[Best of Birthful] How an Anxious Mind Impacts You During Pregnancy

[Best of Birthful] How an Anxious Mind Impacts You During Pregnancy

Adriana Lozada: Hey, Mighty One. With nearly 300 Birthful episodes in over five years, it may be hard to know where to begin listening to the show. To make it easier, we’ve put together the Best of Birthful series, which showcases some of our favorite or most relevant episodes. This is one of those. If you enjoy what you hear, make sure you subscribe. It’s free, and that way you won’t miss a thing. Enjoy. 

Hello, Mighty Parents and Parents-to-Be. Thank you so much for listening and all the love you give the show. So, for today’s renewed episode, I’m bringing back my talk with Parijat Deshpande about your anxious mind during pregnancy, and Parijat is a high-risk pregnancy expert and the author of the book called Pregnancy Brain, which had just come out when I first talked to her, and which frankly I think should be a must read for anyone who’s expecting a baby, especially so if they’ve been classified as “high risk” or have undergone fertility treatments. Now, in terms of anxiety and pregnancy, here’s the thing. During pregnancy, we become more anxious and worried about every little thing, which is nature’s way of firing up our mama bear instincts to make us more protective and increase our infant’s survival rate. 

However, given that we already live high strung lives, that worrying can easily get out of control and that’s why today we’re going to be talking about the intricacies of the mind-body connection, how anxiety plays a role in affecting your mood and health, and that of your baby, and some ways in which you can tame that anxiety to improve outcomes so you can also enjoy these months a bit more. So, let’s get to it. Parijat, welcome! It’s so great to have you here. 

Parijat Deshpande: Thanks so much! I’m so excited to be here. 

Lozada: And so, we’re gonna be talking about your mind during pregnancy and how that affects your health, which is such an interesting topic to me, but before we jump right in, why don’t you tell us a little bit about yourself? 

Deshpande: Yeah, absolutely. So, I work as a perinatal mind-body wellness counselor. I’m a high-risk pregnancy expert and speaker, and author of Pregnancy Brain, and I run a podcast, Delivering Miracles, and basically I do all of this to really empower and educate and inform women about the power of their bodies and how important the mind-body connection is, especially during pregnancy, so that when, if they develop pregnancy complications, they know that they have a lot more control and a lot more influence on their health than they’re made to believe. It really… It’s like turning on a lightbulb in a pitch black room. You all of a sudden go, “Oh my gosh! There’s so much I can do. Really? Me?” And it’s incredible to experience. It’s been incredible to witness with my clients. It’s so, so huge, and anybody can do it. 

Lozada: So, let’s talk a little bit about that, how that happens. How does the mind-body connection work? 

Deshpande: Yeah, so it really sits… I mean, we call it mind-body connection in that yes, it is in the mind, but it trickles down into your body, and so we can’t separate out the two, and so what that means is when you experience some kind of stress, and that means anxiety, it could mean pain, it could mean lack of sleep, it could mean dehydration, any type of stress, what it does in your body is it actually changes your body down to the cellular level. So, there’s three body systems that are particularly impacted. The nervous system, the immune system, and the endocrine system. 

Now, during pregnancy, those three systems work in perfect balance. They do have to shift from what we normally are when we’re not pregnant, but nature has figured out a way to actually shift them, so that they’re in this perfect balance during pregnancy to keep and sustain a healthy pregnancy. Now, when you inject a little bit of stress into the body from any source, whether it’s emotional, like anxiety, guilt, grief, or it’s physical, like pain, or lack of sleep, or dehydration, it actually throws those three systems out of whack, like out of balance, and from there is when you start experiencing the physiological impact of stress. And that’s what we mean by the mind-body connection. 

Lozada: And now, we focus just when you were talking right now on the stress part of that mind-body connection, but there’s also the relaxed response that also works in a very similar way. 

