Navigating Perinatal Anxiety as a Therapist & First-Time Mom

Just before my 37th birthday I found out I was pregnant, and would be joining the growing trend of Latinas having their first child after age 35. About one percent of Latinas are having their first child later in life due to struggles with fertility but many others are making the choice to have children later in life. The reason for this includes a desire to focus on education and career goals to hesitation due to the higher cost of living. Many Latinas also hold off on having children because of fear and anxiety related to pregnancy and motherhood. We know that raising children in our current world will be challenging, and that often there is an unequal burden placed onto us as women.

Initially I was shocked to learn I was pregnant because I had really bought into the narrative that had overtaken my TikTok algorithm stating a woman’s fertility declines after age 35. I had been very doubtful that I could actually get pregnant. The algorithm was so powerful it made me discount my own family history. Women in my family had children in their late 30s and early 40s although for my abuela and my suegra it was their last child and not their first.

After the initial shock at being pregnant I felt fear. Fear for how much my life would change, but especially fear for what could go wrong. I knew that at my age I would be considered “advanced maternal age” (the more politically correct term for “geriatric” pregnancy) and my pregnancy would be classified as high risk. Some of the women in my family had dealt with complications from their own later in life high-risk pregnancies. Also, due to my work as a trauma therapist I was especially aware of all that could happen during pregnancy from pregnancy loss to traumatic childbirth to the potential for birth defects. I knew from supporting clients how painful these experiences could be, and I questioned my ability to cope with all of the unknowns.

After confirming my pregnancy with a test at my primary care office I was referred to an OB/GYN. To my great surprise the OB/GYN wouldn’t see me for another month. This month between visits my thoughts and worries began to fester. Without an ultrasound yet I imagined I would get to this appointment and be told “there is nothing there” or that the pregnancy was ectopic and my life was at risk. I felt myself growing increasingly anxious waiting for the appointment. I began to wake up at night, my racing thoughts focused on the “what ifs.” I felt tense, at times irritable, and nervous. I was distracted by my worries, and unsure of myself. I recognized these as signs of anxiety. Anxiety is something I have dealt with since childhood, but got a good grasp on in my early thirties. However with this pregnancy I felt it return.

After my first visit to my OB/GYN and having the first ultrasound the pregnancy felt official. It was October and my baby was due in April. As I gazed at the long road ahead I knew I had to get my anxiety under control. Not only for my own well-being, but also for the new child growing inside of me. I was fortunate to have tools I had built through my own healing journey, and tools I used with my clients as a trauma therapist. I knew I would have to reach into my toolbag, and use everything I could to get through the months ahead.

My Perinatal Anxiety Toolkit

Radical Acceptance

The first step I took in navigating perinatal anxiety was to surrender to radical acceptance. I accepted the fact that most things were now outside of my control. I could not control my pregnancy symptoms such as extreme fatigue. I could not control whether or not I had a miscarriage. I could not control whether or not my child would show signs of birth defects. And the list went on and on. All I could do was to accept these things as possibilities, and focus on what was within my control like my diet, giving myself breaks to rest, attending all of my doctor appointments, and following medical guidance. Once I released myself from trying to control outcomes I had little to no control over I felt some relief.

Trust in My Future Self

Oftentimes with anxiety we spend time imagining possible negative, scary, and overwhelming future events that we think we won’t be able to handle. The idea of being overwhelmed in the future brings anxious distress into our present. Instead of imagining myself crumbling at these potential negative future events I decided to trust my future self. I trusted that the version of me that would exist in the future could handle what came. I did this by reflecting on my current personal strengths and listing out the different resources and supports I had such as a supportive husband and family and a doctor that I trusted. I also limited my focus to the short-term. Anything beyond my next doctor visit or medical test was something I left for my future self. When anxiety and fear hit I would remind myself that my future self would bring my strengths, resources, and support system to that future situation just as I was able to bring those same things to the present moment. I gave the future to my future self to handle and focused on the now. This reduced the pressure I felt to prepare myself for potential negative outcomes and allowed me to be more present.

Mindfulness

Mindfulness, defined as “Paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally” was another tool I took from my toolkit and leaned on heavily. During my pregnancy mindfulness sometimes meant picking a color, usually purple sometimes orange, to look for while I was out walking my dog. While I was walking I looked for anything that color. When I found it I would take a moment to take a few deep breaths while I held it in my gaze. This practice allowed me to focus intentionally on my surroundings while walking instead of getting lost in my mind. Other times mindfulness was approaching my emotions without judgement. If I did have a scary thought related to pregnancy I would say to myself “You are feeling anxious because you are having the thought that something is wrong with your baby, and that’s okay. That is a scary thought.” I found that by observing my thoughts in this way and validating my own emotions I was able to release these worries and emotions more gently.

My Birth Experience

When I finally walked into the hospital to give birth to my son on a Sunday afternoon I felt nervous of course, but also ready. Because my birth was scheduled I even felt a degree of control. I was being induced at 39 weeks due to multiple risk factors, my age of course being one and my baby’s size being another. I had an idea of how the induction would go, but when the first step failed — the doctor wasn’t able to place the foley balloon that was intended to kick start the entire process — I knew I would need to radically accept that I had much less control than I thought I did. I had envisioned a smooth process, and I accepted that it was about to be more complicated.

In the next two days I attempted to focus on what was within my control, often limiting my focus to only the next few hours, and whatever the next step in the induction would be. I used mindful breathing to slow my brain down when I felt overwhelmed. This allowed me to be more clear headed which helped me to make decisions regarding the interventions I was receiving. Mindful breathing also helped me cope with the many invasive checks performed by doctors and nurses, and when the painful waves of contractions began. Finally, when it came time to push I remembered all of the times during my pregnancy I had trusted my future self. When the doctor told me it was time to push it felt like the future was now. It was my moment to see this process through and deliver my baby as best as I could. And I am lucky and grateful to say he arrived safely, nearly 48 hours after the induction began.

In the end I felt proud of myself for how I had navigated all of the fears and change that comes with having your first child. The journey wasn’t without stress and anxiety of course. Pregnancy and childbirth brought many unexpected challenges, but my toolkit helped me face each one.