Thursday, June 30, 2011
When Hopes for a Happy Pregnancy are Disrupted
It happens. The early joy of a much-wanted pregnancy is suddenly shattered by something unexpected. Whether your partner (imagine former US Congressman Anthony Weiner) reveals some giant stupidity that makes you question whether you want this person in your life anymore; whether your physician delivers some troubling news (imagine a Down Syndrome diagnosis) from a prenatal test; or whether a family catastrophe (imagine being laid off from your job and losing your health insurance) takes over your life, stifling the joy that had nourished your spirit, you feel as if you are in the midst of an emotional balancing act with no acrobatic training.
So how do you cope when a joyful pregnancy is no longer in the center of your life because your partner has demonstrated an emotional betrayal, an act of extreme stupidity or some other unexpected dimension of behavior that you never would have thought possible? As you are re-grouping, you could be weighing whether to remain in the relationship, whether to continue the pregnancy or whether to consider placing the baby for adoption. Each one of these issues feels life changing and overwhelming. And, given the betrayal exhibited by your partner, you may feel reluctant to confide in close friends and family, since you don’t want to face yet more pressure from them about what actions you “should” take. You also need desperately to vent, but hopefully are careful about saying too much too soon. So here is where an excellent option is to seek counseling from a professional who practices marriage and family therapy. This could be a psychologist, a social worker, or a marriage and family therapist. Some pastoral counselors will have this training as well. As I have said in earlier blogs, as well as in chapter 7 of my book When You’re Not Expecting, there are several ways to locate a therapist: recommendations from friends or clergy, names provided by your county mental health clinic, suggestions from a hospital social worker, or contacting your local family service agency. Plan to present yourself as someone who is experiencing a crisis, which will minimize the likelihood of being placed on a wait list. And be persistent in asking for services – if you are concerned that you cannot afford them, ask whether the agency or the therapist has a sliding fee scale. But the bottom line here is that it is important to receive emotional support and guidance in this difficult time from someone who appreciates the complexity of your dilemma AND who has the professional perspective to guide you through the decisions you will face in the months ahead.
Troubling medical news from prenatal tests can be immensely disruptive emotionally. Although the opportunity to learn early about genetic or other developmental disorders is important to expectant parents, the flip side of this opportunity is that often tests cannot predict the extent to which a particular abnormality will affect the developing fetus. This places many parents in an immensely difficult position. Clearly the first goal is to learn as much as possible; medically this may involve more specific tests or a consultations with specialists; emotionally you may very well want to meet parents of children born with the disability (being sure to include children both severely affected as well as minimally affected); and you will want to learn about community support services for children with the special needs that your child may have. All of this information presents a particular challenge to prospective parents who may be considering terminating the pregnancy or placing the baby for adoption. And, of course, your view of your pregnancy is forever changed; you now are apprehensive, anxious and fearful at the same time you also may be feeling protective and hopeful. Prospective parents who make the decision to terminate the pregnancy often choose to present the loss as a miscarriage, in large part to protect themselves from the judgmental reactions of others. Some will be forthright with close friends and family about the careful thought they gave to this wrenching decision. And all will be very careful in subsequent pregnancies to receive early genetic counseling and prenatal testing, as a way of being informed about any risk factors.
In addition to partner woes or worries about the health of a developing fetus, other life catastrophes can take a huge toll on the happiness initially associated with a pregnancy. These days financial issues, unemployment, home foreclosure, family illnesses and other unanticipated crises can be a significant source of worry and uncertainty. Sometimes we have some control or influence over these situations, and other times there is little we can do. Given that anxiety is usually associated with loss of control, perhaps the one antidote is to remain as calm as possible in the figurative “eye” of the situational storm. Since it is known that the cortisol associated with stress can enter the fetus’s bloodstream via the placenta, remaining calm is for the health of the fetus as well as your own. In addition to considering counseling as one path to take in addressing sources of stress, relaxation efforts and mindful behavior also can help you to feel more centered as your pregnancy progresses. The kind of counseling that is most appropriate in dealing with situational stress is cognitive behavioral therapy, where a therapist will help you to re-frame your tensions differently and more manageably. After helping you to think about constructive ways to address the stress, the therapist will offer support and encouragement each step of the way. Not only are you learning about problem management, but you also are learning skills that will be excellent for future difficulties that initially seem overwhelming. Deep breathing exercises, yoga, and mindful relaxation are additional skills you can learn to help you calm your body and your mind when tension intrudes. It can be empowering to learn that even when you cannot change a particular situation, you can exert some control over how you respond to it and the extent to which you allow its stress to affect you.
An initially happy pregnancy can be threatened with worry or misery for a wide variety of reasons. Often our initial reaction at such a time is to turn to friends and family for help and support. After all, haven’t they been there for you in other times of stress? Perhaps. But the examples in this blog go beyond the skills and knowledge that our informal networks typically possess. So, in addition to dealing with the current disruption to the joy in your pregnancy, you also will need to stretch yourself to consider how to access necessary support and skills. Use the web, use the yellow pages, use your spiritual leader or health care professionals, and do it in the spirit of moving forward to learn the acrobatic training for this uninvited interruption in the joy you deserve to nourish.