common psychological concerns in pregnancy and how to deal with them. Father and mother to be.

1. What is happening?
Dr. Shewikar El Bakry
Ass. Prof. of Psychiatry
Banha University

2.  Pregnancy is an experience full of growth, change, enrichment, and challenge. It is
a time when you as a couple confront your fears and expectations about becoming
parents and begin to determine your own parenting style.

3.  Just got a positive result
 Expected? Planned? wanted?
 Ready for it?
 Financial burden?
 Work?
 Am I silly to think of heals and clothes?

4. Psychological Changes in the First Trimester
 women are glowing and happy………. experience many emotions
 Shifts in body image, hormones, attitude toward cultural pressures and expectations
 planned and wished for, unexpected
 high level of stress…….nausea…….less enthusiastic
 usual emotional highs and lows are magnified
 normal Situations ……..provoke you to tears or
depressed or angry
 emotional swings depend upon personality, support,
stress, hormones
 Worry about a miscarriage
 Answer = rest, relaxation techniques

5. Psychological Changes in the Second
Trimester
 general well-being develops
 overwhelming event …….. fetal movement.
 You have more needs than usual, worry about whether your partner will be
available, interested, and able to support
 vaginal lubrication and blood flow to the pelvic region increase. Thus increase in
sex desire and wonder if you are still attractive. associate weight gain with
unattractiveness
 Answer = Talk to partner

6. Psychological Changes in the Third
Trimester
 begin to prepare for childbirth, both physically and emotionally.
 time of anticipation.
 set up the nursery and crib make final decision about a name.
 Sometimes deferential treatment has some negative aspects as ability to function
professionally is diminished in a pregnant woman
 How you feel about the physical limitations of the third trimester is a reflection of
your concerns and feelings about impending motherhood
 Braxton Hicks contractions
 Answer = need reassurance regarding your physical appearance, especially if your
sex drive has diminished again, as well as reassurance regarding your ability to be
a good parent.

7. Dreams During Pregnancy
 fears and concerns
 bodily harm. such as riding in a car or engaging in sports, may provoke some
anxiety…….. Increase anxiety
 Dreams may be realistic representations of your fears and worries
 Dreams about pregnancy and babies often begin in the first trimester.
Uncertainties about your new role as a mother may surface in dreams about your
inability to care properly for your baby
 Themes: being trapped, sex of a child, lost a baby, Assault, lack of ability
 baby will impact your ability to continue your outside interests
 Loss of control over body
 Fear of labor

8. Why Sleeping Can Be Difficult
 Size of baby
 the frequent urge to pee
 increased heart rate
 shortness of breath
 leg cramps and backaches
 heartburn and constipation
 Stress
 Anxiety and fear

9.  Sleep on left side
 practice pillows
 Cut out caffeinated drinks like soda, coffee, and tea
 Avoid drinking a lot of fluids or eating a full meal within a few hours of going to bed
at night.
 Routine of sleep wake time
 Avoid rigorous exercise right before you go to bed
 If a leg cramp awakens you, it may help to press your feet hard against the wall or
to stand on the leg.
 Calcium
 relaxation techniques

10. Smell and Taste
 experienced a change in smell or taste Two-thirds of the women reported
increased smell sensitivity, but they also reported distortions in smells, phantom
smells and abnormal tastes, including increased bitter sensitivity and decreased
salt sensitivity………estrogen increase.

11.  Reading to baby while pregnant…… increase bond
 Sexual drives
 I am turning like my mum

12. Pregnant Brain
 massive hormonal fluctuations might
be why moms wake up when the baby stirs
while dads snore
 Mum affects baby and baby affects mum
 Maternal malnourishment anxiety and
depression affects baby
 Baby’s kicks raises her heart rate and
her skin conductivity, increasing the bond

13.  prenatal depression in the mother has several effects on the fetus: an increase in
fetal activity, delay of prenatal growth, and low weight at birth often occur.
 a pregnant women's mental state can shape her offspring's psyche."
 he greatest gift you can give your child is a strong relationship between the two of
you

14. Pregnancy / Postpartum Wellness
 Research has suggested that experiences of anxiety and mood impairments
during pregnancy can increase a woman's risk for experiencing postpartum-related
depression after delivery.
 With appropriate treatment, you can increase your chances of remaining well
throughout your pregnancy, as well as your ability to cope with the significant life
changes that will occur for you, baby, and other family members during your
postpartum period.
 Feelings of happiness and love for your newborn may be accompanied by feelings
of helplessness, sadness, and anxiety.

