Now that you’re pregnant, you’re saddled with making decisions for both yourself and your unborn child about how to respond and react when things get stressful. You know that you want to minimize stress — so as to have a healthy pregnancy — so you may choose tactics like avoidance.

Alternatively, your responses and reactions may appear, either from your perspective or your partner’s, to be heightened in pregnancy. This may lead your partner to dismiss your concerns and leave you feeling unsupported and misunderstood.

Common reasons expecting couples face relationship stress

Pre-existing stress

Sometimes relationship stresses begin before a couple is expecting, and continue into the pregnancy. Even if you have always wanted to be a parent, the pregnancy may not be planned or the timing may not be ideal in terms of your relationship’s health.

Financial stress

Financial stress in pregnancy can often be a source of relationship tension. As your family expands, it is inevitable that you will need new supplies. You may even need to reconsider your housing situation.

If one or both parents intend to take maternity/parental leave, there is a financial implication to that reduced income. The exorbitant child-care costs in major urban locales like Toronto can also be daunting.

Change and uncertainty

Everything is about to change! Will we still have time to nourish our marriage and our respective need for “me time”? How will intimacy be impacted? Are we ready to be parents?

The uncertainty of what is to come can be very overwhelming and can lead to relationship stress. For some women, these feelings of impending change, evolving responsibility and the resulting worries can be more significant given their physical experiences of pregnancy.

Differing parenting philosophies or gender expectations

In pregnancy, you may be starting to converse about your hopes and expectations of parenting, as well as the division of labour between you and your partner.

Will the child have a religious affiliation? What is important to you about your child’s early life? What are your feelings on discipline, infant sleep and feeding?

As you begin to discuss these hopes and expectations, you may realize you are not on the same page, and compromise may not initially feel achievable.

Unfaithfulness

Occasionally, I work with women who discover their partner has been unfaithful while they are carrying a baby. The hurt, anger, and betrayal that results is so amplified.

You may feel particularly vulnerable when faced with a decision to reconcile or separate when there is a baby on the way. Being a single parent was not what you had envisioned for your life, but perhaps it also does not seem like sufficient reason to stay.

Coping with relationship issues in pregnancy

Methods for dealing with relationship stress are dependent on the nature of the stress. But, as always, you should consider harnessing any established, effective and healthy coping strategies you have.

For example, it may be helpful to exercise, tap into creative outlets, seek social support from friends and family, engage in your religion/spiritual practices, or engage in the community.

It is also important to speak to your obstetrician (OB) or midwife about the health of your relationship. Depending on the hospital where you will be delivering, you may have access to a perinatal social worker who can offer additional emotional support.

You and your partner may also decide to attend couples counselling. Check to see if you or your partner’s employer offers an employee assistance program (EAP) wherein confidential individual and couples counselling is available free of charge. You may also seek out couples counselling by asking your family doctor for referrals, or checking out the Canadian Association for Marriage and Family Therapy.

Domestic violence

Pregnancy is a time of increased risk of abuse. According to the Society of Obstetricians and Gynecologists of Canada, the incidence of violence in pregnancy runs between 4 and 17 per cent.

Physical, sexual, psychological and financial abuse are unacceptable behaviours. You are not to blame and there is help available. If you are experiencing domestic abuse while pregnant, share this information with your care provider.

If in crisis, in danger, or concerned for your immediate safety, call 9-1-1

• To find your local hospital-based sexual assault/domestic violence treatment centres, visit the Ontario Network of Sexual Assault/Domestic Violence Treatment Centre’s website.
• For information, support and telephone counselling, call Assaulted Women’s Helpline: 1-866-863-0511
• For emergency shelter placement in Toronto, call Toronto Hostels Central Intake: 416-397-5637
• For information on support available in other provinces, visit the Ending Violence Association of Canada’s website.

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However, I can’t tell you how often women come into my office and talk about how they are not enjoying pregnancy; and that this feeling leaves them isolated.  Pregnancy is a unique time in your life where we then tend to get stressed about being stressed for fear of its impact on your unborn child.  As a social worker, my job is to try to validate their emotional experience, to destigmatize coping difficulties or mood changes in pregnancy, and reassure someone that they are not alone. 

