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Why anxiety in pregnancy must get more attention

3/19/2016

23 Comments

 
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I have not slept for one year – she told me with tremulous lips. As usual, the resident had breezed past her antenatal history and not got much detail.  She was now admitted with a postpartum psychiatric disorder.

But there was something in her story which made me ask her questions about her pregnancy.
I did not plan this child, she said. I already had four daughters. With every daughter came concern- what will my in laws say? My poor husband was supportive. He worked hard to support all of us- but another loss of face?  I thought I was letting him down by not having a son. My mother in law’s angry face and taunting remarks- I had no energy to go through all that again.

​She went on- My youngest was just 8 months old and this pregnancy happened. For the longest time, I didn’t even realize I was pregnant and when I did, it was too late. The doctor told me she could not do anything- `go and pray that it will be a male child’- she told me.
Since then, my nights and days are filled with anxiety. I worry and worry. Thoughts circle incessantly around my head- what if it will be a girl? What will people say? how will my husband feel?

I did not want to go to any antenatal care. I did not want a scan. I did not take any supplements. It was pure dread- what if?
All night I would toss and turn. All day I would look at the faces of my lovely daughters and wonder - why this pressure on me – and on them?
I could not care for my infant daughter, who still needed me even though my belly was again full.
When I reached term, one day, I felt giddy and then I lost consciousness. I woke up in the hospital and touched my belly. It was flat. I was told I had two `fits’ and my BP was high.
But they told me I had a boy child. He was just one and half kilos and was in the ICU.
There was relief - but no happiness.
My son is now three months old. And all I do is worry. I shake him when he is sleeping to see if he is breathing or not. I worry that he will fall ill. I have no help. My mother in law for whom I had this child, hardly helps.  I started housework 15 days after my Caesarian section. No postpartum rituals or `banantana’ for me. When he feeds from my breasts there is some joy. He is a good child but I worry that my milk is not enough. That he will not get enough nourishment.
I am angry and anxious and worried all the time.  There are times I wish I could just curl up and sleep for days together- without the dread.
 I slept for the first time in a year after coming to your hospital.

Anxiety in pregnancy is an under recognized and under treated problem. It is much more common than what people think. Anxiety is often specific to pregnancy- about pain, loss, abnormality, sex of the child, labour or the mothers own health.
Untreated anxiety may lead to low birth weight in the infant, pre term delivery and more complications.  The mother may neglect antenatal care leading to pregnancy complications.
Antenatal anxiety is a strong predictor of postpartum depression or anxiety.
Anxiety in pregnancy is treatable so should be detected early
​
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    About Author

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    Name: Dr. Prabha S Chandra
    Gender- Female
    Profession- Medicine, Psychiatry
    Occupation- Professor of Psychiatry
    Location - Bangalore, India

    Why this blog?- The purpose of this blog is to write about the topic that I am most passionate about- mental health issues related to childbirth and the mental health of mothers.

     I will write about my experiences as a perinatal psychiatrist in the last 15 years, the jubilations and trials in my job, patient experiences and stories ( complete confidentiality assured), the latest medical news in the field and important links and websites that you folks may want to visit.

    I will invite guest bloggers who are experts in their respective fields to offer to you their stories and words of wisdom.

    Through this blog I hope to reach out to the countless mothers and fathers who have struggled or are struggling with mental health concerns related to childbirth, for those who overcame these struggles and for those husbands and family members who helped them.

    I hope you will accompany me into this journey of stories, musings, my own dilemmas, the stories of my great colleagues and also the grit and courage of my wonderful patients who are determined to survive.

    My Not so Professional Bio-

    I adore babies and dogs. I enjoy writing about things that I feel strongly about. I am passionate about books and travel.  

    I believe in recycling; in the goodness and strength of all human beings; in listening to patient’s illness narratives and stories.

    I enjoy teaching young students and listening to their insights. I feel medical ethics is a neglected subject and strive to discuss it whenever possible.

    For me, motherhood has been the most rewarding experience of my life,  from which I have learnt to be honest, patient, non judgmental, accepting, modest, brave, funny and a combination of being a Tiger Mom and a Teddy Bear Mom as the situation demands!

    I would like to make motherhood as stress free as possible for women who are already struggling with mental health issues and hence this blog.

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