4 Mental Health Tests in Pregnancy

If you had told me when I was in active addiction that I’d one day be expecting a baby with a husband I adore, I would’ve laughed out loud. Well, here I am in my third trimester. Sometimes I have to pinch myself.

Pregnancy has been an incredible journey, but there have also been stressors unique to being a new mom in recovery from alcoholism. Here are some of the lessons I’ve learned, in the hope they can help other expecting moms who may be in a similar place.

The Many “What Ifs” of an Over-Active Mind

“Stinking thinking” is how 12-step programs sometimes describe the tendency to get stuck in negative thought patterns that might trigger a relapse. First-time pregnancy is a magnet for stinking thinking and an over-active mind. The many unknowns—no matter how many books I read about what to expect—can be a source of anxiety and even panic. These measures helped me turn down the dial on the anxious “what ifs”:

• Google and limiting where I get my information – I quickly discovered that googling questions and concerns only amplified the anxiety. Every worrying symptom turned up another worst-case scenario. Since pregnancy can be stressful enough, I gave myself a break from Google and have breathed easier since.

• Consulting my ob-gyn first with medical questions – I hesitated at first because I didn’t want to be a bother, but my doctor encouraged me to reach out whenever I had a concern. Now, when I freak out about a question, I take it to one medical expert only, rather than a whole gaggle of random internet voices.

• Connecting with other moms for support and answers to questions – When medical and other sorts of questions have arisen, having a close network of other moms who have been through pregnancy has been tremendously helpful. They have been through the same journey, have firsthand experience with many of the same issues, and are quick to express empathy and reassurance.

Mood Swings and Emotional Sensitivity

Early pregnancy felt a bit like an emotional roller coaster ride. My doctors assured me that the weepiness and hypersensitivity were normal manifestations of the dramatic hormonal changes my body was experiencing. Even so, I didn’t feel like myself. Every day, at 8pm, I’d crawl into bed emotionally exhausted.

As someone in recovery, I was fortunate to have a mental health care team already in place. I also knew I needed to lean into these existing supports now more than ever. That meant setting up more frequent appointments with my psychiatrist and tweaking my medication regimen. It also meant developing some new stress management tools for when I felt overwhelmed. My therapist and I incorporated these breathwork techniques into our weekly sessions. They helped immensely.

Body Image Insecurities

As someone who has always struggled with their weight, I’m not one who shares confident selfies of their pregnant belly. In a string bikini. On Facebook.

Pregnancy reintroduced some of the old body image insecurities that I thought were gone for good. They came to the fore last fall in the lead-up to a family wedding. By this time, my trusty Spanx no longer could deliver for this swelling belly (not to mention swelling ankles, swelling everywhere).

Fortunately, my tribe of women came through for me when my Spanx could not. They rushed to my aid in response to panicked selfies taken in dressing rooms. With the help of my mom network, I was able to find some outfits that felt comfortable, flattering, and appropriate for the wedding. I’m also coming to view my pregnant body with more positivity and as a sign that my due date is almost here.

Pain Management for Labor Pains

I recently attended a day-long birthing class about what to expect during the labor and delivery process. When the discussion turned to pain management, I really tuned in. Afterall, if I was going to be medicated to relieve painful contractions, I wanted to go with the most recovery-friendly option.

Although I had heard of an epidural, I didn’t know much about it. We learned more about how it works and how it affects the mother and the baby. That seemed like a feasible recovery choice.

Nitrous oxide was another option. Our class instructor explained that you can breathe it in during a contraction to reduce the pain but that the effects wear off quickly once you remove the mask. It reportedly does have some slight mind-altering effects. That raised some concern, and I’ll be checking in with my support system about whether nitrous oxide is right for me as a mom in recovery.

One medication gave me immediate pause, given my past struggles with alcoholism. It reportedly causes feelings of drunkenness that can last hours after its administration (via IV)— hence its slang name “margarita medicine.” While I respect it as a viable option for others, I know for certain that I do not want to be exposed to a medication that will change my mental perception for a long stretch. Going without it may mean I have to deal with a little more pain, but I feel secure in my choice to protect my recovery in this instance.

Being both pregnant and in recovery poses some unique stressors, but with the right tools and supports I was able to savor this time and even thrive. You can, too.

Molly Mammen is Alumni Director at FHE Health, a national behavioral health provider. Shortly after she wrote this piece, she gave birth to a healthy baby boy.