Here are just a few reasons why pregnancy may not be the best of times:

1.     Your expectations and the societal pressure to enjoy it.  You and your partner excitedly start planning for a family and with time, you conceive.  Perhaps you expected to love it and expected it to be a nine-month celebration of what was to come. Perhaps you know someone who is struggling to conceive and you feel you must not take your pregnancy for granted.

2.     The symptoms and complications.  Nausea, changes to skin, hair, weight gain/bloating/water retention, constipation, joint pain, inability to sleep comfortably.  I could go on!  Talk to your health care team, they will have good suggestions on how to cope with many of the discomforts. 

3.     Pregnancy restrictions and all the no-no’s of pregnancy. You may be wondering about that morning cup of coffee you always look forward to, or your weekly sushi meal.  Maybe your doctor is asking you how strenuously you work out. Perhaps you are too tired to socialize with friends to the extent that you normally would. So, your go-to coping mechanisms are suddenly taken away and you are left scrambling to identify how to cope with stress.

4.     You feel unprepared or worried about what’s ahead. Many women that I’ve met simply question, “Will I be a good mom?”, “Will the baby be okay?”, or “Are we ready?”  It is a time of transition when we will soon assume a significant new identity which has broad-reaching impacts on your life.  Anticipating the change can be a really overwhelming exercise.

5.     It’s possible that you just don’t feel like yourself when pregnant.  “Depression occurs in about 15% of women in pregnancy or postpartum. Anxiety may be more common,” says Dr. Cara Brown from the Women’s Mood and Anxiety Clinic: Reproductive Transitions at Sunnybrook Health Sciences Centre.  You may be more irritable or feel like crying. And despite your best efforts, it’s difficult to shift your mood.  Please speak with your doctor or another member of your health care team.  This is important as depression and anxiety in pregnancy can put you at increased risk for postpartum depression.

Here are some tips for getting through those nine months and maintaining your sanity:

1.     Tell someone.  In addition to your family doctor, your obstetrician or midwife, it can feel helpful to confide in your partner or a trusted friend.

2.     Consider counselling.  Hospitals with maternity services usually have a perinatal social worker available to you.  Or try your workplace employee assistance provide (EAP).

3.     Consider all those fundamentals of effective coping – good sleep, good nutrition, and exercise as approved by your physician.  Take some time to consider new ways to take care of yourself or ways that have proven effective for you previously.

4.     Be kind to yourself.  You are entitled to your feelings and to your experience of pregnancy.     

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1. Establish a holiday tradition in your baby’s memory

• Give a holiday donation or give back in another way to a charitable organization in your child’s name
• Decorate or visit the gravesite
• Name a star, light a candle, or purchase a wreath/plant in baby’s name

2. Acknowledge the holiday to the extent that you wish.

• Consider shopping online or with help from family
• Give yourself permission to limit decorating or social gatherings
• Share mementos of your child with friends or family

3. Take care of yourself

• Plan relaxation time, exercise, or engage in a creative activity
• Take a vacation! Perhaps for the first year or two following the loss, it is best for you to be away and/or not participate in certain holiday activities
• Spend time with another grieving family
• If you are participating in therapy, consider an appointment at this time to process your emotions

4. Ask for what you need

• Inform trusted friends and family about how this holiday season is different for you
• Ask someone else to host or inform others of your limitations in terms of contributing to any gathering this year
• Perhaps write this in a letter or appoint a person to communicate a message to others about what is helpful and what is unhelpful to you

5. Consider siblings

• If your baby has any siblings, consider their need to maintain certain traditions
• As appropriate, communicate to them about any changes that you intend to make in terms of celebrating this year
• As appropriate, involve them in any new holiday traditions in baby’s memory

6. Give yourself permission to feel whatever emotions are coming forward

• Anger, sadness, or resentment are more strongly felt by some at the holiday season and that’s okay. It is also okay to feel joy. You are entitled to laugh and feel happiness.

A few tips for friends and family too:

1. Acknowledge the loss. Perhaps you just merely need to find a time to tell them “I am thinking of you”. Consider that silence or “business as usual” at a holiday family gathering can be perceived as dismissal, fear, or abandonment.
2. Don’t forget about dad. He is grieving too.
3. Be patient and kind. Limit your expectations of your loved one to be cheerful or to participate in family gatherings.

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