Dealing with Anxiety in Pregnancy, Labor, and Delivery

The birth of a child can be a time of excitement, joy, and wonder as one experiences the miracle of life. Starting from the moment of finding out one is expecting, to hearing the heartbeat for the first time, to preparing the nursery, culminating in that moment one first sees what love between two people was able to create when the baby takes their first breath. Becoming a mom/parent truly is one of the highest blessings that is even reflected in Scripture.

Children are a heritage from the Lord, offspring a reward from him. Like arrows in the hands of a warrior are children born in one’s youth. Blessed is the man whose quiver is full of them. – Psalm 127:3-4, NIV

Anxiety and Pregnancy

However, the reality is that for most, there is some level of anxiety related to the unknowns, particularly regarding the labor and delivery aspects of becoming a parent. It is only natural for one to worry about the pain and the safety/health of not only their baby, but also the woman bearing the child. A lot of this is normal and even beneficial for most mothers, prompting them to take steps to prepare for the delivery process.

Some steps women may take in preparation are finding a provider they feel comfortable with, asking questions, taking classes to learn positions and comforting measures during the labor process, reading books/listening to podcasts to know what to bring to the hospital, taking tours of the hospital to familiarize themselves with the space, and talking to other women who have been through the experience.

All of these measures are great as long as the woman understands that no matter how much research they do, questions they ask, books they read, or people they talk to, it is the norm to still feel like you aren’t prepared enough, especially when it comes to the delivery of your first child. Having a good support system to remind you of this and to continue encouraging you is crucial, especially as your due date approaches.

Unfortunately, though, there are some women who not only experience the “normal” level of worry during their pregnancy and delivery, but their anxiety reaches what we call “clinical levels.” What this means is that their anxiety is persistent and excessive to the point where it starts interfering with their daily functioning.

Clinical levels of anxiety can then turn a time in life that should be exciting and memorable into one that is daunting, overwhelming, and isolating, with women asking themselves, “Why am I not enjoying this?”

Causes of Anxiety in Pregnancy

Many factors can lead to diagnosable anxiety during pregnancy. These factors can be broken down into three categories: biological, psychological, and social/environmental.

Biological factors include:

• A preexisting anxiety disorder or history of anxiety, depression, or other mental health conditions
• A family history of anxiety or other mental health conditions
• Hormonal changes that occur in pregnancy
• High-risk pregnancy and/or pregnancy complications
• Other medical conditions like thyroid disorders, PCOS, etc. that can affect mood and hormones
• Medical conditions that can lead to complications in pregnancy
• Insomnia or lack of sleep

Psychological factors include:

• High levels of stress
• Previous history of trauma, particularly sexual trauma
• History of infertility, miscarriages, stillbirths
• Previous traumatic pregnancy/birth experiences
• Previous history of a newborn admission to the NICU (Neonatal Intensive Care Unit)

Social/Environmental factors include:

• An unplanned/unwanted pregnancy
• Limited social support
• Financial stress, lack of stable housing or employment
• Relationship/marital conflict
• Domestic partner abuse
• Attachment problems or strained relationships with one’s parents

Though these factors do not always lead to diagnosable anxiety during pregnancy it can put someone at higher risk. If this is the case for you, you are not alone, and there is hope. It may seem that some of these factors are out of your control; however, there are many steps you can take when it comes to this significant life event of bringing a child into the world.

Finding a mental health counselor is a great resource and means of support whether you are experiencing normal levels of worry or significant levels of anxiety during your pregnancy. Not only that, but if you are not yet pregnant but know you are at high risk, proactively seeking counseling is a great way to not only take care of yourself but also prepare yourself to be the best parent you can be for your child.

How Counseling Can Help

If you are already struggling with an anxiety disorder or other mental health condition, a counselor can help equip you with coping skills to help manage your anxiety. A counselor can also help you gain an understanding of your anxiety, including how anxiety works in your body, help you identify triggers, and provide psychoeducation about factors that may worsen your anxiety.

If you are someone who has been through significant trauma, a counselor can help you process that trauma and guide you on a path toward healing using trauma-based therapy modalities. A counselor can also help prepare you for how pregnancy and labor may trigger increased anxiety and how to manage those situations.

If you are someone who has experienced infertility, miscarriages, stillbirth, delivery trauma, or a previous newborn admission into the NICU, a counselor can help you process the grief that often comes with these experiences – grief that is not only related to the loss of a child, but also the loss of not having that smooth labor and delivery experience you had hoped for.

Often, these situations create increased fear coming into a hospital setting, and a counselor can teach you how to challenge these fears and challenge any inappropriate guilt that can also come with these experiences.

If you are someone who has an unplanned pregnancy, relationship/marital conflict, or lack of social support, a counselor can help you process your emotions regarding the unplanned pregnancy. An individual counselor can help you navigate the conflict in your relationship.

Or if your partner is open to it, a couple’s counselor could be a great resource to help equip you and your partner with communication/conflict resolution skills and be a mediator as you navigate decision-making regarding raising and caring for a child. A counselor can also help you identify ways to build your support system so that you do not feel alone during your pregnancy or delivery.

If you are someone dealing with stress or financial challenges, a counselor can help provide you with resources and stress management skills, as well as be a resource to identify possible solutions to the stressors you’re experiencing.

These are just a few of the ways a mental health counselor can help in managing anxiety in pregnancy and the delivery of a child. As a mental health counselor who also works as a labor and delivery nurse, I often see how severe anxiety can affect a woman’s delivery experience.

I am passionate about walking women through pre-pregnancy, pregnancy, labor and delivery, and postpartum stages. I love helping prepare women to take on one of the most important roles in their lives. What I have seen is that by taking the time and effort now to deal with anxiety and mental health concerns, you are, in effect, creating a significant impact not only on your children but on generations to come.