Deshpande: Exactly. So, we always talk about stress being this terrible, awful thing that we need to stop and make go away. And my approach, which you have probably recognized from our work together, and the book that you’ve had a chance to look at, I don’t think stress is the problem. Stress is not actually the problem because our body is designed to be able to withstand stress even when we’re pregnant, even when it throws those three systems off balance, our body’s able to handle that. 

The problem becomes when we don’t actually allow our bodies to repair from the damages of stress, and that’s what can be called the relaxation response. It’s really the parasympathetic nervous system and the impact that that has on the endocrine system and the immune system to actually undo the changes to your body that stress creates. And by allowing your body to relax, and I don’t mean lying on the beach and sipping a cocktail, necessarily. It’s really about giving your body what it needs to feel nourished, to feel calm, to feel safe, and to have the resources to help you heal and repair physically.

Because when you have the relaxation response activated, your body can actually do the repairs that it needs, and it can actually focus on doing what it does best, which is maintaining the body systems the way they need to be to sustain a pregnancy. 

Lozada: So, how does uncertainty play into this stress-relax response? 

Deshpande: Yeah. Absolutely. So, uncertainty is a tremendous source of anxiety, which is an emotional trigger for the stress response in your body, and uncertainty is something that’s very, very common, especially during a high-risk pregnancy, which is typically the clients that I see all have high-risk pregnancies. And you don’t know what’s gonna happen next, you don’t know what’s gonna happen to the baby, the stakes are so high, and there aren’t a lot of answers to the multiple questions that you have about your health, your baby’s health, and what’s gonna happen. And that uncertainty makes you feel completely out of control, and the antidote to that is to really establish senses of control, of recognizing what is in your control, how can you influence your particular situation, and how can you take action immediately to help yourself stay pregnant, or get the care that you need, or what can you do to help restore health right now? And by doing that, it actually reduces the uncertainty that you’re feeling, and physiologically it actually turns off the stress response and it turns on that repair system that’s naturally built into our bodies to help us recover from the impact that stress just played on our bodies. 

Lozada: Yeah. And so huge to recognize. I also appreciate the difference that you mention on anxiety versus fear, and can we talk a little bit, can we make that distinction? 

Deshpande: Yeah. This is a really important distinction. It’s not one that we talk about a lot, because in daily language, we tend to mix up the two. We call anxiety fear and fear anxiety. We just use them interchangeably when in fact they’re actually two very different emotional experiences that have two very different physical impacts, and then thus have two very different approaches on how to handle them. And so, what I like to describe it as is an analogy to being chased by a bear, right? When you’re being chased by a bear, you are terrified. That’s fear, because there is a present danger. Right now, your life is in danger immediately. 

Anxiety is about the future. It’s about something that could happen, or might happen, or will happen, but it is not happening right now, and the reason why that’s important to remember, even though it might feel the same in your body, is because when you recognize that anxiety is about something that is not actually happening in this moment, but is something that you’re worried about in the future. It might be five minutes from now, it might be five days from now, but it’s not happening right now. And when you recognize that, then you can realize that anxiety actually is in your control. 

Now, I recognize that for some people, especially who are struggling with moderate to severe anxiety, it’s really hard to hear that, because it makes it sound like, “Well, then I’m just not controlling it and it’s my fault.” That’s not at all what I’m saying. What I’m saying is first and foremost, it needs to be a shift. That you were not a victim to this emotion, but you can actually manage it when you have the right tools. 

Lozada: Absolutely. Absolutely. So, we toss around the word anxiety a lot. How can you recognize, what are some of the signs that you do have higher anxiety? 

Deshpande: There are a few. You know, you can Google anything and you can find lists upon lists of it. So, for those of you that are listening, I don’t want this to be a list that you diagnose yourself with, so what I’ll start with by saying is do you feel different than how you normally feel, right? That’s really what it is, because we all express anxiety differently. So, it’s not so much “How many boxes can you check on a list?” It’s “Do you feel different?” Because if you’re highly anxious, I’m pretty sure you actually know it. It’s a matter of admitting it to ourselves, right? 

