Time To Chill

Beat the four biggest pregnancy stresses.

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When you're pregnant, a little stress goes with the territory. You're worried about your stretch marks and whether you'll ever get your body back. Or you're frazzled because you have to take pee breaks during important meetings at work.

These concerns won't do any real harm, but chronic stress during pregnancy is linked to lifelong risks for children, including anxiety, aggression and learning disabilities. The good news is that you can safely get a handle on it.

Here, experts offer their best advice on dealing with four major sources of stress during pregnancy.

1. Your Relationship: When the honeymoon is really over.

Pregnancy is a time of major emotional (and physical) change when all expectant couples face stressful moments. But what if you're facing an extreme situation, such as a husband who says he no longer wants a baby? Even this kind of severe stress can be alleviated with good communication and a cool head, says Debra Cucci, M.A., M.F.T., a marriage and family therapist in Hermosa Beach, Calif. Here are her strategies:

Don't Lash Out Immediately. Rather than reacting rashly, Cucci advises asking your partner for an appointment to talk later, when both of you may be calmer and better able to listen to one another.

Have An Expectations Talk. "Many men freak out during this time, as they become worried about changes to their job, friends, sex life, freedom and so on," Cucci says. "A roadmap-expectations talk can help." Address all areas of concern, including sleep deprivation, division of chores and parenting duties. "It's especially good for a couple to address the lack of spontaneity they will soon experience," Cucci says. "Perhaps you can decide to have grandma come stay with the baby when he's 5 months old. Even if all you do is go to a hotel and sleep all weekend, it provides you with something fun to think about doing alone together."

Enroll In Parenting Classes. You'll meet other couples with similar due dates (and help your partner meet other expectant dads). Getting other people's perspective can be eye-opening and constructive.

Sign Up For Marriage Counseling. This can be especially helpful for couples who can't communicate compassionately, or who blame one another or escalate arguments. Cucci says it can help couples find the tools needed to communicate under stress, which will only get harder after the baby arrives and you're both short on sleep and time. For couples dealing with financial challenges, there are usually low-fee resources for marital therapy in most communities.

Show Appreciation "Most men who come to marriage counseling seem to share one common complaint: they don't feel appreciated by their partners," says Cucci. Dig deep and see if there are times when you focus more on what is wrong than on what is right.

Be Careful Who You Confide In Telling family members about your partner's freak-out moments can potentially exacerbate issues or cause him to feel isolated or shunned later at family events. Instead, confide in a therapist, your OB or midwife, or a trusted friend.

2. Your Job: Can it survive your having a baby?

Are you terrified to tell colleagues or your boss that you are pregnant? Stressed out every time you have to leave work for an OB appointment? Panicked that you'll miss out on projects and promotions after taking maternity leave? If you fear pregnancy discrimination on the job, arm yourself with as much information as possible, says Sarah Crawford, director of workplace fairness for the Washington, D.C.-based National Partnership for Women & Families. Crawford recommends doing the following:

Familiarize Yourself With The Family Medical Leave Act (FMLA). It allows for 12 weeks of unpaid maternity leave with your position (or an equivalent one) intact upon return. Also, read the Americans with Disabilities Act; it permits pregnant workers to be treated like other workers with disabilities who may have lifting restrictions, for instance.

Contact Human Resources (HR) At Your Company. Request information regarding maternity leave and related policies.

Know Your Company Culture. Contact a new mother in your office who can tell you her experiences, such as how she was treated after returning from maternity leave. For instance, Crawford says one manager expressed disappointment with a woman for not checking in weekly while she was out on leave. Knowing this can help you to avoid unnecessary grief when you return to work.

Communicate Your Plans Clearly With Your Supervisor and HR. Crawford shares the example of one woman who was fired because an HR official did not know the details of her maternity leave. To avoid such a scenario, email a letter to your boss (and cc your HR rep), outlining when you'll take maternity leave, when you plan to return, who is taking over unfinished or ongoing projects for you and how often (if at all) you'll be checking in during your leave.

3. Your Health: When normal concern becomes high anxiety.

Clearly, combating a serious medical issue, such as cancer or lupus, when pregnant will tax you physically and mentally. You will need support from your partner, family, friends and a good obstetrician who specializes in high-risk pregnancies. And if you are on bed rest, online groups like the pregnancy support network Sidelines (sidelines.org) can be a lifesaver. But what if you freak out over every minor but often scary pregnancy symptom, such as spotting or Braxton-Hicks contractions? Khalil Tabsh, M.D., professor and chief of obstetrics at the David Geffen School of Medicine at the University of California, Los Angeles, who has 34 years of experience in managing high-risk OB patients, advises the following for overanxious patients:

Learn As Much As Possible. Sure, What to Expect When You're Expecting and similar books can bombard you with information on serious issues, but they can also outline what is absolutely normal and put your mind at ease. Just make sure the books and websites you go to are by authoritative sources, such as government health organizations and universities, and steer clear of fear-inducing information from laypeople.

if You're Panicking, Call Your Doctor Or Midwife Anyway. "There's a lot to be said for maternal instinct and listening to your concerns," Tabsh says. "Going in for an evaluation will help you learn how to discern true emergencies."