15. Pregnancy / Postpartum Wellness
•
•Panic attacks
•Phobias
•Obsessive-compulsive disorder
•PTSD
•Manic or hypomanic symptoms
•Eating disorders
•Substance abuse

16.  Once a woman gets pregnant she and her spouse tend to become focused on the
biology of it, which is good. They need to understand it, they need to develop a
birth plan with their doctor, they also need to learn about breast feeding, car seat
safety, infant CPR. Hospitals generally offer classes for these aspects of becoming
a new parent, which is also good. But it's a rare hospital that offers classes about
how having a baby will affect your marriage, how your marriage will affect your
baby, and what your baby's psychological needs are.

17. Psychological Changes in the Father
 bring to a pregnancy their own emotional baggage, as well as the echoes of
their childhood fantasies
 being able to father a child may also create a sense of heightened self-esteem
regarding their masculinity.
 if there were previous losses or a history of infertility, the father-to-be may see
the creation of life as a fragile phenomenon.
 becoming a father means giving up the idea of being a son.
 During most men's childhoods, there was little emphasis on learning fathering
functions, portrayed fathers as helpless in handling babies
 While you wrestle with feelings about the added responsibilities of
fatherhood, you may have to give your wife extra care.
 viewing the ultrasound images can be an invaluable experience because
you will have visual confirmation of the existence of your baby.

18. Dads too!!!
 Chances are you're not just sharing snacks —
you're sharing symptoms too
 It may be difficult for a man to admit openly that
he has concerns, fears, and perhaps ambivalent
feelings
 Anxiety: Even the most chill dudes can
experience restless nights, heartburn, and bouts
of fatigue while their partners are pregnant
 but those who fell in between were more anxious.
 Being more involved can actually make you feel
better prepared and in control.

19.  Morning sickness isn’t exclusive to mornings — or moms-to-be….. anxiety as well
as changes in diet
 Mood swings …..having a baby is a big deal, and your life will never be the same.
In many ways, it's changing already, which could lead to less sleep and even more
mixed emotions.
 Changes in sexual appetite….. Overwhelming, anxiety, responsibility, hurt the
baby….. To excited by changes in partner body
 Weight gain
 Aches and pains….. May be the subconscious feelings of competition

20. What Your Newborn Looks Like
 many newborns are tiny, wet creatures
 heads are slightly pointed as a result of passing through the birth canal. This is only
temporary
 head is so big compared with the rest of the body.
 baby's skin may be red, pink, or purple at first. Some babies are born with a white
coating, wrinkled, or lanugo, a fine hair that develops while in the womb. Lanugo
usually comes off after a week or two
 Rashes, blotches, or tiny white spots also are common
 After initially being very awake, most newborns get sleepy for about the next 24 hours.
 Suckling may be difficult for both mum and baby
that is not sign saying you are bad

21. Your Feelings
 Having a baby is a major, life-changing experience. Don't be surprised to find that
you go through a broad range of feelings.
 You may experience everything from relief to concern to anxiety to pure joy. And
your feelings may change suddenly and unpredictably.
 In addition, the mother has just been through quite a bit physically. There's a good
chance she'll be exhausted, and both parents may start feeling the effects of sleep
deprivation.
 Every parent reacts differently. Some mothers "forget" the difficulties of labor as
soon as they catch a glimpse of their newborns.
 Some feel high levels of energy driven by the excitement of finally having the baby.
 Still others feel sad exhausted and tired

22. "Baby Blues"
 within the first 10 days or so
 "on and off" crying spells,
 emotional mood swings,
 sadness, anxiety, and restlessness,
 may present as uncomfortable for new mothers
 ends within the first few weeks of the postpartum period

23. postpartum depression (PPD)
 Feeling depressed the majority of the day, almost every day of the week
 Noticeable loss of pleasure or interest in typically enjoyable activities (although you
may be physically restricted from engaging in these activities, due to recent
childbirth)
 Significant weight gain or weight loss
 Extreme insomnia or sleeping all the time
 Extreme fatigue or energy loss, most of the time
 Inappropriate feelings of guilt or feelings or worthlessness

