Early on in the pandemic, some women may made the decision to start a family or experienced a surprise pregnancy. As we all know, pregnancy can be a stressful time, and now with COVID and a new vaccine, more serious decisions need to be made when starting a family. At this point, it is unclear whether pregnant women should even receive the vaccine. We know that COVID has long term effects, but we don't know what affects of the virus has on a fetus. Researchers don't know when the virus is going to end, if a new strain will come from it or when the continued death count will slow down.
It's all nerve-wracking.
This is terrifying for everyone, never mind the additional stress for pregnant women - not knowing how your baby will be affected and if you'll lose your job. There's a whole bunch of things you can't predict.
COVID has the ability to put us all at high risk for depression and anxiety. It forces us to face the unknown, puts us in fear of losing loved ones and, makes us feel helpless or hopeless.
For the past several years, the rates of perinatal depression in women have been about 1 in 5. But that's shifted. During COVID, about 1 in 3 women have experienced significant perinatal depression. Stress levels are also higher across the board for all of us -- pregnant or not.
Impacts of Depression and Anxiety on Pregnancy
"Does it matter if I have depression or anxiety during pregnancy? Does it matter that you're more stressed than usual?" Actually, research says yes.
Untreated depression during pregnancy can lead to complications such as: low birth weight, pre-eclampsia, preterm labor, more pain during birth, higher risk of the baby being in the NICU, higher risk of C-sections, bleeding during gestation, spontaneous abortion, and worsening postpartum symptoms including suicidal thoughts. After birth, there is a risk of reduced parent-baby bonding, and delays in the infant's emotional and cognitive development.
If you aren't clinically depressed, but are still experiencing exceedingly high stress levels, there is still a higher risk of preterm birth, and the risk of your child developing asthma or allergies later in life is increased.
Why do Stress and Depression Cause Such Significant Issues?
To put it simply, when you are stressed, you make a stress-chemical called "cortisol." Cortisol typically will come out when we are presented in a "fight or flight" situation.
Think of it this way, if you're enjoying your morning tea and all of a sudden a coyote jumps out at you, your body responds with cortisol. Your heart rate and blood pressure rise. Your body goes into survival mode: digestion isn't important to survive this coyote attack, so let's turn that off. Immune system? Nope, we don't need that right now. Reproductive system? Not important to this fight with a coyote.
When the coyote jumps away, the cortisol would turn off and everything would flow back to normal. But when you have depression, anxiety or just chronic stress, the cortisol doesn't turn off. Your body starts taking in the wear-and-tear of being ready for that coyote attack, even when the coyote isn't there anymore. Cortisol passes through the placenta, so your baby feels it too.
In the case of depression, taking care of ourselves can be exhausting. Basics like hygiene, eating right, and sleeping no longer come easy to us. During baby's entire fetal development, they will not pick up on the vocal tones and sounds of laughter, pure joy and love. Postpartum irritability may occur, which means we might become more frustrated with baby for crying. We may feel more hopeless and, in turn, we subconsciously stop bonding with baby.
Stress Management Tips
2021 is the year for self care and change. Here are a few things that you can do to help yourself reduce your stress levels.
Proper Nutrition. Eating healthy is extremely important, but even more so during pregnancy. Continue taking your prenatal vitamins (these are important because they prevent spinal birth defects for your baby). Eat a lot of calcium, protein, and iron. Leafy greens, beans, legumes, sweet potatoes, fortified cereals, and berries are great options.
Increase your calorie consumption by 0 calories first trimester, 300-350 calories second trimester and about 450-500 third trimester. Eating for "two" doesn't mean a caloric free-for-all -- this could lead to gestational diabetes and other complications.
Exercise. Since gyms are semi off-limits, find alternative ways to stay active. Walk around your home during breaks. Take day-time walks around your neighborhood - if your area is safe -- otherwise, go to a nearby, well-lit park. Youtube has a ton of resources for perinatal yoga and other safe exercises. Don't overdo it, but aim for 30 minutes a few times per week.
Stay Connected. Social distancing is important, yes -- but it doesn't mean that you can't still find ways to be social in a safe way. Zoom, google hangout, skype and other platforms like Facetime can be used to connect with friends and family members on a regular basis. Practicing your faith or prayer with your family via video can be an option if you are religious. Support groups or online socializing groups can be an option if making new friends is on your 2021 resolution list. Also find time to spend relaxing with your partner.
Prioritize Sleep. Sleep changes during pregnancy, and further changes postpartum under the demanding schedule of a newborn. There are a ton of things on amazon that can help comfort in sleeping during pregnancy like pregnancy pillows. Waking during the night can be normal during the third trimester, so ensuring you schedule enough time to properly get your needed sleep is crucial. Otherwise check out this post on sleep hygiene for more in-depth tips.
Find Joy. Quarantine has forced us to stay at home, allowing us to get creative in develop new hobbies. If you used to love painting and drawing, make a little time each week to do that. Be outside in nature. Go for a drive. Snuggle with your kitty or dog (just don't scoop the cat litter). Tend to your plants. Watch your favorite movie or comedy. Read more books.
Whatever it is, make sure you give yourself an hour per week minimum for this.
Stop Watching the News. If you turn on any news station, you're going to be looking at hospitalization rates, political stupidity, human rights abuses, death, and other stressful things you cannot control. Turn if off and turn off the notifications for news on your social media.
Allow Apps to Help. Meditation and mindfulness is something that many people have pledged to do in wanting to improve their mental health, but they feel unsure how to start. Apps such as Calm and HeadSpace are amazing to teach you the practice of meditation. You can set aside ten minutes per day to sit and just allow yourself to breathe. Woebot is a free app that serves as a daily check-in robot-therapist. I've trialed this and think it's actually pretty awesome.
Pamper Yourself! Take a warm bath and just soak with a book, a cup of steaming hot cocoa or peppermint tea. Light some of your favorite candles. Do a hair mask, put on a face mask, foot mask and paint your nails. Do your makeup if it makes you feel good. If you have a little extra money, buy something small you've been wanting for yourself. Make your favorite dinner or dessert. Buy yourself some flowers to put on your counter. Take a nap, and don't feel bad about it.
Reach Out For Help. Remember how we talked about risks of untreated anxiety and depression during pregnancy? It doesn't have to be that way. You are not alone. Reach out to a therapist (either a new one, or your current one) for a session so you can start to build some coping skills. I promise, it'll only help you later when baby is born. Tell your OBGYN, midwife or primary care doctor. Reach out to set up an appointment for an evaluation to see if medication could help you. The risks of being on antidepressants are WAY lower than any of the risks of untreated depression during pregnancy, and we can talk about that during an appointment.
Remember This.1 in 3 women are experiencing perinatal related mood disorders right now. It's okay. Nothing is wrong with that. If you have depression or bad thoughts, they are just thoughts. That's all. Sometimes you feel hopeless, not yourself and you just don't want to live anymore or you keep envisioning horrific things happening to your baby. You feel like a crappy parent already. I promise you, this is more common than you think. You are an amazing person, and you have come this far and overcame so much already. There is relief and it does get better. Reach out and make an appointment!
WIC: a resource for moms + single dads to receive additional nutritional assistance from pregnancy up until the baby turns 5. also includes breastfeeding support.
AZ Food Banks: find a food bank near you