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30 May 2023

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7 minute read

Anxiety: Bane of Mums-to-be’s Wellbeing

By Ms. Vera Pillai

Most women look forward to being pregnant, but carrying a baby in the womb can also bring about various emotions, including anxiety.

In this sense, there are differences between anxiety attacks and panic attacks, according to Vera Pillai, a clinical psychologist for Columbia Asia Hospital – Bintulu and Miri.

“Firstly, while both are what we refer to as anxiety in general, anxiety attack is not an official diagnosis; rather, it’s a colloquial term used to describe a gradual build-up of anxious thoughts that become intense over time,” she tells thesundaypost in Miri.

She says in an anxiety attack, one would feel tensed, agitated and restless, and also find it difficult to concentrate and sleep. This usually lasts for days, which is a longer duration than panic attacks.

“Panic attack is usually unpredictable, involving a sudden feeling of intense fear and dread. It comes with shortness of breath, heart palpitation, dizziness, chest tightness or sweating.

“For reference, I will use the term ‘anxiety’ to include general anxiety, antenatal anxiety, postnatal anxiety, anxiety attacks and panic attacks,” she adds.

Is antenatal anxiety normal?

According to Vera, anxiety affects one out of four pregnant women in Malaysia, indicating that this condition is quite common among mothers-to-be.

“To be responsible for a new life and ensure that the baby’s growth is safe, well and healthy, it’s not an easy task.

“Factoring in with a family history of depression or anxiety, intimate partner victimisation, substance abuse, complications during pregnancy, past miscarriages, disharmony in family relationship – any of these can easily overturn the joy and excitement of approaching labour, and replace it with endless worrying.

“So, if you’re experiencing anxiety as a pregnant woman, know this – you are not alone,” she assures.

How anxiety affects labour

Vera says with the mind being at one with the body, anxiety will bring about changes to a pregnant woman’s body, which may harm the foetus.

Blood flow to the foetus is reduced when the mother is experiencing high anxiety. This can lead to a low birth weight and premature labour, says the psychologist.

“For some, it may increase the labour length, and the need for epidural analgesia. It will also release less oxytocin, a crucial hormone to stimulate uterine contractions in labour and childbirth.”

Moreover, Vera says during pregnancy, the baby is exposed to the mother’s experiences such as sounds, breath and food.

“This also includes the mother’s feelings. Feelings of anxiety can increase particular hormones in the mother that can influence the baby’s development of the brain and the body.”

Seeking professional help

Worrying over one’s new motherhood phase in life is normal, says Vera.

“Emotion-filled anxiety serves to prepare us for what may come, especially when the mind knows that we are about to experience many new changes.

“However, if mothers-to-be start to feel like they are losing control, do seek psychotherapy treatment from clinical psychologists to help learn ways to control your feelings and thoughts.

“I have yet to come across anyone who regrets seeking help for their mental health.

“On the contrary, many patients look back and regret not getting themselves treated sooner.

“The intensity of worry very likely increases as pregnant women approach their labour.

“It takes time to address the root of our worries; thus. it is best to get psychotherapy treatment once anxiety is detected.”

Anxiety medication during pregnancy

For many women, taking anti-anxiety medication during pregnancy may not be an option, says Vera, adding that there is still little information about the safety of such medication for the baby.

“Thus, it is important for pregnant women to talk to their psychiatrist before medicines are prescribed.

“Fortunately, they can opt for other options during pregnancy such as psychotherapy treatment like Cognitive Behavioural Therapy (CBT). This addresses unhelpful thoughts, heavy emotions, and provides anxiety management strategies.

Ways to cope

Learn relaxation skills, Vera advocates.

Exercises such as diaphragmatic breathing, meditation, grounding and mindfulness can help ease the mind from many worries, and can also help calm the body, she adds.

“Get enough sleep. Find out what works best for your sleep such as a pregnancy pillow, a quiet room, or a calming bed routine.

“Consider putting your thoughts and emotions on paper by setting aside 15 minutes at the end of the day to write. Setting this time would help your brain understand that it has a specific time to think about these concerns, so you won’t catch yourself worrying throughout the day.”

Pregnant women can also consider psychotherapy, says Vera, adding that they can identify and learn ways to manage their thoughts and their worries about their pregnancy or anticipated motherhood.

A partner’s help during labour

Partners should stay calm and encourage the mother-to-be to take deep breaths. As best as their can, remain calm and provide gestures of care such as holding hands or a gentle grip on the hands, to help her feel calm.

The partner can also offer assurances by telling the mother-to-be affirmative words such as ‘I am here with you’, ‘you’re doing well’, or ‘I’m so proud of you’, to remind her of the support for each other, and that she is not alone.

“Give her time; don’t rush to calm her down by saying something like, ‘just stop it’.

“She needs time to calm down while the partner offer assurances,” says Vera.

What NOT to say to an anxious mother

“Avoid problem-solving. You can try and offer solutions once the mother is calm. In moments of anxiety attacks or panic attacks, emotions are intense where it is hard for our minds to make rational decisions.

“Avoid asking ‘what’s wrong’ or ‘what’s happening’. Rather, focus on calming her emotions.

“Avoid judgmental comments. A mother goes through a lot of changes in her body. She goes through a lot of worries, even if it is not her first pregnancy or childbirth,” says Vera.

She also reminds people surrounding an expecting mother to stay away from comments like ‘you’re thinking too much’, ‘you’re overreacting’, ‘X has it worse than you’, ‘yot again’.

“Rather, remind her of your support for her.”

Bonding difficulties between mum, baby

“Yes. Postnatal anxiety (anxiety after birth), when severe, can often bring about response of strong avoidance of the fear trigger – in this case, the new baby.

“It is important for newborn babies to bond with their mothers,” stresses Vera.

For such cases, the psychologist highly recommends mothers to seek psychotherapy services to address the root of their fears and help ease their relationship with their newborn babies.

Having their partner’s support in seeking for professional help is essential to help mothers in their anxiety treatment and recovery process.

“The partner can offer support and be a listening ear to understand her thoughts and feelings.

“As some mothers are also overwhelmed with household chores, offer to take turns handling some chores. The partner can slowly be involved in handling the baby such as being with the mother during feeding sessions, or helping to bathe the baby.

Vera says she has seen quite a few cases of mothers refusing to leave the hospital or their homes after giving birth.

“Leaving the hospital means becoming independent when it comes to caring for the baby.

“Leaving the home means exposing the baby to the outside world, risking diseases. These reasons could be signs of postnatal anxiety or depression.”

In view of this, Vera advises mothers going through such situation to consult a clinical psychologist to further understand and at the same time, gain the appropriate treatment via therapy as well as familial support.

“That would be the key to overcoming fears of being a mother,” she stresses further.

This article first appeared in The Borneo Post, 4 June 2023.

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30 May 2023

•

7 minute read

Anxiety: Bane of Mums-to-be’s Wellbeing

By Ms. Vera Pillai

Ms. Vera Pillai

Psychiatry

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