For Jackie Piccolo, the anxiety during her pregnancy manifested itself due to a prior miscarriage.
“I found out I was pregnant for a second time about a month after I had experienced a miscarriage. There were so many emotions when I found out I was pregnant again, but fear was the dominating feeling,” she explains.
She remembers calling her doctor’s office and being told she had to wait until her eight-week appointment for her first ultrasound. “I know this is routine and I can’t fault the office staff for going by regular protocol,” she says. “But I remember feeling like I had been brushed off. I mean, I had just had a miscarriage. What if something goes wrong again?”
“Fear set the tone for the entire pregnancy,” Piccolo says. “I walked on eggshells the whole time, constantly worried.”
While depression and anxiety are more common and more well-known during the postpartum period, according to the Mayo Clinic, up to 23 percent of women experience it during pregnancy. Your risk is higher if you’re prone to depression or anxiety before you get pregnant. And some of the symptoms are often overlooked because they’re similar to symptoms that can occur during pregnancy, for example, sleep disruption, decreased sex drive, reduced energy levels and changes in appetite.
“As medical professionals, we tend to gloss over anxiety and depression during pregnancy,” Dr. Constance Guille, an associate professor in the department of psychiatry and behavioral sciences at Medical University of South Carolina says. “It can be stressful, particularly for those who experienced trouble getting pregnant or for those who do not have support.”
Dr. Guille says that treating anxiety and depression during pregnancy is about weighing the risks.
“If the woman is depressed, she is likely not functioning well, meaning that her diet is suffering and she is most likely not exercising,” Dr. Guille says. “There is a risk of low birth-weight babies in these instances and it could be a factor for an increased risk of postpartum depression.”
She recommends changing your diet, exercising more and utilizing local resources, such as therapy, for women who are experiencing mild to moderate depression.
“Medication will be prescribed only to pregnant women who are experiencing significant to severe anxiety or depression as this creates a risk of untreated illness,” she says.
Dr. Guille says that when she does prescribe medication, she assesses what medication has worked for the patient in the past. “It is always best to know what they responded well to. No sense in putting them on new medication, especially while pregnant.”
Dr. Guille encourages women to confide in their health care providers if they think they are depressed. “Therapy is a great option and there are some therapists that specialize in pregnancy and new moms,” she suggests.
For Piccolo, it was a combination of yoga classes, mindful breathing, therapy and positive affirmations that helped her keep depression and anxiety in check during the pregnancy.
“The yoga classes helped me learn breathing techniques,” she says. “I would do a three-minute breathing exercise in the morning, which really set the tone for the rest of the day.” Piccola also would repeat positive affirmations to help get her day started right. “You’ll start to believe them if you tell your brain over and over again,” she recalls.
Erica Rodefer Winters was Piccolo’s yoga instructor during her pregnancy. Winters teaches prenatal yoga with Spoiled Yogi at the Barefoot Yoga Studio in North Charleston. She not only teaches her pupils about the benefits of yoga practice during pregnancy and into motherhood, but also teaches the importance of breathing.
“Learning to breathe properly will help you soften and relax during pregnancy, labor and for those first trying and sleep-deprived weeks after having a newborn,” Winters says. “The more you take the time to practice those belly breaths, the better.”
Yoga is a mindfulness practice that has also been shown to help with mood as well as back pain, improved sleep, stronger immunity, reducing stress and preparing a mother’s body for birth.
Like Piccolo, Winters found repeating positive affirmations allowed her to remain excited about her own pregnancy and to focus on the positive rather than to fear the unknown. “I understand about feeling anxious during pregnancy,” Winters says. “I felt that way in my second pregnancy, too.” Winters has two daughters, ages 7 and 2.
Since Piccolo had her healthy now 5-month-old baby boy named Knox, she has gone on a low dosage of Zoloft. “It’s safe when breastfeeding. I’m not one to push medications, but I do feel it has helped to be proactive with postpartum depression as a precautionary method.”
But she says that she hasn’t forgotten how she felt in those trying nine months. “I will admit that I did not enjoy being pregnant and that makes me feel guilty, like I didn’t appreciate it.”