From the minute you know you're pregnant, things begin to change. Your feelings change - feelings about yourself, about the baby, about your future. Your relationships change - with your partner, other children and also with parents and friends.

But you're still yourself, and you still have to get on with your life, whether pregnant or not. For this reason, adjusting to the changes that pregnancy brings isn't always easy. This chapter is about some of the worries that may crop up in pregnancy and some suggestions on how to handle them. But, of course, what may be a problem for one person may not be a problem for another. And what is helpful advice for some people may not be right for you. So take from these pages what you find useful, and don't bother about the rest.

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Feelings

When you're pregnant it can sometimes seem as though you are not allowed to have other feelings as well. People expect you to be looking forward to the baby, to be excited and to 'bloom' all the time. You, yourself, may think that this is the way you ought to be. In fact, just like any other nine months in your life, you're likely to have times when you feel low. And pregnancy does bring extra reasons for feeling worried or down, just as it brings many reasons for happiness.

Hormonal changes taking place in your body are responsible for much of the tiredness and nausea that some women feel in the early months and for some of the emotional upsets which can happen. You may find you cry more easily, lose your temper more, and so on.

Of course, there are many other reasons why you may feel rather down. You may have money worries or worries about work or where you are going to live. You may be anxious about whether you will cope as a parent, or about whether you're really ready to be a parent at all. And many of these anxieties may be shared by your partner or family as well. This may be your first baby but not your partner's so you may see and feel things differently. Talk through these feelings together.

Talking about your feelings to your partner, or to someone who is close to you, is often a relief and can help you get things in proportion. It may help your partner too. Making sure you keep yourself well and get plenty of sleep will also help. Anyone who is tired and run down is likely to feel rather low, whether they are pregnant or not. And don't let the pregnancy take over your life. Keep on doing the things you enjoy. Although it's normal to have some worries while you are pregnant and to feel a bit down from time to time, it's a real cause for concern if you're feeling depressed for most of the time. Whatever the reason for your unhappiness, or even if there doesn't seem to be any reason at all, explain how you feel to your doctor, midwife or health visitor. Make sure they understand that you're talking about something more than just feeling low.

 

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Worrying about the birth

One worry that a lot of women have in pregnancy is whether labour and birth will be painful and how they will cope. It is difficult to imagine what a contraction might be like and no one can tell you - though many will try. However, factual information about the options open to you can help you to feel more confident and more in control.

Begin by reading the chapter on Labour and birth with your partner, or a friend or relative who will be with you for the birth, if possible. Ask your midwife or doctor for any further information. Antenatal classes will also help to prepare you for labour and the birth

Think about the sort of labour and birth you would like to have. You will probably have an opportunity to discuss this in more detail with your midwife and to draw up a birth plan during the later months of pregnancy .

Talk to your partner too, or to someone close to you, and particularly to the person who will be with you in labour. Remember they may be anxious also. Together you can then work out ways in which to cope.

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Worrying about abnormality

Everyone worries at some time that there may be something wrong with their baby. Some people find that talking openly about their fears helps them to cope. Others prefer not to dwell on the possibility of something being wrong.

Some women continue to worry because they are convinced that if something does go wrong it will be their fault. While you can increase your baby's chances of being born healthy by following the advice outlined in Chapter 1, you cannot cut out the risk entirely. There are certain problems which cannot be prevented, either because the causes are not known or because they are beyond anyone's control.

It may reassure you to know that 97% of babies born in the UK are normal, although some of these may have birthmarks or some other small variations. A further 1% of babies will be born with abnormalities that can be partly or completely corrected. About 2%, however, will suffer from some more severe disability. Regular antenatal care and careful observation during labour help so that action can be taken if necessary.

If you are particularly concerned, perhaps because someone in your family has a disability, or because someone you know has had a difficult birth, or even if you just feel very anxious, talk to your doctor or midwife as soon as possible.

They may be able to reassure you or offer you helpful information about tests which can be done in pregnancy.

 

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Couples

Pregnancy is bound to bring about some quite big changes in a couple's relationship, especially if this is your first baby. For some people these changes happen easily, others find it harder to change. Everybody is different.

It's quite common for couples to find themselves having arguments every now and then during pregnancy, however much they are looking forward to the baby. Some of these may be nothing to do with the pregnancy, but others may be caused by one or other partner feeling worried about the future and how they are going to cope. Perhaps the most important thing to realise is that during pregnancy there are understandable reasons for the odd difficulty between you and also good reasons for feeling closer and more loving.

One practical question you will need to discuss is how you will cope with labour and whether your partner will be there. Many fathers do want to be present at their baby's birth. The chapter on Labour and birth gives some suggestions on ways in which fathers can help and what it can mean to them to share this experience.

Many people worry about whether it is safe to have sex during pregnancy. There is no physical reason why you shouldn't continue to have sexual intercourse right through a normal pregnancy, if you wish. It doesn't harm the baby because the penis cannot penetrate beyond the vagina. The muscles of the cervix and a plug of mucus, specially formed in pregnancy, seal off the womb completely.

Later in pregnancy, an orgasm, or even sexual intercourse itself, can set off contractions (known as Braxton Hicks' contractions). You will feel the muscles of your womb go hard. There is no need for alarm as this is perfectly normal. If it feels uncomfortable, try your relaxation techniques or just lie quietly till the contractions pass.

If you have had a previous miscarriage, ask your doctor or midwife for advice. Your doctor or midwife will probably advise you to avoid intercourse if you have had heavy bleeding in pregnancy, and you should definitely not have intercourse once the waters have broken since this risks infection in the baby.

