Pregnancy and Anxiety: How to Manage Your Mental Mayhem
There's no need to suffer.
In The Guide
There aren’t too many things that are more difficult than being pregnant.
While the new life growing inside you is incredibly exciting, you are miserable from the discomfort of carrying around 30-plus pounds of extra weight each day.
Nighttime can be worse because the one thing your body could really use right now is evading you:
According to a survey by the National Sleep Foundation, they found that nearly four out of five women had trouble sleeping during pregnancy.
Along with the constant feeling of having to pee, you may also be suffering from heartburn, nausea, back pain, cramping, RLS and general discomfort from your growing belly.
When I sleep, I usually don’t move an inch – so I vividly remember waking up on more than one occasion to find a few of my limbs asleep along with an ugly ache in my hip from being in one position for too long.
Between the nausea (I’m sure you’ve found out by now that the “morning” part of “morning sickness” is a lie), aches and cramps, tender boobs, and trips to the bathroom every five minutes, you may find it impossible to fall and stay asleep.
Your body is going through the most dramatic changes right now – all the hormones and your expanding uterus can make you so uncomfortable that even the idea of rest is unattainable.
There are a few things you can try:
One of the things I missed most during pregnancy was more than one cup of coffee that actually had caffeine in it. I would always switch to decaf after my first cup, but we all know it’s just not the same.
Nevertheless, you should cut down on the caffeine (especially in the afternoons and evening), and try not to drink anything a few hours before you go to bed. That way, you can keep the peeing to a minimum.
Nothing makes nausea worse than an empty stomach. Keep some crackers (or my favorite, animal crackers) on your bedside table to curb a midnight bout of morning sickness.
If you’re craving something more, get up and grab something that will help you sleep: as an idea, protein-rich foods, such as dairy, peanut butter, and eggs, contain tryptophan, which can make you sleepy.
Foods containing tryptophan also increase the production of serotonin, the mood-boosting chemical in your brain.
I believe that one of the things that helped me fall asleep faster was being worn out from my job as a server/bartender during the day.
I actually clocked my steps on a pedometer app on my phone; turns out I was walking about 3.5 miles every day, so falling asleep was not much of a problem for me in the beginning.
If you exercise early, your body will know to power down later. Don’t put off exercising until evening – it will promote insomnia.
Dim the lights, and relax in bed with a book or magazine and a glass of warm milk (remember tryptophan? The protein will help carry you through the night without being too hungry).
You may get a welcome break after you make it through the first three months. While you still may be tired, you will likely sleep better in your second trimester. This is usually the time when your morning sickness will end, and your hormones aren’t seeing as much of a spike, so rest will be much easier now.
You still may have some sleep hurdles to clear, however:
You may no longer have morning sickness, but it’s now been replaced by wicked heartburn. This is due to your growing uterus pushing up on your stomach; all that acid has to have somewhere to go.
Try to eat your biggest meal early in the day and don’t lie down directly after eating. My husband and I tended to eat our biggest meal late at night, so I compensated by spending the first half of the night sleeping upright on the couch.
One study reported that around 25% of women start snoring during pregnancy, and no one is quite sure why. You can try nasal strips to open your nasal passages so you can breathe better at night.
Though it probably will get worse later (yay), you may start experiencing leg cramps or the creepy crawlies in your legs – otherwise known as RLS.
Studies have shown that certain vitamin deficiencies (iron, folate, calcium and magnesium) will result in these cramps, so try to incorporate these vitamins into your diet.
If you feel that you are seriously deficient, talk to your doctor about taking supplements. Stretching your legs and massaging them before bed will help, too.
Many women report bizarre dreams and/or nightmares during their pregnancies. I usually had a recurring dream that there was a toilet overflowing somewhere near me (which sounds weird, I know, but that’s my particular irrational fear).
You can attribute these dreams to hormones and anxiety; it’s natural to feel overwhelmed at the thought of being a new mother.
Your dreams are just your body’s way of sorting out problems; it’s helpful to write them down in a sleep journal while they’re still fresh in your mind. Later, you should talk about them with somebody you trust to help alleviate some of your stress.
Now, staying asleep becomes very difficult; you begin to pee all the time again, your back is killing you, and your 40 pound mammoth of a stomach is making it impossible to stay comfortable.
Your snoring may become worse, and it is harder to breathe from the baby putting pressure on your lungs. This is also the period of time when leg cramps and RLS get worse…yes, there is a hurricane of annoyances that are keeping you up.
FitPregnancy.com reports, “By the end of pregnancy, a large percentage of expectant women report waking up at least three times per night. Two-thirds are awakened five or more times.”
Try to get as much rest as you can. Studies have shown that women that don’t sleep as much may have longer labors and a higher probability that they will have to have a c-section.
If you’re finding it hard to sleep at night, try to rest during the day. BabyCenter advises, “A 30- to 60-minute nap during the day makes you more alert, sharpens memory, and generally reduces feelings of fatigue.
A study by the National Sleep Foundation found that more than half of pregnant women take at least one nap during the workweek, and 60 percent take at least one-weekend nap.”
Even 20 minutes in your car or on the couch will help… just try not to nap for more than 30 minutes at a time, or you will wake up feeling groggy and wrong.
Just one pillow will not do it anymore.
Experts suggest using multiple pillows of different sizes to prop up the areas that are causing you discomfort. If you’re having back pain, a pillow (or three) placed under your upper body to elevate you will help – use this tactic for heartburn and trouble breathing as well.
