By Alex Arpaia and Dorie Chevlen | Updated May 3, 2021

By| Elizabeth Scott, MS | Medically Reviewed by Carly Snyder, MD on September 20, 2020

By: Elizabeth Scott, MS | Fact checked by Sean Blackburn on June 24, 2020

​"From giving an important presentation at work to attending a party by yourself, there are countless situations that can be impacted by negative thoughts. Whether or not you have a diagnosed panic disorder, it's easy to get distracted by negativity and fears that can lead to a downward spiral of emotions.

In order to move forward, it's important to swap negativity with rational, positive thoughts.1 This shift can come to you more easily and automatically with practice, eventually shaping new thinking habits and strides toward recovery. 

How to Ease Stress With Affirmations
Here are some ways to use positive affirmations to manage stress, particularly when dealing with anxiety at the same time.

Identify and Stop Negative Thoughts
First, learn to identify negative thoughts so you can nix the negativity as soon as it enters your mind. For example, if you found yourself thinking, "I'm going to look stupid if I go to that party alone," identify the negative thought and correct yourself in the moment.

Consciously decide to reframe and move your thoughts into a more positive direction.2 Remind yourself that others will likely be arriving alone, that people are looking forward to seeing you, and that you will probably have a good time. These thoughts can help put you in a better frame of mind. 

Use Positive Affirmations
You may find it helpful to learn positive affirmations ahead of time so you're prepared when triggering situations occur. Consider the following options for common scenarios.

When faced with a situation that generates fear, such as traveling or meeting new people, try repeating positive affirmations that acknowledge your negative thoughts or emotions and let them go:

• Anxiety isn't dangerous. I'm just uncomfortable. I'll make it through this. 
• The picture in my head isn't healthy. That's just me being negative. 
• I feel anxious, but so what? I know what that feels like and I'll get through it. 
• I'm going to focus on things I love to get me through this. 
• I will be OK. 

​Managing your anxiety or panic disorder can be particularly difficult in times of stress, such as when you need to give a presentation in public or will be going to a networking event at work. While you may be tempted to call out sick or avoid the situation altogether, that can be harmful to you and your career. Instead, remind yourself of these affirmations:

• I've done presentations before and I can do this one, too. 
• When this is over, I'll be so proud of myself. 
• If I keep doing it, it will get easier. 
• The last time I presented, everyone said I did really well. 
• If I take deep breaths, that will help soothe me before I go in. 

Remain Realistic
Sometimes positive thinking can be taken too far, so it's important to remain grounded. When positive affirmations become unrealistic, they can actually trigger more anxiety as your subconscious mind notes that the ideas aren't realistic.3 You can find yourself more stressed if you start convincing yourself that you can do things you're not prepared for, and the reality of failure hits hard.

Notice that the examples given above focus on realistic and true statements that are also positive. These include what you will gain, what you have accomplished in the past, and what you will realistically achieve."

By: Heather Marcoux | September 02, 2021

"​Labor Day began in the 1800s because factory workers were tired of working 70 hours a week. Here we are 200 years later and surveys still show that mothers report working nearly 100 hours a week, and don't get days off. And it's just getting worse.

Before the pandemic moms were tired and burned out. Now, we're desperate. According to the 2020 World Economic Forum the COVID-19 pandemic has resulted in women around the world losing paid work hours while taking on more unpaid work.

Studies show the pandemic has resulted in moms working fewer hours in paid roles while dads have only reduced their hours by a statistically insignificant amount. We know millennial mothers are almost three times more likely than millennial fathers to report being unable to work due to a day care or school closure.

"Considering women already shouldered a greater burden for child care prior to the pandemic, it's unsurprising the demands are now even greater," says Gema Zamarro, senior economist at the University of Southern California's Center for Economic and Social Research. "While men are more likely to die from infection by COVID-19, overall the pandemic has had a disproportionately detrimental impact on the mental health of women, particularly those with kids."

Why the work of parenting is even more unequal during a pandemic
Today's mothers are spending more time doing paid work than previous generations did, but we're also spending more time on childcare. Today's fathers, too, are spending more time on childcare than previous generations, but there is a big difference in how moms and dads in heterosexual partnerships spend time with their kids.

This can be seen in the aftermath of COVID-19: In a 2020 study that looked at dual‐earner, heterosexual married couples with children, researchers found "the greater childcare and family demands brought on by day care and school closures throughout the pandemic appear to have caused a major reduction in work hours for mothers." Dads aren't seeing reduced work hours but are seeing the benefit of more time with their kids. Nearly 70% of fathers in the United States felt closer to their children during the pandemic than they did before the pandemic, according to research from Harvard. Meanwhile, pregnant women and moms with young children reported 3 to 5 times more anxiety and depression symptoms.

