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May 4, 2021

Prioritizing Mental Health During Pregnancy

By Lacy Chavis, Psy.D., pediatric psychologist at Johns Hopkins All Children’s Hospital

The COVID-19 pandemic has taken a toll on the mental health of people of all ages, but it can be especially hard on expectant mothers who are already experiencing many physical, emotional and lifestyle changes.

Women often experience a range of emotions during pregnancy, and many have at least some worries about being pregnant, giving birth and parenting. Studies show that during a typical pregnancy, maternal cortisol (stress hormone) increases, which is a normal process and critical to the development of organ systems in the fetus.

However, the pandemic may amplify stress for some new or expectant moms. Some common challenges include:

  • Less human interaction leaves many pregnant women feeling isolated from friends and family that normally would have helped to alleviate stress.
  • To limit COVID-19 exposure, some practitioners are scheduling less frequent appointments, while others utilize telemedicine. This can be a new source of stress for pregnant women as the routine checks often ease concerns about health of mother and baby.
  • Many expectant moms are feeling a sense of grief and loss at this time. Many cultures have prenatal and postnatal rituals and celebrations to celebrate pregnancy and birth of a child that may have been placed on hold, modified or canceled to minimize exposures.
  • Birth plans are requiring adjustments as many facilities have altered the accommodations available such as water baths, walking around the hospital and the presence of multiple support persons.
  • Expecting parents fear separation from the baby if mom and/or partner test positive for COVID-19 at delivery.

Tips for Coping with Stress

If you are feeling stressed, you are not alone. It’s important to take an active approach to reducing stress with some of these tips:

  • Be honest with yourself, your provider and partner/family because suppressing or denying negative emotions will cause them to multiply. When we numb the negative emotions, we also numb joy, happiness, love and our sense of worthiness.
  • Build a reliable social support network. Although COVID-19 has made it more difficult to connect, it is not impossible with platforms that allow for audio and visual connection, such as an online or telehealth social support group.
  • Practice cognitive reappraisal: Recognize negative emotion to ultimately turn these into positive responses. For example, instead of saying, “All my plans are ruined,” think, “Plans change, and I can adapt.”
  • Practice relaxation strategies like diaphragmatic breathing, progressive muscle relaxation, guided imagery, meditation/yoga and spending time in nature.

When should moms seek professional help?

All women should talk with their provider about stress, anxiety and depression throughout the pregnancy and during the first year postpartum, especially if your symptoms are interfering with sleep, work, personal responsibilities or social interactions or if you feel like you are just not yourself.


Originally published in May 2021

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