For hip pain, a pillow placed between your knees will take some of the pressure off. Place a pillow under your stomach (while sleeping on your side) to relieve that portion of your torso of all that weight. Elevate your legs with pillows to relieve those pesky swollen ankles.
Some ladies find that those special pregnancy pillows help – just keep in mind that they are pretty massive, so your partner may only have inches of sleeping surface left.
A regular ol’ body pillow will work too if you have one on hand. I, always the cheapskate, opted to use rolled up blankets for the areas I needed propped up. Not the same thing. Invest in some good pillows of many sizes if you’re able; your body will thank you for it.
Depending on where you hurt and what sort of trouble you have going on (breathing difficulty, heartburn, back and hip aches, bone pain in general), you may need to try a few positions with pillows, or even a new place to sleep if your bed is just not working out. A lot of moms find out that the recliner (or, my favorite, sitting up on the couch) is way more comfortable during this home stretch.
The American Pregnancy Association states, ”The best sleep position during pregnancy is “SOS” (sleep on side). Even better is to sleep on your left side. Sleeping on your left side will increase the amount of blood and nutrients that reach the placenta and your baby.”
Dr. Laura Riley from Parents Magazine agrees, “Lie on your side — preferably your left side — because major blood vessels lie to the right of your spine, and sleeping on your left side allows blood to flow freely through these vessels.”
Not only is it better for your circulation and the baby vs. sleeping on the right; I found that sleeping on my left side when I was pregnant was way more comfortable.
I felt that it really helped with my ridiculous “water balloon legs”, as well as keeping indigestion and heartburn at bay.
Maxine made me crave the spiciest food imaginable during my pregnancy (I know a lot of you are cringing right now), and despite having a full head of hair when she was born, I had zero heartburn troubles (I know a lot of you want to punch me right now).
I am a forever stomach sleeper, and held out as long as I could; inevitably, I gave up the battle at a certain point.
Experts agree that while it’s not dangerous to sleep on your stomach, as your belly grows, you’ll likely find it far too uncomfortable to keep sleeping that way.
According to WebMD, “After your fifth month, your back is definitely not best. Sleeping on your back puts extra pressure on your aorta and inferior vena cava, the blood vessels that run behind your abdomen and carry blood back to your heart from your legs and feet. Pressure on these vessels can slow blood circulation to your body — and your baby.”
Sleeping on your back as your stomach grows will likely make you wake up feeling groggy. As your growing uterus puts pressure on your lungs and stomach, breathing troubles and digestion problems may arise and interfere with your sleep.
If you wake up and find that you are on your back or right side, just flip back to your left and don’t worry: your instincts are what woke you up in the first place to tell you, “Hey, something’s off here. You should change positions.”
You may consider medicating to ease your journey to dreamland; there are some that have been proven safe during pregnancy, but don’t take anything without talking to your doctor first.
BabyCenter.com advises, “While it’s best not to take prescription sleeping pills regularly when you’re pregnant (especially in the first and third trimesters), occasional use of some sleep medications is considered safe..the over-the-counter antihistamines diphenhydramine and doxylamine are safe at recommended doses during pregnancy, even for extended periods. (These are the ingredients found in Benadryl, Diclegis, Sominex, and Unisom, for example.)”
This doesn’t mean that just any sleeping pill is safe to take. Studies have shown that certain types of sleeping pills (including benzodiazepines and non-benzodiazepines) have been linked to certain health complications for the baby.
Make sure you are educated on what you are about to take and know the risks; research is still being done on certain medications, so sometimes there is just not enough data available to prove every medication’s safety.
If you were already on prescription medications when you became pregnant, you should absolutely consult with your doctor before continuing. Don’t just stop taking something you need before knowing if it’s safe to take.
Many experts agree that if you are on certain anti-depressants or other medications, it is best to take care of your mental health for your baby’s sake. Postpartum depression is always a risk; bonding with your baby may become difficult if you are not in a good state of mind after stopping your medication.
With this information age, it is very easy to self-diagnose (yes, I am guilty of this) and decide to take something without your doctor’s recommendation.
Though I only took vitamins without consulting with my OB, it is very important to talk to your doctor about any sleeping problems you’re having and follow their direction when it comes to prescription medications. You can read more on medications and pregnancy here.
While it may seem like you are going to keel over from not sleeping, try not to stress. In What To Expect When You’re Expecting, the authors write,
“Don’t worry about your insomnia – it won’t hurt you or your baby…worrying about not sleeping will certainly be more stressful than lack of sleep itself. Judge the adequacy of your sleep by how you feel, not by how many hours you stay in bed. Remember that most people with sleep problems actually get more sleep than they think. You’re getting enough rest if you’re not chronically tired (beyond the normal fatigue of pregnancy). “
If you feel you’ve tried everything and feel like sleep is still hours away, many experts agree the best thing to do is get up and engage yourself in some sort of mundane activity.
“Get up, go to a dimly lit room, and do something boring: Watch a video you’ve seen before, read a tough book, watch bad TV,” says Ursula Anwer, M.D., a neurologist at UMass Memorial Health Care, in Worcester. “Don’t do laundry or turn on all the lights.”
Or, do what I did and play every low-rated Netflix documentary series available. I was always snoozing before it asked me “Are you still watching?”
Try to relax and know that this too shall pass. When I look back on my pregnancy, I usually laugh at the memories of my little night-owl throwing baby dance parties in my stomach while I tried to snooze. I don’t ever think of or miss the sleep I lost.
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