Why are dads happier now while moms are more stressed? It's in part because mothers are more likely to be doing unpaid care work while spending time with the children—the bathing, the cleaning, the feeding—while research finds that fathers' time with kids is more often spent on play and leisure activities.

If you're a dad, it might seem like having a spouse who does most of the household labor is a good deal (and a growing body of research does prove that fathers are happier parents than mothers) but the research also shows that dads want to be more than the fun, weekend guy because while care work is incredibly undervalued and unequal it can also incredibly fulfilling (if the carer is also allowed to rest).

​Mom doing all the drudge work and handing out snacks while dad is at the office (or locked in his home office) sounds like an outdated notion, and that's because it is. When researchers at Boston College surveyed professional fathers in 2015, they found fewer than 5% of the fathers saw themselves as just a financial provider. The survey found most fathers believed they should share their children's caregiving equally with their spouses (but only about 30% said they were actually doing that)."

​"Anyone who's ever had a professional massage knows that both body and mind feel better afterwards — and the same goes for prenatal massage, which can feel extra wonderful when extra weight and changes in posture stir up new aches and pains.

Here’s everything moms-to-be need to know about getting a massage during pregnancy.

​What is a prenatal massage?
Prenatal massages are adapted for the anatomical changes you go through during pregnancy. In a traditional massage, you might spend half the time lying face-down on your stomach (which is not possible with a baby belly) and half the time facing up (a position that puts pressure on a major blood vessel that can disrupt blood flow to your baby and leave you feeling nauseous).

But as your shape and posture changes, a trained massage therapist will make accommodations with special cushioning systems or holes that allow you to lie face down safely, while providing room for your growing belly and breasts. Or you might lie on your side with the support of pillows and cushions. 

Can pregnant women get massages?
Prenatal massages are generally considered safe after the first trimester, as long as you get the green light from your practitioner and you let your massage therapist know you’re pregnant. But you’ll want to avoid massage during the first three months of pregnancy as it may trigger dizziness and add to morning sickness.

Despite myths you might have heard, there’s is no magic eject button that will accidentally disrupt your pregnancy, and there isn't much solid scientific proof that specific types of massage can have an effect one way or the other. Some massage therapists avoid certain pressure points, including the one between the anklebone and heel, because of concern that it may trigger contractions, but the evidence on whether massage actually can kickstart labor is inconclusive (to nonexistent).

It is a good idea to avoid having your tummy massaged, since pressure on that area when you're pregnant can make you uncomfortable.

If you are in the second half of your pregnancy (after the fourth month), don't lie on your back during your massage; the weight of your baby and uterus can compress blood vessels and reduce circulation to your placenta, creating more problems than any massage can cure.
​
And don’t expect deep tissue work on your legs during a prenatal massage. While gentle pressure is safe (and can feel heavenly!), pregnant women are particularly susceptible to blood clots, which deep massage work can dislodge. That, in turn, can be risky. On other body parts, the pressure can be firm and as deep or as gentle as you’d like. Always communicate with your therapist about what feels good — and if something starts to hurt."

By: Rachel Gurevich, RN |Medically reviewed by Meredith Shur, MD on April 20, 2020

"Meditation is the habitual process of training your mind to focus and redirect your thoughts.

The popularity of meditation is increasing as more people discover its many health benefits.
You can use it to increase awareness of yourself and your surroundings. Many people think of it as a way to reduce stress and develop concentration.

People also use the practice to develop other beneficial habits and feelings, such as a positive mood and outlook, self-discipline, healthy sleep patterns, and even increased pain tolerance.
This article reviews 12 health benefits of meditation.

1. Reduces stress
​Stress reduction is one of the most common reasons people try meditation.

One review concluded that meditation lives up to its reputation for stress reduction.

Normally, mental and physical stress cause increased levels of the stress hormone cortisol. This produces many of the harmful effects of stress, such as the release of inflammatory chemicals called cytokines.

These effects can disrupt sleep, promote depression and anxiety, increase blood pressure, and contribute to fatigue and cloudy thinking.

In an 8-week study, a meditation style called “mindfulness meditation” reduced the inflammation response caused by stress.

Furthermore, research has shown that meditation may also improve symptoms of stress-related conditions, including irritable bowel syndrome, post-traumatic stress disorder, and fibromyalgia. 

2. Controls anxiety
Meditation can reduce stress levels, which translates to less anxiety.

A meta-analysis including nearly 1,300 adults found that meditation may decrease anxiety. Notably, this effect was strongest in those with the highest levels of anxiety.

