Managing Anxiety in Pregnancy: Reframing Thoughts

Aug 29, 2021

Have you ever noticed how we tend to talk in extremes with regard to how we feel? We get really attached to one feeling, leaving us with one label of how we are experiencing the world. This is especially strong in pregnancy. People seem to either love or hate their pregnancies. The reality is that most people experience many different feelings in and toward their pregnancy, but we tend to overgeneralize. When we think in extremes like this, we often feel stuck in that label. It can become difficult to mindfully experience life and experience an array of feelings because we start blocking out what doesn’t fit our one label. These maladaptive patterns of thinking are termed cognitive distortions. Here are 4 cognitive distortions that may become prominent in pregnancy:


  1.     Polarized Thinking (Black and White Thinking) – This is when we think in terms of all or nothing. When we get stuck in this way of thinking, we miss out on the complexities of an experience. In pregnancy this may look like “If I have a non-medicated birth experience, it’s a success. If I take medication, I’ve failed.” A helpful way to reframe this may sound like, “Birth can be experienced in many ways. Whether I take medication or not, I am doing the work of bringing a baby into this world.”


  1.     Overgeneralization: This happens when we take a small piece of information or one experience and come to a general conclusion. In pregnancy this could present as one unpleasant test result leading to thoughts that your entire pregnancy and birth experience will be unhealthy. A helpful way to reframe this may sound like, “Even though I have gestational diabetes, I am still able to have a healthy pregnancy by following health-promoting guidelines.”


  1.     Filtering (Disqualifying the positives): In this aspect of filtering, one would magnify the negative details of an event and only allow information to sink in if it aligns with those negative traits. Any positive information would be filtered out as it doesn’t align with the negative details of a situation. In pregnancy, this may mean that feeling physically ill equates to an entirely miserable experience in pregnancy. Promising test results may be dismissed, baby’s movements may be filtered as only an annoyance, and brief moments of joy may be pushed down because they don’t fit the story of your miserable experience. Instead of filtering, we can utilize phrases that incorporate the reality of both good and bad experience. You might say, “I’m feeling really sick and I’m experiencing moments of joy when I feel my baby kick.”


  1.     “Shoulds”: This is often regarded as a critical way of internally speaking to ourselves. In pregnancy it may look like “I should be able to keep up with all of the tasks I took on prior to pregnancy” or “I should be exercising more and eating healthier”. This way of speaking to ourselves only creates further pressure and a separation from our true experience. It’s based in judgment and typically leads to increased feelings of shame. A gentler approach may sound like, “I’m feeling a lot of pressure to act a certain way. I may not be exercising as much as I planned, but I am walking regularly and fueling my body.”  


Our thoughts are very powerful. They can either serve us or get in our way. Mental health can be promoted by observing these thoughts and asking the question, “How is this serving me?” When your thoughts are no longer serving you, consider using gentle reframes. Pregnancy is allowed to be more than one thing. You are allowed to feel sad, sick, discouraged, AND excited, grateful, grounded. Allow yourself to feel validated in a variety of feelings and experiences and you will alleviate the pressure that keeps you feeling stuck. You are experiencing so much in such a short (yes, sometimes it feels like forever) period of time. Take some pressure off and lean into the experience. You are worth it.


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