Understanding Psychological Changes during Pregnancy

Psychological changes in the first trimester usually involve anxiety about the unborn baby. See more pregnancy pictures.
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Pregnancy is an experience full of growth, change, enrichment, and challenge. It is a time when you as a couple confront your fears and expectations about becoming parents and begin to determine your own parenting style. Forthcoming parenthood causes psychological changes in both mother and father.

The following sections will help you understand the normal psychological changes that occur throughout the different stages of pregnancy. If you are having psychological problems that are interfering with your daily life or relationships, talk to your doctor and get help. Don't worry, these changes are normal considering a big life change like pregnancy. In the following sections, you will learn to identify common changes, including:

  • Psychological Changes in the First Trimester You may not be able to see the changes that are happening during the first trimester, but they are significant. During this time, some new mothers might be filled with a feeling of anxiety about losing their new baby. These fears, though unfounded, are perfectly normal. Read about the many emotions that women experience during this critical period in fetal development.
  • Psychological Changes in the Second Trimester Once the stress and anxiety of the first trimester have passed, the emotional changes of the second trimester begin. Though the feelings during this time will usually be less intense, they can be equally as troubling. Many mothers begin to feel self-conscious about the weight they are putting on to support their baby, and these feelings can lead to low self-esteem.
  • Psychological Changes in the Third Trimester In the third trimester, women are anticipating childbirth and coping with significant physical changes. While fears of losing the baby have usually disappeared by this point, a new anxiety takes its place -- the fear of the baby's arrival. Also, worries about labor and birth are also common during the last three months of pregnancy.
  • Dreams During Pregnancy Many women experience strange dreams about childbirth, their newborn baby, and life as a new mother. In this section, we will tell you about some of the more common dreams pregnant women have including dreams about the baby's sex and nightmares about being trapped or assaulted. We will also attempt to help understand what these dreams might mean.
  • Psychological Changes in the Father At the same time that pregnant women are experiencing major physical and emotional changes, expectant fathers are going through emotional changes as well. Some fathers might feel left out during the pregnancy or might become apprehensive about their ability to parent. We will run down these common fears and offer some suggestions for dealing with them.

To begin learning about the specific emotional changes that occur to women during pregnancy, go to the next page to find out what happens during the first trimester.

Psychological Changes in the First Trimester

Most people believe that all pregnant women are glowing and happy. The truth is that women experience many emotions during pregnancy, starting with the first trimester.

Mind-Body Interactions in the Mother-to-be

Although all pregnancies have certain general similarities, each pregnancy is special. Shifts in your body image, changes in your hormones, and your attitude toward cultural pressures and expectations all combine to make your pregnancy unique.

Each of the physical landmarks of pregnancy is accompanied by specific psychological issues that affect your perception of that particular part of your pregnancy. For example, if your pregnancy was planned and wished for, you and your partner undoubtedly responded with joy and anticipation to the news that you have conceived. If the pregnancy was unexpected, you may initially have mixed feelings about it.

Interactions between your body and your mind occur throughout your pregnancy. For example, a high level of stress in your life or negative feelings about being pregnant may contribute to some of the nausea that occurs in the first trimester (three months). And the nausea and vomiting may make you feel less than enthusiastic about your pregnancy.

It's important to remember that because of this interaction between mind and body during pregnancy, trying to maintain a positive outlook may actually alleviate some physical ills.

The First Trimester

Numerous psychological changes occur once you are aware that you are pregnant. Although you may not look any different to other people for weeks to come, you start to feel a number of changes beginning. A rapidly changing emotional state is one of them. Your usual emotional highs and lows are magnified at this time, and if this is your first pregnancy, these feelings may confuse you. Situations that normally would not bother you provoke you to tears or cause you to become depressed or angry at yourself or those you care about.

These sudden emotional swings are more pronounced in some women than in others. This depends on your personality structure, the kind of stress you are experiencing, and the emotional support you are receiving, as well as hormonal changes in your body.

Since the risk of miscarriage approaches 20 percent in the first trimester, you may worry about whether the pregnancy will continue. If you have had a previous miscarriage, this is a time of heightened stress and anxiety.

Talking to a friend or a counselor might be very helpful at this time, especially if the feelings of anxiety and tension appear to significantly interfere with your day-to-day activities. Also, it is important to try to get as much rest as you can during the first trimester because rest helps you feel better. If there is a lot of stress in your life, you may want to modify it, if possible, or attempt to learn some relaxation techniques to help you cope with it. Meditation and yoga are two helpful relaxation techniques.

Relaxation techniques will continue to benefit the expectant mother throughout her pregnancy. Go to the next page to learn about the changes that happen during the second trimester.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.

Psychological Changes in the Second Trimester

In the second trimester, most mothers begin to worry about the weight they've put on.
In the second trimester, most mothers begin to worry about the weight they've put on.
©2006 Publicaitons International, Ltd.