Also, one study found that 8 weeks of mindfulness meditation helped reduce anxiety symptoms in people with generalized anxiety disorder, along with increasing positive self-statements and improving stress reactivity and coping.

Another study in 47 people with chronic pain found that completing an 8-week meditation program led to noticeable improvements in depression, anxiety, and pain over 1 year.

What’s more, some research suggests that a variety of mindfulness and meditation exercises may reduce anxiety levels.
For example, yoga has been shown to help people reduce anxiety. This is likely due to benefits from both meditative practice and physical activity.

Meditation may also help control job-related anxiety. One study found that employees who used a mindfulness meditation app for 8 weeks experienced improved feelings of well-being and decreased distress and job strain, compared with those in a control group.
​
3. Promotes emotional health
Some forms of meditation can lead to improved self-image and a more positive outlook on life.

For example, one review of treatments given to more than 3,500 adults found that mindfulness meditation improved symptoms of depression.

Similarly, a review of 18 studies showed that people receiving meditation therapies experienced reduced symptoms of depression, compared with those in a control group.

Another study found that people who completed a meditation exercise experienced fewer negative thoughts in response to viewing negative images, compared with those in a control group.

Furthermore, inflammatory chemicals called cytokines, which are released in response to stress, can affect mood, leading to depression. A review of several studies suggests meditation may also reduce depression by decreasing levels of these inflammatory chemicals."

By: Boho Beautiful Yoga

"This 10 minute mindful meditation will give you the mental clarity and space necessary to ground yourself with beautiful focus and set your day on the perfect track for success and fulfillment."

​Medically reviewed by Lynn Starr, RNC-OB — Written by Shannon Conner on September 9, 2015

"Most moms-to-be spend a lot of time worrying about their developing baby. But remember, it’s just as important during the next nine months to tune in to someone else’s cues: your own.

Maybe you’re exceedingly tired. Or thirsty. Or hungry. Maybe you and your growing baby need some quiet time to connect.
Your doctor or midwife may say, “Listen to your body.” But for many of us, that’s followed by, “How?”

Meditation can help you listen to your voice, your body, that small heartbeat — and help you feel refreshed and a bit more focused.

What Is Meditation?
Think of meditation as some quiet time to breathe and connect, be aware of passing thoughts, and to clear the mind.
Some say it’s finding inner peace, learning to let go, and getting in touch with yourself through breath, and through mental focus.
For some of us, it can be as simple as deep, in-and-out breaths in the bathroom stall at work as you try to focus on you, your body, and the baby. Or, you can take a class or retreat to your own special place in the house with pillows, a mat, and total silence.

What Are the Benefits?
Some of the benefits of practicing meditation include:

• better sleep
• connecting to your changing body
• anxiety/stress relief
• peace of mind
• less tension
• positive labor preparation
• lower risk of postpartum depression

Doctors and scientists have studied the benefits of meditation on pregnant women and they have shown that it can help moms-to-be throughout pregnancy and especially at birth.

Moms who have high levels of stress or anxiety during pregnancy are more likely to deliver their babies at preterm or low birth weights.

Birth outcomes like those are a pressing public health issue, especially in the United States. Here, the national rates of preterm birth and low birth weight are 13 and 8 percent, respectively. This is according to a report published in the journal Psychology & Health.

Prenatal stress can also impact fetal development. Studies have shown that it can even affect cognitive, emotional, and physical development in infancy and childhood. All the more reason to squeeze in some meditation time!"

​By Claire Gagne and Claire Sibonney

"​Over 1 billion women around the world will have experienced perimenopause by 2025. But a culture that has spent years dismissing the process might explain why we don’t know more about it.

By Christin Perry | February 25, 2020

​"Almost as soon as those two pink lines pop up on a pregnancy test, your hormones get the message that something's different at mission control. Progesterone and human chorionic gonadotropin (hCG) begin pumping to signal your body to halt production on your next menstrual period, and begin forming that cluster of cells into a mini-you instead. As you probably already know, as these hormones get to work, you'll experience an onslaught of early pregnancy symptoms like nausea, fatigue, and breast tenderness.

As pregnancy progresses, our bodies produce extraordinary amounts of estrogen and progesterone, says Aumatma Shah, fertility specialist and naturopathic doctor at the Bay Area's Holistic Fertility Center. "These two steroidal hormones are key to creating dopamine and serotonin, two neurotransmitters in the brain that are important in feeling calm and happy. This is why a lot of women feel amazing when pregnant: Pregnancy offers a surge of hormones and neurotransmitters that help us feel great."

But what happens to those feel-good pregnancy hormones once your baby is born? "Unfortunately, immediately postpartum and the week following delivery, estrogen and progesterone will both plummet. Simultaneously, there will be a surge in prolactin and oxytocin," says Shah.

