Aligning Pregnancy, Mental Health and Your Relationship→

Although most of us are familiar with postpartum depression, people are often unaware that mental health challenges may start before the delivery of a new baby and may affect the expectant or new mother and their partner.

In fact, medical and mental health providers now refer to the emotional distress that occurs during pregnancy until after one year postpartum as perinatal mood and anxiety disorders (PMADs). Not all of these concerns may meet the criteria for a mental health diagnosis, but they impact the individual experiencing them and their loved ones.

Research has shown us that becoming parents is one of the most stressful times for couples and nearly 67% of couples report a significant decrease in couple satisfaction after their first child is born (Shapiro et al., 2000).

This decrease in couple satisfaction is often difficult to navigate, especially if one or both partners are experiencing a PMAD and current research shows that 20% of women will experience a PMAD (Alderdice, 2020), while 1 in 7 men report mood disturbances during the perinatal period (Tissera et al., 2021). Some of the reasons that couples report a decrease in relational satisfaction during pregnancy and after the birth of a child include biological changes, impaired sleep, less time to spend as a couple, reduced communication, financial challenges, and more (Gottman et al., 2004). These difficulties are compounded if the couple has not spent time discussing their expectations of each other, their new roles, and sharing their ideas of what being a parent while still being a couple means (Dueger, 2021).

These conversations are particularly important because becoming a parent is generally the most significant identity shift that anyone will experience after puberty. If one partner shifts in a different direction than the other, it will strain the relationship.

Also, many new parents shift all their focus onto their new baby and put themselves, their partner, and others on the back burner. Over time this heightens levels of frustration, mood disturbances and relationship dissatisfaction. Of course, no one would suggest that the new baby is neglected or is not prioritized; however, there needs to be a balance between nurturing a new baby and taking care of ourselves and our relationship.

Most relationship experts recommend prioritizing the couple relationship and ensuring that partners create a sense of togetherness and a secure bond; Hoppe and Tatkin (2021) refer to this as a couple bubble.

To create a couple bubble most effectively, we need to work on understanding our own biological, neurological, and attachment needs so that we are able to understand how we are responding to one another and sharing our needs effectively; otherwise, our requests may be critical, and our partner may respond defensively or shut down.

Learning to recognize these different needs and communicating effectively is incredibly challenging because we don’t live in a world that provides many good examples of self-awareness, respectful proactive communication, listening attentively, and responding non-defensively. If one or both members of the couple are experiencing a PMAD, these skills become that much harder to master.

Often only the person experiencing mental health struggles will reach out for therapy, but research has shown that a supportive partner is a key aspect in overcoming a PMAD (Tissera et al., 2021). Other types of social support are also hugely helpful when navigating the challenges associated with becoming a parent, and there are some excellent resources, including peer support groups, available through Postpartum Support International and The Seleni Institute.

If you and your partner are considering starting a family, have recently added to your family, or are unsure of what growing your family during a pandemic will look like, I would be honored to help you navigate these challenges. I am a Certified Perinatal Mental Heath Profesional PMH-C and can be contacted here.

References:

Alderdice, F. (2020). What’s so special about perinatal mental health? Journal of Reproductive & Infant Psychology, 38(2), 111–112. https://doi.org/10.1080/02646838.2020.1734167

Dueger, S. (2021). Preparing For Parenthood. Author Academy Elite.

Gottman, J., Gottman, J., Abrams, D., & Abrams, R. (2004). Eight Dates. Thomas Allen & Son Limited.

Hoppe, K., & Tatkin, S. (2021). Baby bomb. New Harbinger Publications, Inc.

Shapiro, A. F., Gottman, J. M., & Carrère, S. (2000). The baby and the marriage: Identifying factors that buffer against decline in marital satisfaction after the first baby arrives. Journal of Family Psychology, 14(1), 59-70. https://doi.org/10.1037/0893-3200.14.1.59

Tissera, H., Auger, E., Séguin, L., Kramer, M. S., & Lydon, J. E. (2021). Happy prenatal relationships, healthy postpartum mothers: a prospective study of relationship satisfaction, postpartum stress, and health. Psychology & Health, 36(4), 461–477. https://doi.org/10.1080/08870446.2020.1766040

Navigating Pregnancy and Infant Loss

Discovering you are expecting a child can be very exciting and usually begins the process of creating a vision for your child and family. Your life’s trajectory immediately shifts. Maybe you immediately shared the news with family and friends, or perhaps you waited until the second trimester to share your exciting news.

But then the unthinkable happens, and you find out that you have lost your baby. You become filled with grief, uncertainty, confusion, and may not know how to respond. If you had not shared your pregnancy news yet, you might feel a sense of isolation because none of your family or friends know what has happened. If you and your partner shared the news, unhelpful comments, advice or questions may ensue. It’s common for family and friends to offer up words meant to console, but these words can fall flat and may actually intensify grief or isolation.

Adding to the difficulty of mourning the loss of a pregnancy or child is when partners grieve differently, which may intensify what already feels unbearable. Often one partner may feel the loss more intensely while the other is more pragmatic, looking at the loss as “this sometimes happens” or saying, “everything happens for a reason.” While these statements may help one partner cope with their feelings or be factually correct since 1 in 4 pregnancies end in miscarriage, these statements may feel dismissive and result in feeling isolated, unseen, unheard, and unloved. Some couples even report feeling that they are blamed for the loss of the pregnancy or baby if they perceive their partner wasn’t excited about the pregnancy or if there were genetic factors that contributed to the loss. These situations are heartbreaking but do not need to result in permanent damage to the relationships. Here are some points to consider after a pregnancy loss:

• Set boundaries to protect your emotional and physical wellbeing. This may mean asking people to respect your privacy or asking them to help with everyday tasks.

• Plan ahead for times that may be especially difficult such as the anniversary of the loss or the missed due date, or holidays like Mother’s/Father’s Day.

• Engage in self-care at a higher level, taking extra rest, spending time in preferred activities, working on mindfulness or spiritual practices, and slowly re-engaging in physical activity as directed by a medical professional.

• Allow yourself to grieve and understand that everyone processes loss differently, although many people find comfort in attending support groups.

• Reach out to a mental health professional or, if you prefer, a clergy person trained in grief and loss.

Unfortunately, for many years infant and pregnancy loss has been kept in the shadows, which has discouraged women from seeking support and sharing their stories. This may be even more true for their partner, who may feel they have less of a right to grieve.

October is pregnancy and infant loss awareness month. As a society, we are beginning to understand that these losses are profound, create grief like any other loss, and should be responded to accordingly. Below are some suggestions for offering support to loved ones who have experienced the loss of a pregnancy or child:

• Ask if they would like to talk about their loss, and then listen without offering advice unless asked.

• Offer to help with everyday tasks like grocery shopping, meal prep, or cleaning. It’s most helpful to jump in with something helpful rather than ask “what can I do?” to someone who can’t organize their needs during grief.

• Avoid rushing them to “move on” before they are ready. Hold space for their pace.

• Check-in with both partners; many partners who did not carry the pregnancy report feeling their grief is ignored, or they think they should put it aside to support the partner who carried the pregnancy.

• Grief requires that it be seen, heard and validated for it to be processed. Simply being a compassionate presence is priceless.

If you feel that you or your partner needs help working through the loss of a pregnancy or child, I would be honored to be part of your healing journey. You can contact me here. Some additional resources that may be helpful can be found at https://www.postpartum.net and http://www.seleni.org