After the emotional stress and anxiety of the first trimester, you can expect a lighter mood in the second trimester, but there are still issues that can come up for expectant mothers.

During the second trimester (months four through six), a sense of general well-being develops. The fear of miscarriage has usually disappeared, and the physical discomforts of the first trimester have diminished.

The most overwhelming event during the second trimester occurs at the time of fetal movement. In first-time mothers, this generally occurs at about 20 weeks. It can occur a little bit earlier if this is a second or subsequent child.

Psychologically, you may begin to feel increased dependence on your partner. You have more needs than usual, and you may worry about whether your partner will be available, interested, and able to support you during this time of change.

During the second trimester, both vaginal lubrication and blood flow to the pelvic region increase. These changes, plus the diminishing of the nausea and breast sensitivity of the first trimester, may increase your desire to have sex with your partner. You may wonder if he still considers you attractive. Some women and men, particularly in this weight-conscious society, associate weight gain with unattractiveness. Talking to each other about this should help alleviate many of your fears and misconceptions, so you and your partner can enjoy a healthy sex life during your second trimester.

As the expectant mother's body continues to change rapidly, so do her emotions. Go to the next page to find out what changes occur during the third trimester.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.

Psychological Changes in the Third Trimester

By the third trimester, the mother's ambivalent feelings about the baby have usually disappeared.
By the third trimester, the mother's ambivalent feelings about the baby have usually disappeared.
©2006 Publications International, Ltd.

After the second trimester, expectant mothers begin to prepare for childbirth, both physically and emotionally.

The third trimester is the time of anticipation. Soon the nine months will come to an end, and your baby will be born. First-time mothers usually have increased anxiety and concern about labor and the delivery. Prepared childbirth classes, usually begun in the seventh or eighth month of pregnancy, are very helpful for educating parents-to-be about what they can expect.

Usually by the time the third trimester has arrived, any ambivalent feelings about the pregnancy have been resolved. During this time, you may feel very special. If you have had difficulty with infertility, the pregnancy may take on more than the usual significance.

During the third trimester, the baby begins to take on an identity of his or her own. You may set up the nursery at this time and make the final decision about a name for your child.

Some people treat a pregnant woman in a deferential way. They may offer her a chair in a crowded room or a seat on a crowded bus. However, this deferential treatment has some negative aspects as well. Some people believe a pregnant woman's ability to function professionally is diminished. If you are still working outside the home, you may face this.

Also, many first-time mothers report that their coworkers become increasingly anxious as the delivery date approaches, and you may find yourself needing to re-assure coworkers that you feel fine. Talking with a colleague who has been through a pregnancy and continued working can be particularly helpful. She can share with you how she dealt with her work situation.

If you are not at risk for complications, you can probably continue to work up to your delivery date. But many other factors affect this decision -- finances, health benefits, and so on. Make your decision based upon your own needs. Many women work until their due date. Others find they want some transition time away from their employment before their child is born.

How you feel about the physical limitations of the third trimester is a reflection of your concerns and feelings about impending motherhood. First-time mothers have a great deal of anxiety about whether they will know when labor will start. In women who have had previous children, Braxton Hicks contractions may be so strong that they also may not know when real labor has started.

During this time, you may need extra attention from your partner, your family, and your friends. You may need reassurance regarding your physical appearance, especially if your sex drive has diminished again, as well as reassurance regarding your ability to be a good parent.

Now you've got the tools you need to navigate the psychological changes that happen to the expectant mother during her waking hours. Go to the next page to discover common dreams that pregnant women experience.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.

Dreams During Pregnancy

Unconscious fears and anxieties can take the form of dreams during pregnancy.
Unconscious fears and anxieties can take the form of dreams during pregnancy.
©2006 Publications International, Ltd.

During pregnancy you may find that you are much more vulnerable to certain fears and concerns. For example, pregnant women are often more anxious about the possibility of bodily harm. Situations you ordinarily take for granted, such as riding in a car or engaging in sports, may provoke some anxiety. These anxieties may surface in your dreams. Dreams may be realistic representations of your fears, or they may take the form of surrealistic nightmares. Dreaming about your worries is normal and may help you to deal with them during the day. Be reassured that dreams do not represent life as it is-or as it will be once the baby is born.

A progression of themes may occur in your dreams throughout your pregnancy. Dreams about pregnancy and babies often begin in the first trimester. Uncertainties about your new role as a mother may surface in dreams about your inability to care properly for your baby. Such dreams are normal.

Pregnant women often dream of being trapped, and in many ways this is a direct representation of fears and concerns about the future. Especially if you have worked outside the home, you may be frightened about how having a baby will impact your ability to continue your outside interests.

Many mothers-to-be dream about having a child of one sex or the other. These dreams may reflect your preference for a child of a particular sex.

