- Fears and worries during pregnancy
- How a perinatal psychologist can help
- Problems with conception
- Methods of work of a perinatal psychologist
- How to choose a perinatal psychologist
Psychological comfort during pregnancy, the joy of anticipation and calm preparation for childbirth - a perinatal psychologist will help you achieve all this.
Perinatal psychology, as a separate direction, originated in the 80s of the twentieth century. Today this is one of the youngest and most promising areas in psychology. A perinatal psychologist accompanies couples at the stage of planning a child, accompanies a woman during pregnancy, helps prepare for childbirth, and also provides psychological assistance if the pregnancy ends sadly.
Fears and worries during pregnancy
Pregnancy for a woman, on the one hand, brings a lot of joy in anticipation of a miracle, but on the other hand, fears and anxieties worsen, new ones are added, especially if it is the first pregnancy. The expectant mother is worried about how it will be, what to do, how to behave correctly, and take care of the health and well-being of herself and her baby. At such moments, she urgently needs support and help. And it’s good if it comes from a professional: clear, accurate, competent information will give confidence against the background of signs, beliefs, opinions and speculations that inevitably surround pregnant women.
What are the main fears a woman experiences during pregnancy? The most common fear is the fear of change. The expectant mother is worried that her body and lifestyle are changing, and it is unclear what will happen to her work and relationship with her husband. Next comes fear, physiological fears, anxiety before childbirth, worries that you won’t be able to cope with the child, etc.
The help of a perinatal psychologist is precisely aimed at helping to cope with these fears.
Fear always has clear outlines. It is very important that a woman can voice her fears to a specialist and receive competent answers to her questions. It often happens that expectant mothers have inaccurate information. Where does it come from - women's forums, the experience of women I know who have given birth, the family experience of mothers, grandmothers and other relatives.
But only a specialist can give reliable information!
Fears of pregnancy
Every woman living in the modern world has fears and anxieties around pregnancy and childbirth. Some of these fears are conscious, some remain unconscious.
Some anxieties are fueled by social attitudes and prejudices, some by one’s own family and significant others.
The quality and quantity of anxiety is influenced by the entire developmental background of the expectant mother, which can outweigh the positive aspects associated with satisfying the desire to have children.
Pregnancy and childbirth are a moment of crisis. But a crisis presupposes not only the disorganization of internal and external habitual life, but also the opportunity to gain new experience: bodily, psychological, relationship experience.
Pregnancy and childbirth revive a woman’s experiences of her own birth and infancy, reviving childhood fears and fantasies. The feelings of an adult woman are intertwined with fantasies and hypotheses regarding her own birth and the relationship between parents.
Experiences related to how loving and supportive the parents were at the time of the birth of the child come to life. Disappointment in the parent couple, mourning their imperfection, irresponsibility or outright “badness” often accompany the prenatal and postpartum period. As a result, relationships with parents in reality may worsen.
Pregnancy is also the final step in establishing one's feminine identity and the final separation from the mother. When a child is born, a woman internally becomes equal to her mother - now she is also a mother, she also gave life.
The main conscious fears before pregnancy center around the worry of not being ready for the birth of a child:
- do not have a stable family, financial and social situation or have lost it,
- fear of dependence or return to a dependent position,
- fear of being a bad mother or giving birth to an unhealthy child,
- fear of taking on someone else's part (male).
Sometimes these fears can be so intense that they prevent a woman from becoming pregnant.
During pregnancy, fears may increase or decrease - much depends on the environment of the pregnant woman. A favorable environment allows you to feel serenity and concentration on your condition and the child, and fantasize about his appearance. An unfavorable , unsupportive, overly anxious environment can provoke unreasonable anxiety in a woman expecting the birth of a baby.
Approaching childbirth also brings us closer to our most intense fears: death, pain and separation.
Pregnancy using the IVF method has its own characteristics. Women seeking help are faced with the need to accept the fact that their own pregnancy is impossible. Acceptance and awareness of the impossibility of independent pregnancy leads to a change in self-image. A period is needed during which the loss of the old female image is mourned and a new one is created, into which infertility and the painful experiences associated with it are integrated. There must be acceptance of assistance in the form of IVF as an integral part in the process of fertilization and pregnancy. It turns out that you need to come to terms with the fact that the most intimate process in a couple’s life will be changed, subject to invasion and control.
The IVF situation suggests that pregnancy should be objectified, i.e. one’s own body, reproductive organs must turn into something external and be experienced as an object with which actions and manipulations are performed. This does not happen during a natural, uncomplicated pregnancy. For example, in a situation of injury, when you need to perform some kind of manipulation with the wound, you need to make the injured organ an object, separate it from yourself, so that it is possible to do something. The surgeon treats the body of the person being operated on as an object, but when it comes to his relatives, it can be extremely difficult to do this, which is why the tradition has developed of not operating on one’s relatives.
