Psychological symptoms of pregnancy - what's that?

We spoke with psychologist Tova Winbladh about the emotional journey it is to find out you’re having a baby, and what happens in the months that follow.

Hi, Tova. How do you really know if you’re ready to have a baby?

Rather than being ready, I think you become ready: pregnancy itself is a huge opportunity to prepare and grow into your new role. Basically no one feels fully ready to have a baby. There are always parts of your life that could be more secure, more predictable – or parts of your inner life that could be more stable and calm. How do you ever feel ready for a task that you will be doing every day, all day, for the rest of your life? It’s hard to do that. But if you’re longing to have children, and if you want your life to evolve and be focused on someone else, then you’re usually right on track. Even if you still don’t feel completely ready for kids.

Overjoyed one moment and flooded with worries and doubts the next – what’s going on?

Almost everyone experiences some degree of doubt or ambivalence in the beginning of pregnancy. A positive pregnancy test tends to kickstart a whole host of different emotions, and those feelings aren’t strictly positive. Maybe you’ve been waiting a long time and when the test finally shows that you’re pregnant, you feel a little empty; it feels unreal. Or maybe the fatigue and nausea have set in and you’ve started to feel some regret; you’re wondering if this was such a good idea after all. Maybe the pregnancy was unplanned and you’re facing a difficult decision that requires an enormous amount of energy. Maybe you’re worried the pregnancy won’t last and you’re afraid to celebrate.

Those feelings of ambivalence are a part of everything that’s happening in your body and mind at the beginning of a pregnancy, both for the pregnant partner and for the co-parent, if you are in a relationship. It can be very stressful to doubt your decision to have a baby or to be bounced between delight and panic, but that’s all part of the journey towards becoming a parent. Major psychological adjustments usually come with complex emotions; your psyche has to adjust on multiple levels to what’s going to happen, and it doesn’t feel easy or simple – it feels multifaceted and fragile.

Feeling unfocused or inwardly focused, or struggling to muster the energy for anything else are all common experiences for many parents-to-be – especially the one carrying the baby. Why does this happen?

In part, it takes a lot of energy physically just to be pregnant, which makes it easy to feel tired and less focused. Your psyche also needs to adjust to the major task ahead, and as a result, it might be difficult to take interest in anything unrelated to your family life. Our brains are so clever – the psychological process of becoming a parent is constantly underway, even when these thoughts aren’t conscious.

How common is it to start to have doubts or to feel differently about your partner and the future parent of your child? What can you do about such thoughts?

Doubts of all kinds are common when you’re expecting a baby, including doubts about your co-parent. It might be comforting to remember that most people grow into their role as a parent once the baby is born; it can be difficult for some people to really imagine what it entails to have a child before the baby arrives.

What should you do if you are out of sync, or if your partner isn’t being understanding when it comes to your feelings and reactions to pregnancy?

How we experience pregnancy is different, and so is how it feels to be expecting a baby – which means it’s important to share your thoughts and feelings with your partner. It will be easier to understand your partner if you talk to each other about what’s going on internally – both physically and in your heart and mind. If it’s hard to talk about the situation together on your own, then consider seeking support from your midwife or another professional who knows how it feels.

Renovate your flat, buy a house, change cars... What psychological process is underway when you start to nest?

Most mammals prepare and nest when expecting their young. Humans do, too. It’s important to us for our children to be born in a safe and secure situation and circumstances. Plus, it’s often enjoyable and fun to work on concrete, practical things before the baby comes, because that makes the whole thing feel real. Preparing practically can be a way to exercise your role as a parent already now, while the baby is still in the womb, and to fantasise and imagine how life will be.

Some parents-to-be might feel stressed in this preparatory process and embark upon major renovations or feel pressure to work a ton and bring in money for the family. It’s easy to get caught up in it all, but if you’re feeling overwhelmed, it may be wise to pause and reflect on whether the things that seem so important are truly the right things to prioritise before the baby’s arrival. Rest and time for reflection are at least as important when preparing for a baby as having a finished nursery or the perfect pram.

When will your feelings for the baby arrive?

Most people experience a variety of emotions when awaiting a baby – but not always the ones you might have expected. For some people, it takes about two minutes to feel close to the baby they are carrying, and to feel at home in their role as a parent; for others, it can take several months. We’re all different when it comes to how we bond with the baby in the belly, and there is no way right or wrong way to be! And even if you aren’t feeling flooded with love right away, you can still be an outstanding and loving parent; it’s very important to remember that.

Tova, do you have any tips for partners who feel excluded during the pregnancy, for example at medical appointments or by the people around you?

First and foremost, I think that as a partner, you’re automatically excluded at doctor’s appointments, because care for the pregnant person is primarily meant to ensure their health and the health of the foetus. And naturally, there often won’t be enough resources or time to put much focus on the other parent-to-be. That might feel strange to some people, because as a partner, you’re just as much an expectant parent. Meanwhile, if everyone around you is also focusing solely on the experience of the pregnant partner, it isn’t surprising that you might feel frustrated. Daring to take up space with your own thoughts and feelings is likely the best way to become more visible as a partner. Take part in conversations and at appointments with the doctor or midwife; be bold enough to ask your own questions and read up on your own, so that you’re just as aware as your pregnant partner. This tends to produce a better sense of equality during the pregnancy and will also make you a more equal parent once the baby comes.

How much people enjoy being pregnant seems to differ a lot: some people love it; others hate being pregnant and don’t feel well at all. Do you have any tips for people who are really suffering through body changes and unpredictable moods?

It’s okay to complain, especially to others who feel the same way! Many people really dislike being pregnant and an important part of getting through it could be talking to others who also aren’t loving the experience – that way, you won’t feel alone. It’s also important to complain to your partner and friends, and to be permitted to feel awful without others thinking you regret your choice or that you’re going to be a bad parent. Your midwife can often provide great support, as can other professionals, like a counsellor or psychologist. The best part about disliking being pregnant is that pregnancy passes on its own, and at that point, the whole situation tends to change quickly. What you need the most help with is coping and having a little fun, despite the ordeal of pregnancy. Talk about how you’re doing with friends and family and ask them for extra consideration and encouragement during this period. Given the chance, the people around you will usually be understanding and supportive!

People who have had mental health issues before, such as anxiety, depression, or an eating disorder, may find that pregnancy triggers these challenges. In that case, it’s important to talk to your midwife so that you can get the proper support during pregnancy. You should not have to put up with mental health problems just because you’re pregnant and potentially think it’s supposed to be that way. On the contrary, it is especially important to seek help for these problems, both for your own sake and for the baby.

Please note that all information above is based on Swedish recommendations.