The second part from her series introducing us to maternal mental health, we welcome back Anne Marie McKinley who is a Midwife and Birth Trauma Specialist at Afterthoughts NI. Here, Anne Marie explains how pregnancy is an opportunity to influence the future mental health and wellbeing of baby before birth and shares simple strategies to build resilience and interestingly, how imagination and visualisation can be of benefit.
The influences of external and internal factors on the health of the developing fetus and a growing baby have been widely researched. The belief that investing in psychological support for women who have mental health diagnoses and who report symptoms of depression or anxiety in pregnancy has evolved. Midwives, on booking, are encouraging women to appropriate pathways when symptoms are revealed. The importance of self-regulation, supportive environments, GP input, and psychological care are more prominent now than at any other time in the history of maternity care.
This is a cause for celebration because much can be done in ordinary terms to alleviate symptoms. In therapy, or a counselling environment, it is important to provide hope. Many women are stressed for very practical reasons, and the addition of becoming aware that this may have an influence on a growing baby in her uterus can add to existing worries and concerns.
On one hand, this feels burdensome. If women experience depression or anxiety in pregnancy, they are not on their own as one fifth of women suffer from one or both of these conditions in their pregnancy.
Realistic acceptance of symptoms, and a genuine attempt to work at reducing them, is a good plan. Developing confidence in yourself to be able to manage symptoms, and to believe that your body was designed to hold and manage all kinds of concerns may seem to be a little impossible.
However, this can create an opportunity for self-care, stimulated by a desire to create a healthy growing environment for baby. This correlates with work done by Dr Daniel Siegel. He asks therapists to listen to another person saying No or reading the word No, 7 times. He then asks them to repeat the same exercise but this time repeating the word Yes. He reported on how people feel, when they hear each word. Associations with No included anger, a physical restriction in the abdomen, fear or shutting down. The responses to Yes were the opposite, creating a reactive positive state, feeling sensations of freedom, relief or release. (Siegel, 2010). 1
We know that both genetics, epigenetics and life circumstances influence baby’s development. It is still important to view pregnancy as an opportunity to influence the future mental-health and wellbeing of baby before birth.
Chemical changes accompany anxiety responses. Corticosteroids constrict blood vessels. It is possible to give a growing baby a reduced stressful environment simply by being proactive and beginning to allow yourself to believe you are the one who can make this difference (Poulin, 2013). 2
Strategic pathways that work well together are:
1. Be pro-active about moving that adrenaline response along.
2. Become body and mind aware.
3. Recognise in any given hour or day how often there is a surge of anxiety or a dip in mood.
4. Make a plan. Try one or more of the following each day and add extra as resilience grows:
- Offer the mind 30-minute spaces throughout the day when it can worry or feel these authentic feelings of anxiety or sad and bad. It’s always important to be authentic. Truth is… life can be hard.
- Say yes and thank you to your body – ‘You have all I need to do this.’
- Try breathing exercises for 60 seconds, in response to a surge of anxiety or feeling despondent. Try breathing in for 5, and out for 5. If you add tapping on your knees, or collar bone, you start to occupy the brain. Your mind slows down, the breath helps you to switch from ‘stress’ to ‘coping’ and the tapping helps to move the negative hormones along.
- Gratitude is shown to increase happiness over time. Saying thank you or being thanked gives your body a positive shift in hormones. Find a notebook and make notes every day of what makes you happy. Look for joy in small things.
- Use your imagination to help you communicate with your baby, Offer a greeting to your growing baby. Send love through the blood system. Imagine as you think about your baby, warmth or love moving along the neural pathways. Imagine your baby receiving your greeting.
- Offer yourself five reasons daily, to be kind to yourself. Offer yourself a smile and a ‘well done’.
- Make plans to accommodate difficult days. Call a friend. Alternate rest with walks or gentle exercise.
- Speak with professionals if your feelings are overwhelming or persistent. Medication is often a better alternative to the level of sad or anxiety you are experiencing. It’s good to talk it out and it is helpful to ask your midwife or GP for advice. Make sure that others know how you are feeling.
- The Mindful Therapist: A Clinician’s Guide to Mindsight and Neural Integration By Daniel J. Siegel Norton, New York, 2010
- Michael J. Poulin et al., “Giving to others and the association between stress and mortality”, American Journal of Public Health, September 2013
- The Upside of Stress: Why stress is good for you (and how to get good at it) by Kelly McGonigal Vermilion London 2015
A growing list of other support, weekly: