Hello Pregnancy Anxiety, My New Friend

Prenatal anxiety is a thing. It’s a thing that’s common and often goes undiagnosed. Many of you out there may be nodding.

It hit me around 34 weeks.

Somewhere along the gestational way I lost my confidence. This third pregnancy has been wild and jarring. But I imagined that once I settled in to the routine, my body’s institutional knowledge of pregnancy and childbirth would take over.

I mean, I’ve done this before. I got this.

Sure enough, in the second trimester I found a groove… but I couldn’t rely on it. I seemed to be trying to cross a creek, jumping from one off-balance and awkwardly shaped rock to the next. And around 34 weeks I fell in.

Prenatal anxiety can be about all kinds of things—how you’ll adjust to having a newborn, fear from previous pregnancy loss, medical complications, life stress.

My anxiety centered around actually giving birth. I’ve had two uneventful vaginal births, and somewhere deep down I know I can do it again, but I just don’t want to. I didn’t sign up for this one, and I don’t want to do it. Birth is exhausting and overwhelming and unpredictable. The technicolor feelings of fear and stress about the health of the baby from the first trimester came flooding back, but in new shades of worry: I’m not strong enough. There’s no good way out. How will I survive the weeks of waiting? How will my husband cope as I demand more and more support?

As the third trimester began, I was also diligently listening to the Hypnobabies self-study course I had ordered to prepare for this birth. Everything started out great and I drank every drop of the reassuring Hypnobabies Kool-Aid, but things started to fall apart when I was supposed to imagine my perfect birth. If you can imagine your perfect birth, your mind and body can make it happen for you.

I have spent the last four years eliminating perfect from my vocabulary. It’s a bully word. Perfect sets up high expectations that often aren’t tied to reality, and it’s not flexible. It doesn’t move and change: It just beats you up for being less than.

At the same time, I was becoming increasingly unwieldy, with eczema, heartburn, nosebleeds, and discomfort sleeping. Exhaustion was setting in and I was unable to manage the daily logistics of our life. Holding on to the crumbling façade of my Hypnobabies adventure amidst mounting physical challenges had me thinking: How in the world am I going to manage childbirth?

Then the insomnia started for real. Lack of sleep is always good fuel for anxiety.

Luckily, I kept bringing up my fears and symptoms to my midwife.

Note: If you have anxiety or worries during pregnancy that seem to take over, keep talking to your provider about them. Don’t let your provider make you feel like pregnancy is simply an emotional time. Even though your worries may be on the spectrum of normal, your concerns shouldn’t be minimized: There are so many tools out there to help you manage what you’re going through, and you should be pointed toward them instead of having them brushed aside.

I’m lucky because after the second visit of me bringing up my anxieties over the birth, things clicked with my midwife. “We have a behavioral therapist on staff. Would you like to see her?” Yes!

I have a great therapist I see on a pretty regular basis, but the behavioral therapist connected with my clinic was conveniently located and specifically oriented to tackle issues around birth. She helped my husband and I think about pacing, outside resources, and creating an action plan leading up to the birth (by the way, if you can go to a session with your partner, do it!).

My anxiety subsided by 38 weeks. I’m still dealing with insomnia and lingering worries, but life feels calm and manageable. When I wake at night I’m able to relax instead of spinning the stress wheels in my mind. Now I’m 39 weeks pregnant and in a much better mindspace—enjoying a bit of vacation from the real world as I wait for baby to arrive.

I think there are a number of factors that really helped me:

• An action-oriented behavioral therapist who gave me tools to use specifically leading up to the birth, including a daily pacing guide and a format for my husband and I to check in with each other at the end of the day.
• Meal delivery from friends. Normally this starts after baby, but my friend Sara put together a MealBaby registry and I requested to have it start before the birth rather than after, since I was so overwhelmed. (Thank you Sara, Hannah, and Libby for pre-birth meals!)
• Extra babysitting hours for the boys. (Thank you, Carmen Rose!)
• Readjusting my expectations around 1) what I can accomplish while pregnant with two young kids, and 2) what the third birth needs to be like (anything goes as long as we’re healthy).
• Lowering my level of activity so that I wasn’t feeling defeated by all the things left undone.
• The knowledge that outside resources such as Baby Blues Connection can help deal with prenatal anxiety, even though they’re typically thought of for postpartum depression.

I wanted to make sure to write this post, before the Fairy Pig arrives and I’m in a fog for months, for those of you who have experienced prenatal anxiety, are dealing with it now, or who may know someone who is having a tough time. You’re not alone.

The Third Pregnancy: Almost Done, Almost Done

You reach a point in pregnancy when you start to lose your mind and are willing to sacrifice things to the gods in order to get the damn show on the road. At least I do. It’s supposed to be that every day is joyous and filled with magic and the amazing prenatal bond of mother and baby that can never be broken.

But what really happens is that I eye the squirrels thinking, “Deities, if I sacrificed this tree rodent family for you, would you let me go into labor tonight? I’ll add in the robin on my back porch. Do we have a deal?”

There was a point in my pregnancy with Baby Woww that I was just DONE. And my friend Jamie’s preschooler grabbed my phone and took a great picture that captured it all. I love that post.

This time, our friends’ six-year-old took a wonderful shot for me. It’s more poetic, probably because he was truly tender behind the lens, wanting to capture the baby. Although I have a photo that’s more accurate–with a tampon up my nostril to stop a nosebleed and my pregnancy eczema raging–I really love this one. Thanks, Noah.

“Evelyn, You’re A Mess.”