Commonly, what I see for the women that I work with is they just… They’re just not able to relax, so they just feel awake, or jittery, or just kind of antsy all the time. Some of them have trouble falling asleep or they wake up in the middle of the night and then they have trouble falling back asleep. When you have that hamster wheel constantly going through your head of all the scenarios you’re playing out in your head of the things that could happen. You’re thinking about all the what ifs. That’s a sign of that. 

For some, it actually shows up as crying. They might mistakenly think they’re depressed, but sometimes crying just way more than usual can be a sign of it. You might be picking fights with your partner more often than not. That can be a sign of relieving anxiety. There’s just… There’s so many different symptoms of it, but really the number one question you want to ask yourself is, “Do I feel different than I normally do?” Because that’s gonna be the ultimate guide of knowing whether anxiety is being a problem for you in this moment and whether you need to seek some additional support to help you guide yourself on this path that you’re on right now. 

Lozada: I personally feel that when I am… I get paranoid. I’m like, “This is all going too well. This is so good. Something’s gotta fall. The other shoe to drop.” That’s my… I read that in your book and I was like, “Ah, yeah. I know that feeling.” 

Deshpande: Yes. I recognize. I know that one very well, too. And there’s actually a lot of women who are pregnant feel that way, as well. Especially if you’ve experienced loss in the past. If you’ve delivered preterm in the past. If you’ve had complications in the past. It’s really hard to let yourself believe that actually this time it could be better, that it could be easy, and so yeah. I think a lot of people can really relate to that. 

Lozada: Yeah. Anxiety. With this… It was so big. With this mind-body connection being a two-way street, right? You can approach it from either the mind or the body, and I really love the shift that you present in your book on focusing on your body instead of on your thoughts to control that anxiety. So, can you talk a bit more about that? 

Deshpande: Yes. So, oh my gosh, I can talk about this for hours. So, here’s the thing, so it starts with the idea that yes, the mind-body connection is a two-way street. So, your mind influences your body and your body influences your mind. And here’s the thing. I am trained in clinical psychology. I’m clinically trained. I’m classically trained. So, all the tools that I had been trained with are all about when you have anxiety, you deal with it from the mind, and then there will be a cascading effect into your body. 

When I became pregnant with a high-risk pregnancy, I realized very quickly that those tools are not going to be very helpful, because I know I shouldn’t be anxious. I know I shouldn’t be having these what if thoughts, and these negative thoughts, and all that. But I can’t stop it! And I think that’s the approach that I take with my clients and what I present in the book, Pregnancy Brain, is that you don’t have to manage negative thoughts by doing cognitive work, that you can actually manage something like anxiety by focusing on your body. 

And what I mean by that is these emotions, any emotion is actually… It exists in your mind and it also exists in your body physically. And there are physical symptoms of the emotion at the same time that there are cognitive symptoms, like all the what ifs, or the negative thoughts that you’re having. Same thing. So, by identifying where your emotion is sitting in your body, you can actually turn the whole experience around. It can turn on its head. And you start focusing on what can I do to relieve that symptom in my body? 

So, for example, maybe your anxiety sits in your stomach and you have this pit in your stomach. You just feel sick to your stomach all the time. So, the goal is not to reduce anxiety, right? The goal and what I teach to my clients is how can I reduce my stomach ache? How can I make that better? Now, you might be thinking, “Well, if I just stop being anxious, then that would get better.” Absolutely. But if that were to work, that would have worked already, right? So, my focus with my clients and what I teach in the book is: Focus on the physical symptom. What is going to relieve that upset stomach? How can you make your stomach feel better? And what happens, it is mind blowing. Every single one of my clients, when they experience this, they go, “Oh my God, I had no idea.” That’s how powerful this is, because you turn it into an action that has a very specific goal, and when you achieve that goal, you restore a sense of control, which is the antidote to anxiety. It is really, really powerful stuff, and when you’re able to do that, it is mind blowing how much you realize you can actually influence your body, and thus influence your mind, and ultimately influence the health of your pregnancy. 