Another common theme in dreams is looking for a child or having lost a child. These dreams usually occur toward the end of the pregnancy, when you begin to anticipate the delivery of your child. They may reflect your concerns about the health of your baby. And, in a sense, a loss is about to occur -- when you give birth and cut the umbilical cord.

Assault is another theme that may occur in your dreams about pregnancy, reflecting your worries that if you were to be assaulted or injured, the consequences might harm your baby, as well as you. Also, as the pregnancy continues and your body enlarges, you may worry that you will not be able to react quickly in a dangerous situation.

Perhaps another anxiety about assault that a pregnant woman has to deal with is the loss of control over her body. Clearly, you are not in control of your body's changes during pregnancy. Especially for the first-time mother, these dreams about assault may reflect your fears about what labor and delivery will be like. Then, too, the dreams may reflect your feelings about the little stranger that is within your body.

Remember, having these frightening dreams is normal and should not worry you. In fact, because of the love you feel for the baby inside you, your concerns about his or her fragility, as reflected in your dreams, are not at all unusual.

Pregnant women experience a wide variety of emotions, but expectant fathers have their share of concerns as well. Go to the next page to find out about the emotional changes that can happen to fathers-to-be.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.

Psychological Changes in the Father

It is normal for expectant fathers to experience emotionals changes during pregnancy.
It is normal for expectant fathers to experience emotionals changes during pregnancy.
©2006 Publications International, Ltd.

As a father-to-be, you may also undergo psychological changes during a pregnancy. Although there is no physiologic basis for this, it is nevertheless very real and to some degree predictable. A father-to-be, particularly in the third trimester, may feel a need for a creative outlet. You may want to paint or decorate the nursery or make a cradle as a way of becoming involved in the forthcoming birth.

Men, as well as women, bring to a pregnancy their own emotional baggage, as well as the echoes of their childhood fantasies about the mechanics and significance of pregnancy, birth, and parenthood. How the father-to-be perceived his own parents can directly affect his feelings about becoming a parent himself. For some men, being able to father a child may also create a sense of heightened self-esteem regarding their masculinity. Conversely, if there were previous losses or a history of infertility, the father-to-be may see the creation of life as a fragile phenomenon.

Impending fatherhood also seems to bring with it all the memories and emotions of a man's childhood relationship with his father. In some ways, becoming a father means giving up the idea of being a son. It also means reconciling the experience that one had as a child with being a father. It seems that these feelings are stronger during the pregnancy than during the months following the birth of the child.

During most men's childhoods, there was little emphasis on learning fathering functions, except perhaps for the provider role. Television and cartoons from the 1950s and early 1960s portrayed fathers as helpless and inadequate in handling a young child. Women were seen as having the primary duty of raising their children.

For fathers-to-be, there is no internal reality -- no physical changes to feel. You must rely on your partner's reports about her feelings in experiencing the pregnancy. Perhaps not until fetal movement is obvious will you perceive the fetus as a growing child, and often this does not occur until the seventh month of gestation. Participating in prenatal visits may be a way to increase awareness of the reality of the pregnancy. If an ultrasound study is indicated, viewing the ultrasound images can be an invaluable experience because you will have visual confirmation of the existence of your baby.

Pregnancy can elicit strong feelings even in a man who has had children previously. It provides an opportunity to think about the kind of father he has already been to the children that he has, as well as the increasing responsibility he faces. If the father-to-be is proud of his prior fathering experience, and if the new child is wanted, he may feel extremely happy about the new pregnancy.

It may be difficult for a man to admit openly that he has concerns, fears, and perhaps ambivalent feelings about his partner's pregnancy, yet these feelings are nearly universal. Studies indicate that more than one out of ten men will have psychogenic (having an emotional or psychological origin) physical symptoms in relation to a pregnancy. These symptoms tend to appear by the beginning of the second trimester of the pregnancy. There may also be increased feelings of anxiety and depression.

The relationship between you and your partner may also undergo profound changes from your perspective. Previously, you may have had a sense of predictability in your partner's reactions, but her reactions may change significantly during the pregnancy. You may also have significant feelings about the changes in her body proportions, as well as her shifting sexuality. While you wrestle with feelings about the added responsibilities of fatherhood, you may have to give your wife extra care. This is particularly true in our culture, where the extended family is often not readily available to provide support.

Understanding the common psychological changes that occur during preganancy will help both expectant mothers and expectant fathers to understand themselves and their partners better. This understanding can not only ease the emotional transitions during pregnancy, but also deepen the relationship between mom and dad.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.

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ABOUT THE AUTHOR:

Elizabeth Eden, M.D. is a practicing obstetrician with her own private practice in New York City. She serves as an attending physician at the Tisch Hospital of the New York University Medical Center, as well as a Clinical Assistant Professor at the New York University School of Medicine.