These wildly swinging hormones are to blame for those crazy emotions you'll experience after giving birth. Here's a closer look at what happens to your hormones postpartum and when so you know what to expect—and so you know the loony emotions you're feeling are all completely normal.

​What Happens to Hormones Immediately After Giving Birth?
The birth of your sweet bundle of joy is undoubtedly one of the most exciting moments of your life. No matter how long you labor or what time you give birth—yes, even if it's at 3 a.m.—you'll likely feel an amazing, indescribable high when you meet your baby for the first time, or shortly thereafter. But those surging hormones will plummet over the next few days. Here's what's going on:

• Progesterone and estrogen decrease as soon as baby and the placenta are delivered.
• Oxytocin surges immediately following birth to compensate for the initial drops in progesterone and estrogen. This hormone is responsible for that strong mothering instinct you'll feel, but you'll probably still experience some "baby blues" in the first few days postpartum as the oxytocin works itself out of your system, says Shah.
• Prolactin increases to encourage breast milk production.

Postpartum Hormones at 3 to 6 Weeks
After those first few weeks pass, you may start to feel those rollercoaster-like emotions start to regulate a bit as you begin to get into the groove of caring for baby and get used to the lack of sleep. Ashley Margeson, a naturopathic doctor says, "the first three months are a bit of a whirlwind of sleep loss and emotions as your system runs mostly on adrenaline to move you through the day."
​
Around the six-week mark, she says, symptoms of postpartum depression may begin to show as those positive post-birth hormones continue to fade. "The changes you should look for closely are not wanting to shower or focus on hygiene, being afraid of leaving your baby with someone else, not being able to sleep fully due to continually checking on baby, and lack of desire for common tasks like eating, drinking, being around people, and leaving the house."

By: Jessica Grose | February 4th, 2021

"In early September, as the school year inched closer, a group of mothers in New Jersey decided they would gather in a park, at a safe social distance, and scream their lungs out. For months, as the pandemic disrupted work and home life, these moms, like so many parents, had been stretched thin — acting as caregivers, teachers and earners at once. They were breaking.

As are mothers all over the United States.

By now, you have read the headlines, repeating like a depressing drum beat:
“Working moms are not okay.” “Pandemic Triples Anxiety And Depression Symptoms In New Mothers.” “Working Moms Are Reaching The Breaking Point.”

You can also see the problem in numbers: Almost 1 million mothers have left the workforce — with Black mothers, Hispanic mothers and single mothers among the hardest hit. Almost one in four children experienced food insecurity in 2020, which is intimately related to the loss of maternal income. And more than three quarters of parents with children ages 8 to 12 say the uncertainty around the current school year is causing them stress.
​
Despite these alarm bells clanging, signaling a financial and emotional disaster among America’s mothers, who are doing most of the increased amount of child care and domestic work during this pandemic, the cultural and policy response enacted at this point has been nearly nonexistent.

The pandemic has touched every group of Americans, and millions are suffering, hungry and grieving. But many mothers in particular get no space or time to recover.

The impact is not just about mothers’ fate as workers, though the economic fallout of these pandemic years might have lifelong consequences. The pandemic is also a mental health crisis for mothers that fervently needs to be addressed, or at the very least acknowledged.

“Just before the pandemic hit, for the first time ever, for a couple months, we had more women employed than men,” said Michael Madowitz, an economist at the Center for American Progress. “And now we are back to late 1980s levels of women in the labor force.” The long-term ramifications for mothers leaving work entirely or cutting back on work during this time include: a broken pipeline for higher-level jobs and a loss of Social Security and other potential retirement income.

“Covid took a crowbar into gender gaps and pried them open,” said Betsey Stevenson, an economist at the University of Michigan. Her long-term concerns are even more fundamental: Will watching a generation of mothers go through this difficult time with little support turn the next generation of women off from parenthood altogether?

The economic disaster of the pandemic is directly related to maternal stress levels, and by extension, the stress levels of American children. Philip Fisher, a professor of psychology at the University of Oregon who runs an ongoing nationally representative survey on the impact of the pandemic on families with young children, points out that the stressors on mothers are magnified by a number of intersecting issues, including poverty, race, having special needs children and being a single parent.

“People are having a hard time making ends meet, that’s making parents stressed out, and that’s causing kids to be stressed out,” Dr. Fisher said. This buildup can lead to toxic stress, “And we know from all the science, that level of stress has a lasting impact on brain development, learning and physical health.” Almost 70 percent of mothers say that worry and stress from the pandemic have damaged their health.