24. Perfectionism in Motherhood
 The true vulnerability of being a mother cannot be easily described. We must hold
the body, mind and spirit of a precious, fragile little person in our hands and hearts
for the rest of our lives.
 The recurring theme of our discussions was that we wished we had been less
uptight and more spontaneous - another way of saying we were scared stiff and
worried too much about the wrong things.
 Perfectionists who are mothers not only have the issues mentioned above, but
also have an invisible internal pressure to accomplish raising a popular,
accomplished, happy and successful person.
 Competition amongst moms can also be a trigger for perfectionists
 wisdom of their mothers and the current trends communicated through social
media, friends, Google searches and their doctors:

25. Perfectionism in Motherhood
 Must I breast feed?
 Am I a bad mother
 Should I discourage thumb sucking
 use a pacifier?
 hitting the correct milestones?
 Will they be healthy and smart?
 Am I engaging them in the right activities?
 Would my child have a learning problem?

26. Tips for Overcoming Perfectionism
 Think “People First.” Instead of focusing on making yourself, your children and
your world perfect, put your heart into connecting with the people you love.
 Come out as a human being. Authenticity is a requirement for the pleasure of love,
joy, fun and overall happiness. Yes it is messy, but being real and looking foolish
will be worth it.
 Challenge your negative self-talk by turning the volume down rather than trying to
shut out all critical thoughts. Try to avoid comparing your efforts to those of others.
Be you.
 Let your children learn to be who they are rather than what would look best.
Remember that they need a little hurt and a few bumps in life to become that
wonderful person.

27. Tips for Overcoming Perfectionism
 Have fun and/or be around others who do. Smile authentically; get dirty and let
children get dirty – play. Reward yourself for the effort of having fun.
 Let go of expectations and try to accept people as they are. We are all unique and
flawed as human beings. Don’t judge your flaws or those of others. Embrace your
essence and see it as all part of being you. Amazing things will happen if you let
go.
 If this list seems daunting, seek professional help. Change will come faster when
you have a guide who can help you be yourself with a little less discomfort.
 Remember it is never too late. Even adult children will benefit from you becoming
lighter.

28. ،‫واإلثراء‬ ،‫والتغير‬ ‫النمو‬ ‫من‬ ‫كاملة‬ ‫تجربة‬ ‫هو‬ ‫الحمل‬
‫والتحدي‬.‫لمواجهة‬ ‫الزوجين‬ ‫عند‬ ‫الوقت‬ ‫هو‬ ‫والحمل‬
‫لتصبح‬ ‫تحولكم‬ ‫كيفيه‬ ‫حول‬ ‫والتوقعات‬ ‫المخاوف‬‫آباء‬ ‫وا‬
‫بكم‬ ‫الخاصة‬ ‫التربية‬ ‫أسلوب‬ ‫تحديد‬ ‫في‬ ‫والبدء‬.

29. ‫متوهجة‬ ‫النساء‬‫وسعيدة‬..........‫العواطف‬ ‫من‬ ‫العديد‬ ‫تجربة‬
،‫الجسم‬ ‫صورة‬ ‫في‬ ‫تحوالت‬‫والهرمونات‬‫الثقافية‬ ‫والتوقعات‬ ‫الضغوط‬ ‫تجاه‬ ‫والموقف‬ ،
‫وتمنى‬ ‫التخطيط‬‫لل‬‫متوقع‬ ‫وغير‬ ،
‫من‬ ‫عال‬ ‫مستوى‬‫التوتر‬.......nausea ...... .less‫متحمس‬
‫المعتادة‬ ‫العاطفية‬ ‫واالنخفاضات‬ ‫االرتفاعات‬ ‫تكبيرها‬ ‫يمكن‬
‫الحاالت‬‫العادية‬........provoke‫أو‬ ‫الدموع‬ ‫لك‬
‫الغضب‬ ‫أو‬ ‫االكتئاب‬
،‫الشخصية‬ ‫على‬ ‫تعتمد‬ ‫عاطفية‬ ‫تقلبات‬،‫والدعم‬
،‫اإلجهاد‬‫والهرمونات‬
‫اإلجهاض‬ ‫بشأن‬ ‫تقلق‬
‫الجواب‬=‫االسترخاء‬ ‫وتقنيات‬ ،‫بقية‬