Lozada: So, would that be something like if I’m feeling anxious and I’m noticing that my breath is short, focusing on longer breaths? 

Deshpande: It could be. Yeah. Absolutely. It could be. And you know, I encourage my clients to get really creative. What else can you do? If you notice your breath is short, then there’s probably some other symptom, like your shoulders are also really tight, or your chest feels tight. What else can you do to help yourself take a big, deep breath? Maybe it’s blowing through a straw, right? Blowing bubbles in some water like we used to when we were kids, right? 

Or going outside and taking, and smelling flowers. It’s not just about taking a deep breath, but how can you force that physical experience? 

Lozada: And I love that it also quiets the mind in that, because I look at it from the birth perspective, and how you birth with your body, not with your mind. And it’s your primal brain that’s at work, so you need to get your neocortex, your thinking brain out of the way, because they don’t think… It’s an either or proposition. They don’t think at the same time. 

Deshpande: Right. They can’t do it at the same time. 

Lozada: Right. And for birthing, you need the primal one to be thinking, which is also where hormones are secreted, and you’ve got your oxytocin flowing, which goes back to what you were talking about with the nervous, immune, and endocrine systems working together, right? Your hormonal system. 

So, just giving that mind… Distracting it. 

Deshpande: Yes. Exactly. And that’s how we’re able to do something like anxiety management, stress management, without having to deal with our thoughts, because in the end, we’re gonna be worried about our babies. There’s no way around it. That is part of pregnancy. In fact, mildly elevated anxiety is actually a symptom of pregnancy. That’s normal. That is natural. It is built in so that we are… We maintain ourselves as risk-averse. We keep ourselves protected. Because we’re growing a life. 

So, instead of trying to fight what’s naturally there, let’s find a way, my perspective is at least, to let’s find a way to allow our bodies to do the best that they possibly can, and that only is possible when the relaxation response is on, when the self-healing mechanism is turned on in the body, to help you relieve and repair from the damages of stress. And the best way I’ve found to do that is to actually forget what’s happening in your head and focus on your body. 

Lozada: However, it’s not all coming just from you. You are more vulnerable, I would say, to events, and thoughts, and what you read, and what you hear during pregnancy and what others tell you, right? Because words… Somebody saying, “Oh, it looks like you’re carrying big. It looks like you’re gonna have a big baby.” That can be so triggering. 

Deshpande: Yeah. Yeah. And how often do women hear things like that? I mean, it’s unreal how many times women are told these kinds of stories by family members, by friends, and by their doctors, too. I hear so often from women that their doctors kind of predict what’s going to happen, and granted, yes, they have years and years of medical training. They’ve seen thousands of cases, so they know general patterns of what to expect, but nobody can actually tell you exactly what’s going to happen in your pregnancy. Nobody. Not one person on this earth. Doesn’t matter how many degrees they have or where they’re from. Nobody can tell you that. But for some reason, we’ve found it okay to have this language thrown around that, “Oh, you’re carrying big. You might… You’re probably gonna need a C-section.” Or, “Oh, your pelvis is really small. You’re probably going to need a surgery.” Or all kinds of things like that people hear. 

Women hear lots of scary stories about birth, right? But that compounded with all the messages that we get from doctors. “Oh, you can’t do this. Oh, this is not gonna be possible for you.” Or predicting, “Oh, you’re going to need surgery,” or not going to. All those messages just feed into the anxiety that you feel, and that helplessness, and that out of control feeling of, “Oh. Well, it’s out of my hands. There’s nothing I can do.” And it really triggers that stress response very, very strongly. And so, it’s really important that you surround yourself with people who trust your body first. It doesn’t matter what the research says. It doesn’t matter what your doctor has seen previously. If your body is telling you something otherwise, that’s what needs to be leading the treatment that you have or the care that you’re getting, or the support that you receive from family, and friends, and whoever else is on your team. That has to be number one. 