The statistics on stress levels are shocking, but they are sterile; they don’t begin to expose the frayed lives of American mothers and their children during this pandemic. A young mother who self-identified as American Indian/Alaska Native summed up her situation in response to Dr. Fisher’s survey: “We are requesting government help for food. Relationship between partner and I are tense. I am personally struggling more now with depression and anxiety. My toddler has become more anxious as well and shown aggressive behavior. She seems overwhelmed most of the time.”
​
Times editor-at-large Jessica Bennett spent months communicating with three women, who kept detailed diaries of their days, for a look at just how much American mothers are doing every waking second."

By: Pregnancy & Postpartum TV | March 6, 2019

"Prenatal Yoga Bedtime or Prenatal Yoga Before Bed. Help get to sleep with this prenatal bedtime yoga or prenatal bedtime stretch. Prenatal yoga bedtime as a pregnancy insomnia remedies."

By Wendy Wisner | Medically reviewed by Carly Snyder, MD |Updated on June 14, 2021

"What Is Prenatal Depression?
Prenatal depression, also called perinatal depression, is depression experienced by women during pregnancy. Like postpartum depression, prenatal (or perinatal) depression isn’t just a feeling of sadness—mothers who experience this mental health disorder may also feel anxious and angry. 

You've likely heard of postpartum depression—and that's a good thing. The more that postpartum depression is talked about and understood, the more mothers will seek the help they need so that they can feel better and live full and healthy lives as new moms.

But prenatal depression is a maternal mood disorder that hasn’t gotten nearly as much attention as it should. While prenatal depression can be treated, many expecting mothers don’t even know that it’s a “thing” and therefore don’t seek treatment for it.

Many feel ashamed to even share how they are feeling. After all, you are supposed to be overjoyed and excited when you are expecting a baby, right? It’s easy to feel guilt and shame when you are feeling the exact opposite.

Here’s what you should know about prenatal depression, including how common it is, what to look for in terms of symptoms, and most importantly, how to get help.

​How Common Is Prenatal Depression?
Like postpartum depression, which impacts as many as 1 in 7 new moms, prenatal depression is actually quite common.

According to a journal article by Maria Muzik, MD, and Stefana Borovska, published in Mental Health in Family Medicine, 13% of pregnant moms experience depression.

​As the authors note, perinatal depression (both prenatal and postpartum) is even more common among mothers facing adverse experiences, such as a history of depression or economic hardship.

“The prevalence of perinatal depression is even higher in vulnerable groups with certain risk factors,” the authors explain. “Young, single mothers, experiencing complications, with a history of stress, loss or trauma are far more likely to succumb to depression. Furthermore, one study found that up to 51% of women who experience socioeconomic disadvantage also report depressive symptoms during pregnancy.”

It's important to note prenatal depression doesn’t discriminate: You can experience it whether or not you have pre-existing risk factors. Always remember there is no shame in experiencing a serious bout of depression during pregnancy, and you are not alone.

​Causes
Similar to postpartum depression, experts can’t pinpoint one particular cause of prenatal depression, but have hypothesized that it’s likely caused by a confluence of factors—a “perfect storm” of triggers that come to a head for some mothers during their pregnancies.

Either way, it’s important to note that whatever caused your prenatal depression, it most certainly wasn’t your fault. There was nothing you did wrong, and you are not a bad mom (or going to be a bad mom).

“Depression and anxiety during pregnancy or after birth don't happen because of something you do or don't do—they are medical conditions,” notes the Academy of American Pediatrics (AAP).

“Although we don't fully understand the causes of these conditions, researchers think depression and anxiety during this time may result from a mix of physical, emotional, and environmental factors,” they add.

Symptoms
Prenatal depression manifests differently for every mom—you may even experience it differently from one pregnancy to another. It’s important to understand that anytime you feel overwhelmed by your emotions, unable to function in your day-to-day life, or just “off,” you should reach out to discuss your feelings with a trusted loved one or medical provider.
Here are some of the most common symptoms of prenatal depression:

• Anxious thoughts and excessive worry about your baby
• Feeling hopeless and overwhelmed
• Lack of interest in activities you used to enjoy
• Feeling guilt about how you are feeling, or guilt in general
• Feeling less interested in eating, or overeating eating
• Having trouble concentrating
• Having trouble sleeping
• Racing thoughts
• Anger
• Reluctance to follow prenatal health guidelines
• Not believing others when they try to reassure you
• Pushing others away, wanting to disconnect from loved ones
• Participating in unsafe prenatal activities, such as smoking, drinking, drug use
• Experiencing thoughts of suicide

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911. 
For more mental health resources, see our National Helpline Database."