While sex is safe for most couples in pregnancy, it may not be all that easy. You will probably need to find different positions. This can be a time to explore and experiment together. The man on top can become very uncomfortable for the woman quite early in pregnancy, not just because of the baby, but because of tender breasts as well. It can also be uncomfortable if the man's penis penetrates too deeply. So it may be better to lie on your sides, either facing or with the man behind. Many couples find that a position in which the woman is on top is most comfortable.

Some couples find making love extra enjoyable during pregnancy while others simply feel that they don't want to have intercourse and prefer to find other ways of being loving or of making love. It's important to talk about your feelings with each other.

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Families and friends

In some ways pregnancy is very private, just to do with you and your partner, but there may be a lot of people around you who are also interested and concerned about your baby - parents, sisters, brothers and friends.

People can offer a great deal of help in all sorts of ways and you will probably be very glad of their interest and their support. But sometimes it can feel as if you're being taken over. If so, it can help everyone if you explain gently that there are some decisions that only you can take and some things that you prefer to do on your own.

You may also find that being pregnant puts you on the receiving end of a lot of advice, and perhaps a bit of criticism too. Sometimes
the advice is helpful, sometimes not. Sometimes the criticism can really hurt. The important thing is to decide what is right for you.
After all, it is your pregnancy and your baby.

 

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Work

If you enjoy your work and the company of those you work with, you may have rather mixed feelings when the time comes to stop work before your baby is born. Try to make the most of these few weeks to enjoy doing the things you want to do at your own pace. It is also a good opportunity to make some new friends. You may meet other mothers at your antenatal classes (see pages 64-5) or you may get to know more people living close by, now that you have more time to stop and chat.

You may have decided that you are going to spend some time at home with your baby or you may be planning to return to work, either full or part time, fairly soon after the birth. If you know that you will be going back to work, or even if you think you might be, you will need to start thinking about who will look after your baby well in advance. It is not always easy to find a satisfactory childcare arrangement and it may take you some time.

Any decision you make about childcare will be determined both by your income and by the kind of facilities available locally. You may be lucky enough to have a relative willing to provide care. If not, you should contact your social services department (in Northern Ireland your local Health and Social Services Trust) for a list of registered childminders and nurseries. Few nurseries take babies and prices are usually high. You may also want to consider organising care in your own home, either on your own or sharing with other parents.

Care in your own home does not need to be registered but you should satisfy yourself that your carer is experienced and trained to care for babies. Contact the National Childminding Association for more information.

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Coping alone

If you're pregnant and on your own it's even more important that there are people with whom you can share your feelings and who can offer you support. Sorting out problems, whether personal or medical, is often difficult when you are by yourself and it's better to find someone to talk to rather than to let things get you down. You may find it encouraging to meet other mothers who have also gone through pregnancy on their own. Gingerbread is a self-help organisation for one-parent families which has a network of local groups and can offer you information and advice. They will be able to put you in touch with other mothers in a similar situation if you wish.

If money is an immediate concern, read Rights and benefits for information on what you can claim and your employment rights. Your local social security office, Benefits Agency/Social Security Agency (Northern Ireland) or local Citizens Advice Bureau (CAB) will be able to give you more advice. If you have housing problems, contact your local CAB or your local housing advice centre. Ask for the address from your local authority at the town hall (in Northern Ireland contact the Northern Ireland Housing Executive).

The National Council for One Parent Families can also supply information on a range of topics from benefits to maintenance . There may be a local support group in your area. Ask your midwife or health visitor.

Don't feel that, just because you don't have a partner, you have to go to antenatal visits and cope with labour on your own. You have as much right as anyone else to be accompanied by the person you choose - a friend, sister, or perhaps your mother. Involve your 'labour partner' in birth classes if you can and let him or her know what you want from them. There may be antenatal classes in your area run especially for single women. Ask your midwife.

Think about how you will manage after the birth. Will there be people around to help and support? If there is no one who can give you support it might help to discuss your situation with a social worker. Your doctor or hospital can refer you or you can contact the social services department of your local council directly.

If you're considering adoption or fostering you should discuss this with a social worker.

 

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Domestic Violence

One in three women experience domestic violence at some point in their lives. This may take the form of physical, sexual, emotional or psychological abuse. Thirty per cent of this abuse starts in pregnancy and existing abuse may worsen during pregnancy or after birth. Domestic violence should not be tolerated.

It risks your health and that of your baby before and after birth.

You can speak in confidence to your GP, midwife, obstetrician, health visitor or social worker.

If you wish, they can help you take steps to stop the abuse or to seek refuge. You may prefer to contact one of the organisations listed under domestic violence on this site, again in confidence.

 

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Bereavement

The death of someone you love can turn your world upside down and is one of the most difficult experiences to endure. This may be harder to cope with if you are pregnant or have just had a baby.

Family and friends can help you by spending time with you if you have been bereaved. A sympathetic arm around the shoulders can express love and support when words are not enough.

Grief is not just one feeling but a whole succession of feelings which take time to get through and which cannot be hurried. If you need help or advice, you can contact your GP or any of the organisations listed here.

If your partner dies

If your partner dies during your pregnancy or soon after childbirth you will feel emotionally numb. It is like no other loss. It is not something you get over, more that you learn, eventually, to live with.

Don't be afraid to lean on family and friends. If your partner was going to be with you at the birth you will need to think about who will be with you instead. Try to choose someone who knows you very well.

Financially, you may need urgent advice and support. You can get the leaflets suggested (see box) from your local social security office/Benefits Agency/Social Security Agency.

As well as speaking to friends, family and social services, you may like to contact WIDWODS, a small support group set up by young widows