Therefore, preparation for IVF is necessary, including psychological preparation, in order to avoid the horror that arises in the situation of transition from oneself as a subject to oneself as an object.
Generally speaking, any child experiences curiosity and fear in relation to the genitals of his parents, trying to unravel the mystery of his birth, how he was born. Children's fantasies about how conception and birth occur can be frightening and even terrifying. And as we grow older and experience and information appear, some of these fantasies are transformed, while others remain unchanged, hidden from consciousness. And this hidden part can, under conditions of unhindered conception, remain in the unconscious and not reveal itself in any way.
In an IVF situation, when there is a lot of uncertainty, various anxieties and doubts, it becomes easy to actualize these childhood experiences.
In my work, I hear many stories about how, as children, my patients experienced horror or disgust when they became unwitting witnesses to the sexual relations of their parents, and how then a friend, sister or someone else added their explanations, sometimes no less frightening, confusion and rejection of these relationships.
Sometimes in family history, most often in the mother’s family, there are tragic, psychologically “unprocessed” events driven into the depths of consciousness that influence the next generation of women. More than once I have heard from patients experiencing problems with conceiving and bearing a child, family stories about how mothers, before their birth, lost a child as a result of unsuccessful births or problems in the postpartum period. Having given birth after this, the mothers, afraid of another loss, were in severe anxiety, which was transmitted to their daughters, and also overprotected them, practically not giving them space for psychological growth and development.
However, thanks to the analysis and “disidentification” of themselves with their mother, these women gained hope for a successful outcome of the birth and a meeting with their baby.
The participation of the child's father in childbirth gives many women additional support and a sense of psychological connection within their family.
How a perinatal psychologist can help
Many questions arise in a woman already at the stage of pregnancy planning. Is she ready for motherhood, can she cope with the role of a mother? The specialist assesses a woman’s psychological readiness for a new role, gives answers to pressing questions, discusses fears and doubts, and helps to cope with them.
A psychologist can diagnose the family system. This diagnosis helps to find out whether the family has the necessary psychological resources that will be needed after the birth of the child.
The specialist works with pregnant women and at the stage of assistance in the delivery room, accompanying them to the operating room (if a caesarean section is planned), if the woman has a need for this. Consults the future father (if the birth is a partner), helps relieve anxiety, alleviate feelings, and advises on non-drug methods of pain relief.
At the postpartum stage, psychoeducational work takes place in terms of which changes in a woman’s psychological sphere are the norm and which ones should be paid attention to.
The development of modern medicine has led to the fact that a person is considered as an individual in terms of biological, psychological and social well-being. It is important that not only physiological parameters correspond to the norm, but psychological health is in order. When a woman is in a state of stress, anxiety, anxiety, a number of biological substances (hormones and neurotransmitters) are suppressors, that is, they suppress the action of other hormones that are important for the successful course of childbirth. A comfortable emotional state is the key to ensuring that a woman’s birth process goes as smoothly as possible.
Which fruit is considered large?
It is considered normal if a child is born weighing up to 4 kg and height from 48 to 54 cm. If at the time of birth the child weighs from four to five kilograms, doctors talk about a large fetus. Although this does not take into account the height of the child. Large babies are also superior in height, reaching up to 56 cm at the time of birth.
According to statistics, the number of large children accounts for 5–10% of all pregnancies. Doctors believe that this is due to improved living conditions and nutrition of pregnant women. Cases of the birth of children weighing more than five kilograms are also known, but they are few in number.
Problems with conception
When both partners are healthy, but pregnancy still does not occur, perhaps the problem lies in psychological health.
If you have problems conceiving, many doctors advise you to “let go of the situation,” believing that the problem is in your head. A perinatal psychologist helps to identify negative psychological factors: stress, internal conflict, depressive feelings and work through them.
He does this with the help of psychodiagnostics: a woman’s relationship with her own body is examined, the type of psychosomatic response is established, internal conflicts are examined, the level of stress is diagnosed, the motivation for pregnancy is examined, and much more.
And based on the diagnostic results, you can see what problem will need to be worked on.
Specialist help may also be needed in case of perinatal loss, as well as when using IVF.
Causes of a large fetus
In fact, there can be many reasons for the development of a large fetus. Some are related to heredity, some may be an echo of health conditions or previous lifestyle. The most likely reasons are:
1. Pregnancy lasts longer than expected.
Sometimes the due date was set incorrectly, and the baby is born 10-12 days later, but completely healthy. There is also a true post-term pregnancy, in which the placenta ages, the amniotic fluid acquires a grayish tint, and the baby may experience wrinkling of the skin.
2. Diabetes mellitus.
Women with diabetes should be examined more thoroughly during pregnancy than others. Statistics show that such women are more likely to have a large child.