By: Robin Elise Weiss, PhD, MPH | June 14, 2021

"Affirmations are statements that you use intentionally to instill a sense of positivity and purpose in your mind about a particular subject. You can use these short phrases and sentences to help yourself focus on and accept a positive message that you wish to remember.Affirmations are an example of using positive thinking to set an intention and increase the likelihood of positive results. Even better, they are simple to do, free, and accessible to all.

Why They Work
While there is no guarantee that affirmations will actually change the outcome of your pregnancy, some studies suggest that affirmations can reduce stress and anxiety—which can make it easier to rest, eat, and avoid issues such as headaches and fatigue. Plus, positive thoughts tend to cultivate positive feelings, which may help to make your pregnancy experience more enjoyable and relaxed.

Studies show that using positive affirmations impacts brain pathways, increasing activity in the areas of the mind responsible for self-worth, self-regulation, and core values. Researchers believe that making a regular practice of saying affirming statements can effectively shift your focus from negative emotions or stressors to your own expansive capacity to cope, bolstering your confidence and bringing you new ideas, strategies, energy, and hope for the future.

​Write Your Own
The beauty of positive affirmations is that you can write your own to use whenever you like. They can be said out loud or silently in your head, quietly whispered to yourself, or written down. In lieu of writing your own, you can also use one you have read or heard elsewhere. If it makes you feel strong, positive, and hopeful, then you're on the right track.
Remember, your affirmation should be in the present tense, as if what you wish to happen is already occurring. For example, someone who is worried about coping with childbirth might say, "I am strong." A person who is trying to get pregnant and having difficulty might say, "I am a good parent to my child."

This person might decide to repeat the affirmation every morning as a reminder of their goal and to foster their hope for this desired outcome. During infertility treatments, they might visualize this affirmation while undergoing procedures and tests, as well. During pregnancy, daily pregnancy affirmations may serve to enhance the mother's bond to their growing baby while also alleviating the worry that something might go wrong.

How to Do It
​Anything that speaks to you can work as an affirmation. If you're unsure, brainstorm statements that connect to the feelings, values, and intentions you want to affirm. If you have a specific worry or negative thought that keeps coming to mind, try flipping it around to a positive one.

If you catch yourself thinking, "I can't do this," counter that with, "I can do this." "Childbirth is scary" becomes "childbirth is beautiful." Simple is good. Setting your positive intention can literally change your mind.

​To help you get started writing your own affirmations, consider beginning with phrases like the following:

• Breastfeeding is
• I am
• I believe
• I feel
• I know
• My baby is
• My body is open to
• My body knows
• My heart is
• My labor is
• My mind is open to"

​"When we meet with women for perinatal psychiatry consultations, we now ask about vaccinations.  It’s not something we typically do, but after the last year, we are now getting involved in their decisions regarding vaccination against COVID-19.  Just as we counsel women to avoid alcohol and to consistently take their prenatal vitamins, providing information on the COVID-19 vaccine is an important aspect of promoting the health of pregnant and postpartum women.  

Considering a growing body of evidence indicating that pregnant women are more likely to have certain manifestations of severe COVID-19 illness,  including admission to the ICU and mechanical ventilation,  the American College of Obstetricians and Gynecologists (ACOG)  has urged the CDC’s Advisory Committee on Immunization Practices to include pregnant and lactating women in the high-priority populations for COVID-19 vaccine allocation.   ACOG clearly states that all pregnant and lactating people should be allowed to receive the vaccine, and that their decision to do so should be based on a careful discussion of risks and benefits with their healthcare provider.   

From our vantage point, there are other benefits to the COVID-19 vaccine.  During the past year, before the vaccination was available, we watched as pregnant and postpartum patients undertook the most extreme forms of lockdown.  Many of these women were literally housebound: never leaving the house and cutting off contact with friends and family, while at the same time taking on more childcare responsibilities as outside care providers and day care centers were no longer available.  And all the while wondering what would happen if they or a member of their family felt ill?

We are yet to fully appreciate the impact of the COVID-19 pandemic on perinatal women, but preliminary studies indicate that during the lockdown, pregnant and postpartum women reported higher levels of stress, loneliness, depression, and anxiety.   And this is not really a surprise.  So many of the things we typically recommend to reduce stress and social isolation, such as exercising regularly or spending time with friends and family, vanished.

While it might seem like the pandemic is fading into the distance, the resurgence of the pandemic in places like India and Brazil where immunization rates are low, we cannot be so sure about this.  So far the most successful way to avoid becoming seriously ill with COVID-19 is to get vaccinated.  
​
A recent article in Medscape, however, suggests that mothers appear to be less likely to get vaccinated than others in the general population.  According to a recent poll from Morning Consult, about two-thirds of adults in the US have either already been vaccinated against COVID-19 or plan to do so.  In contrast, mothers are the most likely to be hesitant about the vaccine.  In this study, 51% of the mothers reported that they are unwilling to get vaccinated or are uncertain about getting vaccinated, at 51% (compared to 32% of other women and 29% of fathers)."

