I wanted to slap her when a friend suggested I get back into mindfulness during my second pregnancy. I had already been through one awful pregnancy, the kind where you never stop vomiting and the nausea is absolutely wall-to-wall. The kind where you take tablets that you don’t understand in the hope of staying well enough to keep your baby safe and then feel guilty about it. The kind where people tell you that you are “just like Princess Kate” as you are vomiting into your ninth sick back on the London Underground, looking very much like an emaciated alcoholic. So, when I got the positive pregnancy test the second time my feelings were mixed. I was excited about another baby (I cannot get enough of babies) but I doubted my ability to survive another pregnancy and I felt I had tried “everything” last time.
I had tried a lot of things. I bought the device that electric shocks your wrists, the acupressure bands, the medications, and the ginger. Oh, so much ginger. Nothing had made even a slight dent in the sickness and as the pregnancy progressed, far from feeling joyful excitement, I just fell into a deep, and logical, depression. I’d lost everything overnight, my social life, my coping mechanism (running), my work and my health. I couldn’t even reach out to friends on my phone because I could not look at my phone. How could I feel anything other than depressed?
As an NHS psychologist, I obviously knew about the benefits of mindfulness. I had trained in it and found it incredibly helpful for my mental well-being through the stress of doctorates, weddings and funerals. Yet it didn’t even occur to me to use it when I was sick in pregnancy. My sickness felt SO physical, surely mindfulness couldn’t touch that?
Luckily for me my friend is a resilient and capable psychologist who wouldn’t accept my first answer so she bombarded me with evidence that I was wrong. You see there is loads of research that tells us that mindfulness helps with all kinds of health conditions. In fact, mindfulness, a Buddhist practice, was originally turned into a psychological therapy by Jon Kabat-Zinn precisely for the treatment of chronic pain. Study after study after study tells us that it works but how it works may not seem like common sense.
Just to remind anyone who hasn’t recently had someone force them to think about mindfulness… Mindfulness is the skill of playing with your attention. When we are mindful we can choose to shine the spotlight of our attention on one specific thing (like a sensation or object) or we can choose to turn up the floodlights and illuminate our whole experience. Importantly when we are mindful we don’t judge ourselves for the thoughts or sensations we are experiencing we just notice them with a kindly nod and continue focusing our attention where we want it to be.
We can use mindfulness to help us feel “present” in the moment we are living right now rather than getting lost in thoughts about the past, future or imagined scenarios. We can use it to ground ourselves in the here and now, like an anchor, so the anxious and depressive thoughts that come up for us all when we are under stress don’t push us around so much. But how does mindfulness work for sickness and pain in pregnancy?
When it comes to sickness and pain mindfulness is a superpower that we can use in several ways. If you are interested in the science then I recommend you take a look at Zeidan & Vago (2016) and this article from Pathways for a full review. I will give the key points here.
Life can start to feel very empty when your world consists of waking up, vomiting, staggering downstairs to drink some water, vomiting, showering, vomiting, collapsing, vomiting, returning to bed…vomiting. There is evidence that mindfulness can help us focus on things that bring our lives meaning, like loved ones, work or even a film we enjoy, rather than spending all day focused on our nausea or pain. I know this might seem impossible right now but this was one of the first benefits I noticed when I tried it myself and it made so much difference.
When we are suffering we have a tendency to get angry about it. I personally felt rage about my pregnancy sickness. It robbed me of so many experiences I had been really looking forward to. I didn’t get to announce my pregnancy with coy, smug infused joy. No, I had to guiltily explain to everyone that I wasn’t vomiting on them or refusing to see them because I was drunk or angry but in fact…pregnant. Scans were nothing but an inconvenience, six vomits in the car and an anxiety-provoking stint in a hot waiting room while I tried not to embarrass myself in public. There really wasn’t any of the “magic” I had been promised and I was so angry and sad about that. That is natural and I couldn’t switch those thoughts off. But the angry and sad thoughts had too much power over me. They were deciding how I felt every hour of every day. They were giving me tension all over my body and making me feel like I was ready for a fight at all times. Now, I know I always feel a bit sick when I’m angry so that probably wasn’t making the sickness any better was it? And it certainly wasn’t good for my mental health. Mindfulness helps us get some distance from the unhelpful thoughts we often get when we are suffering physically so we can treat them like an annoying bit of background noise instead of letting them call all the shots.
