By Sade Oguntola
Everyone feels anxious sometimes. Even in pregnancy, it is natural to feel a bit anxious. But for some women, thoughts about the health of the baby, the delivery experience, or how the baby will affect their relationships with friends or family members may become obsessive, even when doctors are reassuring.
Basically, in humans, a certain amount of anxiety is protective; in fact, these worries in these women are completely normal. But when it starts to also appear as physical symptoms, such as a rapid heartbeat, difficulty breathing, or panic attacks and interfere with day-to-day functioning, relationships, or job performance, it becomes a cause for concern and may require further attention.
Dr. Imran Morhason-Bello, a consultant obstetrician and gynaecologist at the University College Hospital (UCH), Ibadan, describes excessive anxiety that happens during pregnancy as a common concern that can have negative effects on mothers’ mental and physical health as well as the health of their newborns.
Although pregnant women may experience excessive anxiety for different reasons, he declared that it is more common in women with their first pregnancies, those who have had a traumatic birthing experience, miscarriage or stillbirth, or women with pregnancies in old age or with a previous mental health illness.
Furthermore, pregnant women informed that their babies will be delivered via caesarean section are more likely to be anxious.
According to him, “the excessive worry in these women may appear as physical symptoms such as a rapid heartbeat, irritability, restlessness, feeling dread, chest pain, shortness of breath, sweating, feeling faint, an inability to concentrate, and difficulties falling asleep due to worries.”
Studies on excessive anxiety have been found to complicate 10 to 40 percent of the pregnant population and suggest that it may negatively affect both the mother and the fetus. Anxiety increases the risk for preterm birth, low birth weight, earlier gestational age, and a smaller head circumference (which is related to brain size).
Antenatal anxiety is also associated with future emotional and behavioural problems in the children of such mothers.
Fortunately, there are many treatments that can reduce anxiety during pregnancy and help you feel better. For many women, anti-anxiety medication is not an option during pregnancy, as there is little information on the safety of such medication for the unborn child.
Dr Morhason-Bello said things that have been found to be helpful to alleviate anxiety in pregnant women include regular physical activity, adequate sleep, practicing mindfulness, writing down the worries to brainstorm on potential solutions and concerns, as well as the end of exercises such as yoga.
However, he said that exposure to childbirth audiovisuals did not result in a significant reduction in anxiety levels, and it may possibly have some negative effect on first-time mothers.
“Findings in our study showed that exposure to childbirth educational audiovisual materials might increase the level of anxiety in the early postpartum period, contrary to the widely held view. Although the observed increase in postpartum anxiety was marginal and statistically insignificant, this may suggest that the use of audiovisual material as a counselling tool may increase the anxiety of pregnant mothers.
“The audiovisual materials presented to pregnant mothers covered only the second stage of labour and delivery of the placenta. The childbirth video may have created a painful and difficult scene, which could heighten the anxiety levels of first-time mothers.
“Second, most women in the experimental group presented in an advanced stage of labour than the control group, which, expectedly, is associated with higher anxiety levels.”
A randomised controlled trial was conducted at the University College Hospital in Ibadan, Nigeria, among first-time mothers (primigravid). It was documented in the 2021 edition of the African Journal of Medicine and Medical Sciences.
A total of 120 pregnant women were recruited, with 115 participants followed up till birth and included in the analysis based on the intention to treat (ITT) analysis. The experimental group watched a documentary video of the childbirth process during the antenatal period, while the controls did not.
Dr Morhason-Bello stated that regardless of the fact that the study did not account for other likely causes of anxiety that may have occurred during the second stage of labour, such as adverse psychosocial life events and other unpleasant experiences that could have swayed the outcome of anxiety assessment, this emerging practice of watching audiovisual materials about the second stage of labour within the context of Nigerian maternity settings needs further assessment of its potential benefit.
He also declared that it is important that women who feel anxious a lot or have panic attacks during pregnancy ask for help and find ways to manage the symptoms.
“The more they know about their mental health history, the better they can support them during pregnancy. The doctor or nurse won’t criticise or judge you for having these feelings. They know this happens to many pregnant women, and they will focus on finding the right treatment to help the woman recover,” he added.
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