COVID; Mental Health; Your Pregnancy Matters
Tips to manage 'pandemic pregnancy' stress
April 21, 2020
Some pregnancy-related stress is expected: Is the baby growing properly? Am I eating healthily enough? Will these stretch marks go away?
But during a "pandemic pregnancy," patients' stress levels might be much higher. As COVID-19 continues, patients tell us they're worried about how pandemic-related stress will affect their family's long-term mental and physical health.
How am I going to keep up with the kids’ school assignments from home? Is my job safe? How are my elderly parents doing with the recommended shelter-in-place rules? Are my allergies really a sign of COVID-19 infection?
A KFF Health Tracking poll conducted March 25-30 reports that 45% of U.S. adults are stressed about the pandemic's negative impacts on their mental health. And 24% of women rated the impacts as "major."
Our Ob/Gyn patients have reported more anxiety about typical pregnancy concerns during the past few months, likely due to concerns about the virus. They're worried about how the virus might affect their pregnancy, delivery, or their family's health.
It's normal to have fears and questions in uncertain times, and we are here to support you. I've invited Yaprak Harrison, M.D., Ph.D., a volunteer clinical faculty member at UT Southwestern, to help answer some of those questions and offer stress-management tips for a more peaceful pregnancy during the pandemic. First, a few questions:
Children and teens are experiencing distress in response to social isolation and other significant changes in their daily and academic routines. Children need their parents' help during such a difficult time. If we can patiently listen to their worries and encourage them to express their feelings, it will reduce the effects of stress.
By providing routines and predictability, parents can promote resilience and enable their children to better cope with higher levels of distress.
Set aside time every day to talk with your children. Try to acknowledge their feelings, and answer their questions in a simple, age-appropriate way. Do your best to develop routines that establish a sense of normalcy. For example, return to a bedtime schedule that is relatively close to what they were used to before. Kids thrive on predictability, which can be comforting as they adjust to their new normal. You can also include them in daily activities, such as cooking, cleaning, and exercising.
Related reading: COVID-19 and pregnancy: Answers to 10 key patient questions
Ample resources are available online to help you create structure and communicate with your kids during the pandemic. I recommend this guide from the Center for the Study of Traumatic Stress as a place to begin.
The quarantine could also be an opportunity to teach a different set of values that often escapes us amidst the responsibilities of our busy lives. Demonstrate the value of paying attention and really engaging with one another. Sharing emotional states – from laughing and playing to enduring boredom and frustration together – is central to healthy human development.
Keep in mind that children often react to stress differently than adults. Kids might become needy, confrontational, or less interested in their favorite activities.
Stress can cause children to temporarily revert to thumb-sucking, bedwetting, or having nightmares. Try to be patient – the added stress of you getting upset can make the situation worse for your children. Take care of yourself and attend to your needs to de-stress.
Also, children with preexisting anxiety, depression, or other mental health conditions could experience worsening symptoms during this stressful time. The same is true for adults.
A history of anxiety, depression, or trauma can lead to higher levels of distress throughout the pandemic. If you have a preexisting mental health issue, watch for symptoms such as these that might indicate worsening of the condition
- Increased general anxiety
- Impaired sleep
- Changed perceptions of safety
- Anger or scapegoating
- Risky behaviors, such as substance use
Physical or social isolation can increase mental health risks. Especially during the pandemic, it's important to self-monitor and check in with trusted loved ones to help you recognize mood changes.
If you notice changes, connect with your doctor before symptoms get worse. You likely won't have to risk exposure going to the doctor's office – at UT Southwestern, 100% of our psychology and mental health services are available as virtual visits.
Gyms and parks are closed, and “shelter in place” means even walking or running outside is limited. But there are plenty of pregnancy-safe exercises you can do indoors without equipment.
Yoga is a great option because it combines strength training and mindfulness to work the body and ease stress. Get the whole family to participate – search for free yoga programs on YouTube for kids and adults. There are also many free apps and instructional videos online to guide you through simple cardio and stretching routines.
Listen to your body and report unusual aches or pains to your doctor. And cut yourself a little slack. In this stressful time, don't worry about breaking personal records. Make healthy movement and self-care daily goals until the pandemic is over.
Related reading: Yoga and pregnancy: A safe, effective fitness option for moms-to-be
Take a virtual tour of labor & delivery suites
As part of our COVID-19 emergency response, tours of the labor and delivery and postpartum areas at William P. Clements Jr. University Hospital have been temporarily suspended. This video provides of preview of the accommodations for new moms and their families.
Self-care tips for a healthier 'pandemic pregnancy'
Relax your body by practicing breathing exercises such as stretching, meditating, or engaging in mindful movements. Mindful movements include slow, intentional activity such as walking, yoga, or exercise.
Practice simple mindfulness techniques, such as a breathing exercise – for example, a technique called “4-7-8.” This technique involves sitting comfortably with good posture and counting with the “in breath” to four, holding your breath to a count of seven, and exhaling to a count of eight. Do this four times and breathe normally, practicing as needed.
Mindfulness has been found to help relieve anxiety, depression, and stress during pregnancy. Research also suggests that mindfulness during pregnancy could positively affect babies after birth by reducing maternal anxiety.
Eat a healthy diet
Comfort foods have their place during crises. But remember to stick to a healthy diet, including fruits, vegetables, and lots of water to drink.
Related reading: Quarantine cuisine: Easy meals to support a healthy immune system
All pregnant women should avoid using alcohol, tobacco, and other drugs. If you've struggled with substance use, the stress of the pandemic can increase cravings. You might consider joining a virtual support group such as Alcoholics Anonymous or Smart Recovery.
Get enough sleep
Sleep resets the body and mind, supporting our immune systems and our mental health. Both are particularly important to take care of during pregnancy.
Pregnant women need seven to nine hours of sleep a night. Establish a good sleep routine to help achieve this goal:
- Go to bed at a consistent time every day, even on the weekends.
- Avoid caffeine a few hours before bed.
- Shut off devices at least two hours before you go to bed.
Limiting device time reduces light stimulation, which can make falling asleep difficult. It also reduces opportunities to feed the "worry loop" – when your stress relief method ultimately causes more anxiety, as when, for example, you’re perusing Facebook for funny memes and stumble across a distressing COVID-19 story.
Related reading: Tips to get better sleep during pregnancy
Physically isolate but stay social
Human connection will help reduce symptoms of anxiety, depression, boredom, and loneliness. Though we can't physically be with loved ones right now, we can connect in other ways.
Consider using Skype, FaceTime, or another video chat service to visit during the pandemic. Seeing each other's faces can be reassuring and calming. Text and talk on the phone with a supportive family member or friend regularly – use the time to brighten each other's day or to share your concerns.
Virtual social groups are booming as well. You might enjoy a hobby- or fitness-focused online group that offers fun ideas to craft or work out indoors. Just be cautious of getting medical advice online. Social media influencers often are paid to endorse products and services they don't use or know enough about, which could potentially be detrimental to your pregnancy.
Managing stress is important for any pregnant patient, and that's especially true during the pandemic. Remember – you are not alone. We are here to support your mental and physical health in this challenging time.