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Why Managing Your Anxiety During a High-Risk Pregnancy Isn't Working (and what to do instead)

Imagine you’re afraid of flying.

Your anxiety has been creeping up as you approached the day of your flight.

The smell of the cabin as you enter the aircraft triggers a wave of anxiety. You associate that smell with every other time you’ve flown, when you’ve felt unsettled until you were back on the ground.

As the plane prepares for takeoff, you’re aware of every single sound. Being thousands of feet up in the air, all you hear are the clicks, bangs and whirrs of the plane, sounds that you’re convinced are the early warning signs of bad things to come.

You think about all of the horrible things that could go wrong with the aircraft and those thoughts fuel your anxiety even more.

You know you’re overreacting. Your friends and family have told you so. Your therapist has given you tools to keep you calm on your flight.

Deep breathing, mindfulness meditation exercises and positive mantras to help keep you calm until your back on the ground. They work to a degree or maybe you need to take some medication but you find your way to calm yourself enough until you breathe a sigh of relief once you’ve landed.

Now imagine a different scenario.

You get on a plane, ready for a flight. Every flight you’ve taken has gone smoothly with no problems. Sure, maybe a few flights here and there had some turbulence that shook you awake, but otherwise you give no thought to flying other than making sure you have enough in-flight entertainment to keep you occupied.

You’re over 30,000 feet up in the air and out of nowhere you hear a noise. You tell yourself it’s nothing. Planes make sounds all the time.

You go back to your book when you feel the plane jolt suddenly. Oxygen masks drop down, which you’ve only seen while half-watching the cheesy pre-flight video they show about emergency procedures.

You realize the sounds you hear aren’t normal airplane engine sounds. They’re the sounds of something actually going wrong with the plane. Your heart stops. You can’t feel your hands and you don’t even know if you’re still breathing.

Imagine listening to a guided meditation telling you to breathe deeply to calm yourself as you feel the plane dropping in altitude.

Seems ridiculous, doesn't it? That’s because it is.

This is the difference between the emotional experience during a healthy pregnancy and that during a pregnancy with complications.

There’s a very real difference in the stress experience for women who have typical pregnancies versus those who have high-risk pregnancies.

The anxiety of a woman who is worried about developing preterm contractions even though she’s never experienced them and has no risk factors for developing them is entirely different than the fear experienced by a woman who has a history of delivering at 26 weeks due to an incompetent cervix, is pregnant now and feeling tightness in her belly.

Both of these women’s emotions are valid and need to be taken seriously because the stress caused by both situations does affect pregnancy health. But the approach to help each of them is entirely different, and not something many providers in the obstetric, women’s mental health and birth-work fields realize.

It boils down to this one thing.

During a high-risk pregnancy, you are having a very visceral, biological reaction to protect your baby, as any mother of any animal species would. You’re also worrying about all of the other things that can go wrong beyond the challenges you’re already facing.

Both of these are triggers for a physiological stress response in the body. That stress response impacts your immune system, making you more susceptible to infections and increases inflammation in your body, which has been associated with numerous pregnancy complications including preterm delivery.

The solution is to realize that there are 2 issues at hand during a high-risk pregnancy that require two different management styles.

One is the generalized worry that anything and everything could go wrong, even if there is no evidence to prove that it could. This is what what we mean by “anxiety”. This is what you feel in the first airplane example.

This apprehension is very often fueled by, the second and more pervasive issue during a high-risk pregnancy - fear. Fear is the reaction that you feel because something is already going wrong, like in the case of a crashing plane. This is the feeling you have when you realize this is not a drill.

Though the words are frequently used interchangeably, anxiety and fear are two distinct emotional experiences. Anxiety is future-focused and fear is present-focused and instinctive. (Tweet that!)

Both anxiety and fear influence each other so there is often significant overlap

Anxiety is managed effectively by many tools any therapist or mental health counselor can teach you. Meditation, mindfulness, breathing exercises and challenging your thoughts are excellent at helping you feel calmer. This is often the path most women take, which is great for managing anxiety, but I hope you can now see that it's addressing only part of your emotional experience.

Fear, what most women with a high-risk pregnancy feel, won’t respond to these tools because fear is an involuntary, biological response to be on high-alert when your baby’s life is endangered in any way. There is nothing pathological about fear because your body is designed to fight for your baby’s life, which is exactly what you’re doing.

Our bodies are only meant to feel fear in short bursts.

However, a high-risk pregnancy goes on for months, which means your body is under tremendous stress for an extended period of time - something it is not meant to know how to handle.

This is why feeling fear for the duration of your pregnancy triggers a stress response in your body that can impact the health of your pregnancy.

All this to say, fear must be dealt and must be managed with differently than anxiety for a safer pregnancy. (Tweet that!)

This is why maternal wellness is so critical to a healthy pregnancy even if you have complications.

By sleeping better, improving your relationships, eating healthier, and effectively addressing your worries that fuel the never-ending “what ifs”, you’ll dampen the biological stress response that has been shown to affect your pregnancy. Though your fear will still be present, it won’t consume you to the point of insomnia or unstoppable tears, which is essential to relieving the physical stress and tension from your body.

By strengthening your body and quieting that stress response, you’ll be better equipped to handle the days you have a bleed, receive concerning ultrasound results or feel contractions too early. The result is you won’t feel smothered by overwhelm for days at a time after you have a bad day.

Both fear and anxiety are manageable during a high-risk pregnancy

You are not as helpless as you feel with these emotions and with knowing the distinction between the two is critical to you receiving the right support for a healthy high-risk pregnancy. (Tweet that!)

If you’d like to know more about how I can help you cope with your fear and stress so you can focus on bringing home a healthy baby, let’s talk! Also, check out Pregnancy Brain to learn how managing your anxiety can improve your overall pregnancy health, even if you have complications!

How does fear versus anxiety show up for you in your mind and body? Do you notice any similarities and differences? Leave your comments below. I would love to hear from you!

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