"The amount of sleep you get while you’re pregnant not only affects you and your baby, but could impact your labor and delivery as well. Lack of sleep during pregnancy has been tied to a number of complications, including preeclampsia (a serious condition that affects your blood pressure and kidneys). This condition could result in pre-mature birth. Now is the time to take sleep seriously.When you become pregnant, one of the first symptoms you may notice is being overwhelmingly tired, even exhausted. Sleep will be irresistible to you. You can most likely blame your changing hormones for this, especially the extra progesterone that comes with being pregnant. In the beginning, pregnancy also lowers your blood pressure and blood sugar, which can make you feel tired.

Shortly after the first trimester, your energy should return. Sometime during the third trimester, you’ll begin to feel tired again. Some of this feeling can be blamed on the sheer physical exhaustion that comes from growing a baby and the stress that it puts on your body. However, your weariness during this time is in direct relation to your inability to get a good night’s sleep.

​Even if you’ve never had trouble sleeping before, you may find it much more difficult while you’re pregnant.

Path to improved health
Sleep should never be seen as a luxury. It’s a necessity — especially when you’re pregnant.
In fact, women who are pregnant need a few more hours of sleep each night or should supplement nighttime sleep with naps during the day, according to the National Institutes of Health.

For many pregnant women, getting 8 to 10 hours of sleep each night becomes more difficult the farther along they are in their pregnancy. There are many physical and emotional obstacles to sleep in this stage. Anxiety about being a mom or about adding to your family can keep you awake. Fear of the unknown or about the delivery can cause insomnia. Plus, there is the getting up every few hours to go to the bathroom. It also can be difficult to find a comfortable position in bed, especially if you are a former stomach sleeper.


If any of the following is keeping you awake at night, try these strategies for getting a good night’s sleep.

Heartburn
At some point in their pregnancy, most pregnant women suffer from heartburn, which is a form of indigestion that feels like burning in your chest and throat. Heartburn can wake you up in the middle of the night and ruin a good sleep. Minimize the chance for this by avoiding spicy foods. Also, cut down on rich foods for dinner.

Restless leg syndrome
Few things are more distracting than restless legs syndrome (RLS), especially when you are trying to go to sleep. While you can’t take traditional RLS medicines when you are pregnant, you can try to reduce the feelings of RLS with a good prenatal vitamin that includes folate and iron.

Morning sickness — at bedtime
Despite the name, morning sickness can occur any time and is often worse later in the day. Try eating a few crackers at bedtime and keep a stash in your nightstand in case a wave of nausea hits as you are trying to go to sleep.

​Insomnia
There are many ways insomnia can creep in and compromise your sleep time. Often, it’s just about being able to shut down your brain. Most medicines for insomnia should not be taken while you are pregnant. Instead, try journaling some of the things you are anxious about. Write down what is stressing you and try to let it go as you go to sleep. Also, stop drinking caffeine by early afternoon. Try not to take long naps during the day. Doing any — or all — of these things can help ease you back into sleep at a reasonable bedtime.

Leg cramps
Not many things can wake you as quickly and painfully as a leg cramp. Sometimes called a charley horse, these cramps are usually a contraction of your calf muscle. Less frequently, they can occur in your thigh or your foot. These can plague you in pregnancy because of a lack of minerals, especially calcium and magnesium. They also are more common if you are dehydrated. To guard against leg cramps, make sure that you continue to take your prenatal vitamin and drink plenty of water and other fluids during the day.

Finding a comfortable position
As your body grows, sleep becomes a little harder to come by, especially in the third trimester. It’s difficult to get comfortable. It’s harder to move around and shift positions in bed. If you’ve been a stomach or back sleeper, it can be hard to adjust to sleeping on your side. The best position to sleep in when you’re pregnant is on your left side. This improves blood flow and, therefore, nutrient flow to your baby. Try lying on your left side, knees bent with a pillow between your knees. It also helps to tuck a pillow under your stomach, as well, for extra support.

Frequent bathroom breaks
With the baby pushing down on your bladder, you likely can’t make it all night without waking at least once to go to the bathroom. You can help minimize nighttime bathroom trips by cutting down on how much you drink in the evenings. Just be sure to get adequate hydration during the day. Bright lights can make it harder for you to fall back asleep, so use nightlights so that you will not need to turn on the lights when you get up to go to the bathroom.
In addition to minimizing the common obstacles to getting a good night’s sleep, there are also ways to encourage good sleep habits. This is called good sleep hygiene.