I’ve been getting nosebleeds for the last couple weeks. This is a first. But a lot of things this pregnancy are firsts: nausea, international flights, girl child…

One morning, my husband had the kids in the car ready for me to drive them to school, and my nosebleed from the hour before started again. I grabbed a fistful of tissues, but as blood started dripping onto the garage floor it became clear that this scene from CSI really shouldn’t travel.

A nosebleed seems like a misdemeanor-level injury. You should be able to go about your business without too much interference. I mean, the nose is small, no bones are broken, a little bleeding should stop on its own.

Twenty-five minutes later, I was in bed still working on getting my nose to behave normally. You’re supposed to keep constant pressure with one hand, which makes it very easy to have a pity party, but strangely difficult to do any other activity. Like eat. Or get dressed.

At this point I went to ZoomCare.

Jenn, the physician’s assistant, stuck a light up my nose. “Your membranes look angry: Pregnancy gives you way more blood flow, you have allergies, the air’s been really dry. Apply pressure, use an icepack, buy tampons to stick up your nose… I don’t think we need to cauterize your capillaries yet, which is good news, because that’s painful.”

Great!

“Jenn, while I’m here, can you take a look at the scaly skin around my eyes and nose?”

“Sure! Exczema. Normally I would prescribe a steroid, but that’s not recommended during pregnancy. You’re a mess, huh?”

Jenn was not like the yo mama midwife. As she gamely told me what a wreck I was it felt like we were in on a little joke together. I know, I’m a disaster! And there’s no hope except to push this baby out in June. Until then we’ll watch as my body falls apart from the inside out! Ha ha ha ha ha!

As I was leaving, I picked up my purse, and Jenn saw the giant pound of strawberries sticking out in its grocery-store container. “I couldn’t eat breakfast, so I just shoved those in my purse,” I said.

“Evelyn, you’re a mess!” she laughed.

It’s nice to have an official diagnosis.

***

Epilogue:  Last night at dinner I got another nosebleed in spite of my precautionary work. It was a bad one, and I got really overwhelmed. Having blood spurt uncontrollably out of your nose and onto your clothes will do that to you.

“I should… have bought… tampons,” I sobbed to my husband, hoping he would run out to the store to brave the feminine products aisle so that his incredibly pregnant wife could shove tampons up her nose.

He would have, but we located a box at the back of my cabinet, and now we’ve stashed them around the house ready for my next nosebleed. So if you come over, that’s why three men and a pregnant lady are using tampons for home decor these days.

Yo Mama So Fat…

Weight gain during pregnancy is a touchy subject.

If you’ve been with me for a while, you might remember the fruit midwife from Baby Woww’s pregnancy. She was worried I was having too many milkshakes. So she did a little PSA about how fruit grows on trees and that in Oregon they sell it at these magical places called farmers markets.

“Maybe you could try boysenberries…?” My response was something like, “Maybe you could stick your wet fingers into a light socket.”

I eat a really healthy diet, and I figure when you have the duty of carrying around a little gremlin, or Furbie, or Fairy Pig for a while, you should be able to treat yourself.

Not surprisingly, in this wild and crazy round three, we’ve upped the midwife ante.

I didn’t gain much weight the first twenty weeks; I was really nauseous. I also started the pregnancy kind of underweight. Anyhoo, the last four weeks I’ve been feeling sloth-level tired, and emaciated-lion-level hungry. Still, I maintain my low-grains, low-dairy, low-sugar diet that is high in veggies and protein. I started this diet overhaul last year in the throes of recurring bronchitis.

But Midwifey’s scale don’t lie. And when I went in last week it said I’d gained 12 pounds.

I was seeing this particular midwife for the first time. Let’s call her Minka. “Twelve pounds in four weeks,” she said. “You know, when some people stop being nauseous, they start eating everything in sight. Have you been eating a lot?”

It was kind of like her saying, “So your husband likes a little meat on his bones, eh?”

I was taken aback. I imagined the midwives at their midwife meeting, discussing the question “What do you tell a patient who is gaining too much weight?” Minka answers, “I start telling ‘yo mama’ jokes. She gets the point.”

I answered her: “Yes, I’ve been eating a lot: I’m hungry. But I eat a really good diet, and I don’t eat a lot of sugar.”

At this point, K-Pants, who along with Baby Woww, make the most terrible tag-along medical appointment team in the world, shouts, “That’s not true! You eat treats!”

Like what, man? Granola and vegan cashew cream? The one ice cream sundae I had in March? Please! Stick to fighting with your brother in the corner instead of ratting me out.

“I do eat a lot of fruit,” I admitted.

“Fruit has lots of sugar.” She decided my high intake of apples and oranges probably wasn’t the problem. It was bananas. “They’re very high in sugar.”

“But I eat them as part of kale smoothies.”

“Well, be careful. We don’t want to see this kind of weight gain again.”

At this point I was mad. I’d just had to do that horrible gestational diabetes test where you drink a disgusting sugar syrup so the medical team can measure your blood sugar. Now I was being told that I was ballooning out of control because of the four bananas a week I eat.

“I’m not changing my diet,” I said.

“Well, maybe you could exercise,” she countered.

“I have a bad cold and I’m constantly exhausted,” I said.

“Well you do have to kick that, first.”

Ha! I’d won!

This being March still, I felt like we were in the last 45 seconds of the second half of a Sweet Sixteen game. It was all stategery and a well-placed zinger. I was going to keep my unsweetened kale, tofu, zucchini, banana, and apple smoothies, dammit. This woman was cray cray. It helped my cause that the gremlins were frothing in the corner and she knew that with a word I could unleash their snotty noses and sharpened incisors.

But when you see me next, feel free to say, “So Evelyn, when you sit around the house, do you sit around the house? [Nudge, nudge.]” According to the midwife, this kind of thing is a sure winner where pregnant ladies are concerned.