And from there, you can have real conversations about “Given this particular situation, what’s likely to happen? And how can we improve the odds for that?” That’s the really important piece of the conversation that needs to happen with yourself, with your partner, with your family friends, and then definitely with your medical team. 

Lozada: Yeah, because that could shift that conversation back to there is stuff you can control, so how-

Deshpande: Exactly. 

Lozada: How can we be proactive about the situation in a positive way? 

Deshpande: Right. Right. It’s been realistic, but optimistic at the same time. You can do both and I think, and we could talk about this forever, about all the different reasons why doctors have to be so straightforward about some of this stuff. Of course, you don’t want them to be lying to you. You want them to be honest. But there is a difference between giving you bad news and then making you feel like there’s nothing you can do and that’s all there is left, versus giving you bad news and then working together to find a way to reduce that risk, or to help you mitigate the symptoms, or to help you through it so that you don’t feel alone in it. There’s a very subtle but extremely powerful difference between those two. 

Lozada: And it’s about feeling like you have a say in what’s going on and that you are very much a protagonist of your experience, rather than things happening to you which are out of your control. 

Deshpande: Exactly. 

Lozada: And out of your… Yeah. Unpredictable and sort of bowl you over. So, in that sense, it seems like that’s another thing that is hugely important and totally under your control of being very careful and very mindful of the team that you choose to come with you on this pregnancy and birth journey. 

Deshpande: Absolutely. There’s actually an entire chapter in Pregnancy Brain about this very thing for that reason, because like you said, it is totally in your control and it is extremely important for the health of your pregnancy, because if you end up working with a team, anybody, whether it’s a midwife, a doula, a lactation consultant, an OB/GYN, whatever it is, who makes you feel like there’s nothing you can do, who makes you feel like bad things are coming without you being able to do anything about them, or prevent them, or anything like that, it turns on your stress response the same way that anxiety does. The same way that guilt does. The same way that lack of sleep does. 

And that has the same impact on your pregnancy health that any other sources of stress do and you need to work with a team who’s not going to activate that stress response consistently, but is going to activate the relaxation response with you, so when you’re with them you feel comforted, you feel taken care of, you know that they’re telling you the truth no matter how hard it is to hear, but you know that they’re going to work with you to navigate this difficult journey, so you’re not gonna feel alone and helpless. 

Lozada: So, let’s talk a little bit more about that situation and that… What questions or what things should you go into a first meeting with your care providers so that they can pass that test and be on your team? 

Deshpande: Yeah. You definitely want a provider who is invested in educating you and informing you about what’s going on so that you feel, and you know this in your gut. You know whether a doctor’s hiding something from you, or they’re just brushing it off, or they’re actually telling you everything you know. Now, you’ll see in the book, there are times when I question that. But that was more because of my anxiety than anything else. But you know when a doctor’s being very forthcoming with you, so you want a doctor who’s invested in that, being honest and open with you no matter how hard it is to hear the truth. They’re invested in educating you, so that you have the same information that they do.

The other thing you want to be mindful of, is this a doctor that— even though they give you difficult news to hear, which can happen a lot, especially if you have a high-risk pregnancy— you want them to share that information with optimism, right? So you can have a conversation. I’ve had plenty of them during my pregnancy where… There was one in particular I’m thinking of, where one of my maternal-fetal medicine specialists (a high-risk OB), she was having a conversation with us about termination. That is an extremely difficult conversation to have. It is so emotionally charged. It is so hard to hear, especially when you’re pregnant. But the way she shared it, I will never forget that moment, because I was so surprised at how I left that appointment feeling supported and cared for, even though a decision hadn’t been made, but we had talked about termination and I still left that appointment feeling positive. 

