragement and understanding.
Breaking the Stigma
Despite progress in raising awareness about mental health, there remains a stigma surrounding the topic, particularly concerning pregnancy. Many women feel ashamed or afraid to admit they are struggling emotionally during this supposedly joyous time. However, it's essential to remember that experiencing mental health challenges during pregnancy is common and nothing to be ashamed of. Evidence suggests that 20 - 40% of pregnant women experience anxiety and depression during pregnancy.(12) The general causes of worries during pregnancy can revolve around fetal wellbeing, maternal illnesses, social and financial support, and mortality.(13)
By openly discussing mental health and pregnancy, we can break down barriers and encourage women to seek help without fear of judgment. Every woman deserves to feel supported and empowered throughout her pregnancy journey, and addressing mental health is an integral part of achieving that goal.
Stay Informed About Postpartum Mental Health
While focusing on mental health during pregnancy is essential, it's also crucial to be aware of the potential challenges that can arise postpartum. Educate yourself about postpartum mental health conditions such as postpartum depression and anxiety so you can recognize the signs and seek help if needed.
Pregnancy is a remarkable and transformative experience, but it's also a time of vulnerability and emotional upheaval for many women. Prioritizing mental health during pregnancy is not only essential for the well-being of expectant mothers but also for the health and development of their babies. By understanding the impact, prioritizing self-care, seeking support, and breaking the stigma surrounding mental health, women can navigate the challenges of pregnancy with strength, resilience, and grace. Remember, you are not alone, and help is always available.
1. Centers for Disease Control and Prevention. (2023, April 25). About Mental Health. Centers for Disease Control and Prevention. https://www.cdc.gov/mentalhealth/learn/index.htm \. Accessed 5 March 2024.
2. Pfizer. (n.d.). What is Wellness? Pfizer.
https://www.pfizer.com/health-wellness/wellness/what-is-wellness#:~:text=Wellness%20is%20the%20act%20of,how%20it's%20linked%20to%20health. Accessed 5 March 2024.
3. Stoewen D. L. (2017). Dimensions of wellness: Change your habits, change your life. The Canadian veterinary journal = La revue veterinaire canadienne, 58(8), 861–862.
4. Dhillon, A., Sparkes, E. & Duarte, R.V. Mindfulness-Based Interventions During Pregnancy: a Systematic Review and Meta-analysis. Mindfulness 8, 1421–1437 (2017). https://doi.org/10.1007/s12671-017-0726-x. Accessed 5 March 2024.
5. Kabat-Zinn, J. (1994). Wherever you go, there you are. London: Piatkus.
6-7. Lachance, L., & Ramsey, D. (2015). Food, mood, and brain health: implications for the modern clinician. Missouri medicine, 112(2), 111–115.
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10. Scott, A. J., Webb, T. L., Martyn-St James, M., Rowse, G., & Weich, S. (2021). Improving sleep quality leads to better mental health: A meta-analysis of randomised controlled trials. Sleep medicine reviews, 60, 101556. https://doi.org/10.1016/j.smrv.2021.101556. Accessed 5 March 2024.
11. Better Health Channel. (n.d.). Sleep hygiene. Better Health Channel. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/sleep-hygiene. Accessed 5 March 2024.
12-13. Araji, S., Griffin, A., Dixon, L., Spencer, S., Peavie, C., Wallace, K. (2020, November 30). An Overview of Maternal Anxiety During Pregnancy and the Post-Partum Period. J Ment Health Clin Psychol. 4(4): 47-56
https://www.mentalhealthjournal.org/articles/an-overview-of-maternal-anxiety-during-pregnancy-and-the-post-partum-period.html. Accessed 5 March 2024.