I remember those nine months feeling like an eternity. My mind kept telling me that I was “never going to feel joy again” and I spent hours worrying about how I would cope with labour in my depleted state. Mindfulness can help you notice those thoughts and choose to focus on something else instead so you don’t get stuck in the trap of visualising a bleak future that will only make you feel worse.
How many things have you stopped doing because you are scared of making your symptoms worse? The only thing I attempted to do in that first pregnancy was work, everything else felt impossible and that made life very miserable indeed. Obviously there are things you simply can’t do when you are feeling really sick or in lots of pain but there are some things that might just be worth the discomfort to give you a little meaning in life. Mindfulness can help you put the thoughts about the worst-case scenario (for me vomiting or passing out in public) to one side and focus on what matters to you the most. This helped me significantly in my second and third pregnancies when I wanted to be present for my older children as they experienced milestones like the first day at school but didn’t exactly feel like “fun mum”.
When we are mindful we activate the parasympathetic nervous system. This effectively switches “off” the stress response in the body and allows us to enter the “rest and digest” state that we need for our physical systems to function properly. There is evidence that the body starts to “calm down” when regular mindfulness is used. This helps ensure that your body is in the best position to cope with your physical symptoms and stops it from creating additional nausea and pain.
Mindfulness can also help you sleep better as a result of all of the above and sleep, in my experience, is key to reducing nausea in pregnancy but can be hard to come by when you are at the mercy of your angry, fearful, sad thoughts.
Most of the studies I’ve linked to here are based on mindfulness meditation and structured mindfulness-based stress reduction groups. However, there is some evidence that just being mindful in everyday activities is also beneficial, and sometimes more realistic, for busy people struggling with pregnancy and other commitments.
For me, my symptoms were so bad that I was able to make time for meditation. It is kind of easy to spare ten minutes a day to meditate when you don’t leave your bed much anyway and I am very glad that I did. My second and third pregnancies were MUCH better than the first and although there were likely physiological factors that played a part, I credit a lot of that to my daily meditations. However, I know from talking to my therapy clients that meditation is not the answer for everyone. Thankfully there are lots of ways you can get the benefits of mindful practice in your life, even if you hate the thought of “being still” and have no interest in mantras.
Meditation involves sitting quietly, often with audio to guide you, and practising paying attention to specific things. You can’t get it “wrong” it is all about learning to direct your attention even on days when the mind very much wants to do its own thing. It can be very relaxing but isn’t always.
Mindful movement. You can be mindful of any movement you are doing. Yoga can be a great choice in pregnancy as prenatal classes (and youtube videos) focus on the breath and slow, manageable movements that don’t put too much strain on a fatigued body. If you are well enough you can also walk, or even run, mindfully. Typically this will involve choosing a key sensation to focus on such as the breath, muscles moving or the foot striking the floor. You can choose several different focus points throughout your movement session.
Mindful life. Pick a sensation to focus on in any part of your daily routine. If you are trapped in bed right now then pick a sensation like the feel of the bed sheets against your skin or the breeze coming through the window, or even the hum of your boiler working. If you can get up then focus on small things like the water on your skin when you wash your face or how water tastes and feels when you take a sip.
Anything can be mindful when you understand the basics of the skill so I usually recommend to my clients that they start with meditation in sessions with me and then look for other ways of building mindfulness into their lives.
In my next post I will share with you one of my favourite mindfulness exercises so you can get started today.
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About the author: Dr Rosie Gilderthorp is a Clinical Psychologist, mum of three and founder of The Innovation in Mental Health Project. She is here to support you whether you are pregnant, dealing with the consequences of a difficult birth or having a hard time adjusting to parenthood. She offers evidence-based psychological therapy and hypnobirthing courses. Access our free resources or book your free consultation with one of our specialist Clinical Psychologists at https://drrosie.co.uk