Not because of what was on the table for us, but because of how cared for I felt. When you leave the appointments, it’s really important that you feel comfort. And not just emotionally, but physically in your body. Do you feel physically relaxed? Even if you’ve had a really difficult conversation. Do you feel like your shoulders are more relaxed, that you’re breathing okay, that you’re just more present and feeling optimistic in a way where your body is allowed to feel relaxed? I think that’s the ultimate kind of test to see if this is the right doctor for you, because your body’s always going to tell you the truth about whether this is the right partnership or not. And listening to that and trusting that is really, really important. 

Lozada: And I think that’s huge, of knowing that your body is going to tell you the truth, and that can be a really hard place to get to if you’ve had a situation where your body… You feel your body has let you down for years, or that you have let your body down for years. So, what are some of the ways that you can build that trust in your body and vice versa? 

Deshpande: It really starts with you gotta experience it. I can tell you, you can tell your listeners, people can tell you all the time, “Your body’s not lying. Your body’s not lying.” But it’s not until we actually experience it ourselves that we start to believe it. So, find ways to influence your body, and this is why… We talked about a while back, right? Earlier on this episode. Why I don’t do cognitive work anymore. I want for my clients and I want for your listeners to experience wins consistently. So, focus on your body. What do you need in your body right now? 

So, I’ll tell you right now, in this moment, my tongue’s feeling a little bit dry. I know I need water, right? So, you go and you get some water. You drink some water. And you notice how it changes how you feel in your mouth. That’s a very small example, but you start small, and start experiencing how your body responds to the actions that you’re taking, and slowly you start building that up to impact your pregnancy health, your bigger parts of your health that are impacting maybe pregnancy, fertility, whatever that is, postpartum. When you start to do that, start small and you build up from there, you actually get to experience how much your body is responding to you. And in turn, you start to realize how many different ways your body is speaking to you about what it needs. 

Lozada: And that response loop is a great indicator, like it provides so much clarity. 

Deshpande: Exactly. 

Lozada: Because once you pay attention, you see the response, you’re like, “Yes, this is what I needed.” It’s an instant loop, right? 

Deshpande: Exactly. Exactly. Yes. It’s instant. And that’s—

Lozada: True communication. Yeah. 

Deshpande: And I understand as a former therapist, I know about working hard, and building the foundation, and setting things up for long term. That’s great, but when you’re pregnant you don’t have that kind of time. So, I’m all about get the instant reward right now, see how it worked, and it’s just gonna create this feedback loop that’s gonna make you want to do it again and again and again, and before you even know it, you’ve set up a much healthier lifestyle than you had before, and you’ve hardly had to do the work to do it. 

Lozada: Yeah. It starts with that just noticing. Just paying attention to what your body has been trying to tell you for so long, like because it’s constantly speaking to you. 

Deshpande: Exactly. 

Lozada: Thank you so, so much for being on the show today. It’s been delightful. 

Deshpande: Thank you, Adriana. I love this. As always, it’s so nice to chat with you. 

Lozada: You’ve been listening to a Best of Birthful episode. To listen to the original, longer version of this episode, click on the link in the show notes. And there are many more where this came from. Look for episodes with the words Best of Birthful in the title to continue your deep dive to inform your intuition. You can find the in-depth show notes for this episode at Birthful.com. You can also connect with us directly on Instagram. We’re @BirthfulPodcast. 

Birthful was created by me, Adriana Lozada, and is a production of Lantigua Williams & Co. The show’s senior producer is Paulina Velasco. Virginia Lora is the managing producer. Cedric Wilson is our lead producer. Alie Kilts contributed to the production of the Best Of Birthful series. Thank you for listening to and sharing Birthful. Be sure to subscribe on Apple Podcasts, Amazon Music, Spotify, and everywhere you listen. Listen every week for more ways to inform your intuition.   

CITATION: 

Lozada, Adriana, host. “[Best of Birthful] How an Anxious Mind Impacts You During Pregnancy.” Birthful, Lantigua Williams & Co. December 28, 2022. Birthful.com.