• Be consistent with your sleep schedule. Go to bed and wake up at the same time every day.
• Prioritize sleep. It’s one of the healthiest things you can do for your body.
• Exercise, but do not exercise at bedtime.
• Keep daytime naps short.
• Stick to a bedtime routine that relaxes you, and don’t vary from it.
• Make your bedroom inviting. Do not keep a TV, computer, or other distracting tech gadgets in your bedroom.
• Do not eat at bedtime. Finish eating two to three hours before going to bed. 

​Things to consider
Sleep is essential to health. Lack of sleep is associated with many chronic diseases, including type 2 diabetes, obesity, depression, and even heart disease. If you’re pregnant, not getting an adequate amount of sleep can put you at risk for some serious conditions. Lack of sleep can also complicate your delivery.
In one research study, pregnant women who slept less than six hours at night late in pregnancy had longer labors and were more likely to have cesarean deliveries.

Another study reports that the sleep you get in your first trimester can affect your health in the third trimester. Women who don’t get enough sleep (less than five hours per night) in the first trimester are nearly 10 times more likely to develop preeclampsia late in pregnancy. Preeclampsia is a condition associated with pregnancy-related high blood pressure, swelling of hands and feet, and protein in urine.
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If you’ve ever had a sleep disorder, it could be made worse by pregnancy. If you’ve had sleep apnea in the past, your snoring may get worse during pregnancy. This is especially true if you were already overweight when you became pregnant. Expect that RLS will worsen during this time. Heartburn will intensify, too."

Overview
"For a new mom-to-be, experiencing sleep deprivation after the baby is born is a given. But you probably didn’t realize that it could also occur during the first trimester of pregnancy.

Most women experience sleep problems during pregnancy. Pregnant women tend to get more sleep during their first trimesters (hello, early bedtime) but experience a big drop in the quality of their sleep. It turns out that pregnancy can make you feel exhausted all day long. It can also cause insomnia at night.

Here are some of the most common culprits for insomnia during early pregnancy, plus a few tips to help you get a better night’s sleep.

What is insomnia?
Insomnia means you have difficulty falling asleep, staying asleep, or both. Women can experience insomnia during all stages of pregnancy, but it tends to be more common in the first and third trimesters. Between midnight bathroom breaks, out-of-control hormones, and pregnancy woes such as congestion and heartburn, you might be spending more time out of your bed than in it. The good news: While insomnia might be miserable, it’s not harmful to your baby.

Sheer logistics play a role as well. By the end of a pregnancy, many women have a hard time just getting comfortable enough to sleep well. During the first trimester, you might not have much of a baby belly to accommodate, but there are other issues that can prevent a good night’s sleep.

What causes insomnia during pregnancy?
Expecting? There are many reasons you might be wide awake in the wee hours. These can include:

• need to urinate frequently
• nausea or vomiting
• back pain
• breast tenderness
• abdominal discomfort
• leg cramps
• shortness of breath
• heartburn
• vivid dreams

Other causes of insomnia can be stress-related. You might feel anxious about labor and delivery, or worry about how you’ll balance work with being a new mother. These thoughts can keep you up at night, especially after your third visit to the bathroom.

It can be difficult to distract yourself from these thoughts, but try to remember that worrying isn’t productive. Instead, try writing down all of your concerns on paper. This will give you a chance to consider possible solutions. If there are no solutions, or there is nothing you can do, turn the page in your journal and focus on another worry. This can help empty your mind so you can rest.

Being up front with your partner about your feelings and worries can also help you feel better.

Develop a bedtime routine
One of the best things you can do to manage insomnia while you’re pregnant is to set up good sleep habits.

Begin by trying to go to bed at the same time every night. Start your routine with something relaxing to help you unwind.

Avoid screen time at least an hour before bed. Blue light from the TV, your mobile phone, or tablet can have an impact on your body’s circadian rhythm. Try reading a book instead.

Taking a soothing bath might also make you sleepy. Just be careful that the temperature isn’t too hot — that can be dangerous for your developing baby. This is especially true during early pregnancy.

To be safe, avoid hot tubs.

Diet and exercise
Diet and exercise can have an impact on your sleep.

Drink up
Drink plenty of water throughout the day, but minimize drinking after 7 p.m. Try to avoid caffeine starting in the late afternoon.

Eat to sleep
Eat a healthy dinner, but try to enjoy it slowly to reduce your chances of heartburn. Eating an early dinner can also help, but don’t go to bed hungry. Eat a light snack if you need to eat something late in the evening. Something high in protein can keep your blood sugar levels steady through the night. A warm glass of milk can help you feel sleepy, too."