Don't Try To Manage Your Own Care. This is especially important if you do develop a medical condition. "For instance, the patient diagnosed with gestational diabetes who decides to manage her high blood sugars by severely restricting her diet (rather than by taking insulin if needed) is endangering her fetus," Tabsh says. (For information on discontinuing antidepressants or similar meds during pregnancy, see "Should you Stop your Psych Meds?")

Get Help If You Dread Delivery. A Swedish study found that women with tocophobia—an extreme fear of childbirth— who received counseling, delivered vaginally without forceps or vacuum intervention only 51 percent of the time, compared with 75 percent for the women who had no fears. The tocophobia sufferers requested elective Cesarean sections 30 percent of the time (compared with 4 percent for the women with no fears), and also had more emergency C-sections.

The researchers noted that most women with a deep-seated fear of childbirth are not only worried about pain, but also about losing control and being unable to "persevere mentally or physically." Experts say it's imperative that such women talk about their fears with a supportive mentor, such as a midwife or doula, join a support group and/or undergo psychotherapy.

4. Your Finances: This baby is going to cost how much?

Especially in this economy, it's no wonder you're stressed out about money: Children are expensive. In fact, having a baby is the leading cause of "poverty spells" when a family's income can no longer cover basic living expenses, according to research by Momsrising (momsrising.org), an online and grass-roots organization promoting economic security for families. This is especially true if one parent has recently lost a job. While this information is frightening, don't panic: Planning can help, says Eric Brotman, a Baltimore-based financial planner and author of Debt-Free for Life (One Hour Or Less Publishing). He suggests these three steps:

Build A Budget That Includes The Costs Of A Baby. Brotman estimates this to be $9,000 to $11,000 a year, depending on where you live. If you'll need paid day care, your expenses will, of course, be higher. Figure out ways to save money—by breastfeeding rather than using formula, for example, and by buying baby clothes and select gear at thrift stores, consignment shops and garage sales. (your baby won't know—or care.)

Use Tracking Software. Quicken and Mint (mint.com), which is online and free, are good choices. "It's imperative to know what you're spending," Brotman says. "You have to know where you are in order to know where you are going."

Eliminate Existing Debt. If possible Brotman recommends using a debt-reduction planner, such as Quicken's. Credit counseling services can be a good idea, but he warns that finding reputable agencies can be difficult, so do your homework. You can find a list of government-approved organizations at usdoj.gov/ust.

Stress Relief For Whatever Ails You

No matter the root cause of your anxiety, research shows these tried-and-true activities will make you less anxious and stressed.

Yoga: Yoga lessens depression and anxiety, according to a 2010 Boston University School of Medicine study. Scientists found higher levels of the amino acid GABA in people who practiced yoga three times a week for 12 weeks, but not in others doing the equivalent amount of strenuous exercise, such as walking. GABA helps promote a state of calm within the body, and low levels are connected with depression and anxiety disorders.

Meditation: A 2010 Harvard University and Massachusetts General Hospital study showed that 30 minutes of mindfulness meditation a day resulted in decreased activity in the amygdala, a region of the brain connected to anxiety and stress. If you think 30 minutes is too long to keep your mind from wandering, try a defined meditation, such as Guided Mindfulness Meditation (Hyperion), an audio CD by Jon Kabat-Zinn, Ph.D.

CBT: Cognitive-Behavorial Therapy (CBT) can teach you how to think more realistically so that fearful or stress-inducing thoughts, such as I can't afford a baby, don't build into chronic anxiety. Guided by a trained therapist, you exam- ine the thoughts that underlie those feelings and determine whether or not they really make sense. If not, you can replace them with more realistic thoughts. A therapist can lead you to understand that babies don't have to be as expensive as you might fear.

Should You Stop Your Psych Meds?

If you've been taking drugs for anxiety, depression or other psychological problems, the impulse is to stop abruptly when you find out you're pregnant. This is the wrong way to go. "The jury is still out on whether psychotropic meds like antidepressants should be discontinued when a woman is pregnant," says James La Rossa Jr., publisher and editorial director of Medworks Media, whose journals have chronicled government and industry studies on this subject for the last two decades.

"Whatever you do, don't discontinue your medication abruptly, as dangerous side effects can occur," he adds. "It is best to [taper off] slowly with the guidance of your OB-GYN, psychiatrist or family doctor." Also, don't start taking a nutraceutical like St. John's Wort, La Rossa says. "The effects such products may have on the fetus are completely unknown. If faced with the choice, it would be far safer to stick with your antidepressant, since pharmaceuticals have been studied and scrutinized far more closely than herbs or vitamins."