No later than 32 weeks, such women should be hospitalized in order to be under constant medical supervision. After a thorough examination, a decision is made on the due date. If the fetus is large and the patient has diabetes, the question arises of artificially inducing labor at 36 weeks (not earlier). Doctors can make the same decision if a woman’s condition worsens, there is polyhydramnios, gestosis, or a decrease in blood sugar levels. During childbirth, the presence of a therapist is required, who monitors sugar levels and decides on the administration of insulin.
3. Hemolytic disease.
This disease occurs due to Rh conflict between the child and his mother. It can develop due to a negative Rh factor of the mother and a positive Rh factor of the baby inherited from the father. The child's hemoglobin level in the blood decreases, jaundice appears, the liver and spleen enlarge, and fluid accumulates in the body cavity. This causes swelling and excess weight.
4. Heredity.
If the baby’s parents are large and tall, then the likelihood that the child will be the same is very high. In this case, one should take into account not only what the parents look like now, but what they were like at the time of birth.
5. Second and subsequent pregnancies.
Statistically, second and subsequent children are born heavier than their older brothers and sisters. This is explained by the fact that the woman’s body is already ready and trained to bear the fetus (the metabolism between the baby and the mother improves), and also by the fact that the woman is less afraid and worried during her second pregnancy.
6. Nutrition for a pregnant woman.
If a pregnant woman abuses the amount of food rich in carbohydrates (sweet, starchy), the child and mother may experience obesity. The baby’s body gains excess weight because it is forced to work like its mother’s.
Methods of work of a perinatal psychologist
We will list the most common methods of work of a perinatal psychologist. The choice of one method or another depends on what specific problems the expectant mother needs to solve and what points she needs to pay attention to:
- answers to troubling questions - thus, the psychologist examines the woman’s personal history and helps to cope with her experiences;
- drawing up a family genogram (“family” tree) - a specialist finds out exactly what scenarios of motherhood were in the family, what parental attitudes go from generation to generation;
- art therapy, role-playing exercises;
- teaches relaxation techniques and breathing exercises;
- recommends floating and similar methods.
Is there a danger with a large fetus?
The most crucial moment is childbirth. During the delivery process, carrying a large baby can cause some difficulties that can affect the health of both the baby and his mother.
Sometimes the size of the baby's head and the mother's pelvis may not match. It is very difficult for the head of a large baby to pass through the birth canal, no matter how strong the labor is. A large fetus can cause disruption or cessation of labor.
After the birth of the head, problems may arise with the removal of the shoulder girdle. The neonatologist must then check the condition of the baby’s collarbones and arms. A baby may have a cerebral hemorrhage due to a discrepancy between the sizes of the mother’s head and pelvis. Natural delivery becomes difficult.
How to choose a perinatal psychologist
A woman needs to take a responsible approach to choosing a specialist. Pay attention to the specialist’s education, reviews of him, whether he has modern knowledge in the field of psychology, but one of the most important indicators is trust, so that you feel his support and attention, so that you feel comfortable working with him. For those who are interested in the field of perinatal psychology, we can recommend our course “Practical Perinatal Psychology. Social and psychological support of pregnancy, childbirth and the postpartum period."
How to avoid danger?
Don't panic when you hear from your doctor that you have a large fetus. Just try to determine the cause with your doctor. Continuous observation in the hospital may be required until delivery.
If the reason is heredity or high consumption of sweets, the doctor will prescribe a special diet. Food should be wholesome, healthy, but not contribute to weight gain.
The main thing is not to worry or be afraid of childbirth. Your doctor will discuss the progress of labor with you in advance. They will prescribe a planned caesarean section, depending on the indications, or take a wait-and-see approach.
If within four hours from the onset of labor there are signs of a discrepancy between the baby's head and pelvis, surgery will be performed urgently.
Behavior of the expectant mother
Expectant mothers should eat well and wisely, and this should be done even before pregnancy, since the child may inherit excess weight. Carefully control the amount of carbohydrates; in the last trimester, their amount should be no more than 400 g.
Do not refuse the help of doctors if pathologies of a large fetus have been identified. Treatment can begin already during pregnancy, and this will avoid health problems for the child in the future.
The hero inside you is a beautiful baby who simply requires a little more attention, care and love, but is in no way a reason for fear, worries and worries.
Anxiety disorder and pregnancy are common neighbors
The woman’s entire nervous system is tense and aimed at maximizing the preservation of the child. But sometimes the hyperactivity of this natural mechanism has the opposite effect. Therefore, it is important to monitor the condition of the expectant mother. If she worries more often than she is happy, her worries do not have a specific reason (pregnancy is proceeding smoothly), and she cannot distract herself from them - perhaps this is already a disease.
Often, a pregnant woman, even realizing that something is wrong with her, is afraid to seek help because she may be advised to terminate the pregnancy or be prescribed medications that will harm the baby. There is a way out of this situation!
Treatment for a pregnant woman differs from therapy for ordinary patients, because it is important not only to help the mother, but also to protect the baby.
