Anxiety During Pregnancy: How Counting the Kicks During Pregnancy Can Help Ease Anxiety

Taking a step into motherhood territory can be filled with anticipation but also worry and anxiety, sometimes caused by thinking about pregnancy effects on baby, whether for a new or experienced mum. In other words, pregnant women are often anxious about how their baby is doing.

According to a study from the Journal of Maternal-Fetal & Neonatal Medicine, aspects of a mum’s maternal anxiety can be managed by understanding her baby’s fetal movements and their pattern, especially in the third trimester. 

In order for pregnant women to better manage anxiety in pregnancy through counting kicks and understanding their baby’s movement patterns, we spoke to Dr Grace Huang, the resident doctor at DTAP Clinic Robertson.

Dr Huang shares the reasons pregnant women should count their baby’s kicks, benefits of doing this, as well as insights on maternal anxiety and stress, and their effects on the unborn baby. 

Counting the Kicks During the Third Trimester

How important is it for a pregnant woman to count her baby’s kicks during the last trimester?

• Counting kicks during the third trimester is important as a sudden change, particularly decrease, in foetal movement is often an early sign of foetal distress. Being attuned to your baby’s kicks will allow you to pick up changes in movement patterns more easily, and see your obstetrician for an early review.

How is counting kicks tied to preventing stillbirth? What does the reduction in foetal movement signify?

• Up to 50% of mothers who suffered a stillbirth in the last trimester reported a decrease in their foetal movement in the days leading up to the death. The reduction in foetal movement is one of the earliest signs of foetal distress. Picking up a decrease in the foetal movement early may allow intervention that could potentially save your baby’s life.

What other benefits are there to counting kicks, other than helping prevent stillbirth?

• Counting kicks can also be part of bonding with both your unborn baby as well as between you, your spouse, your children and the baby.

There are several methods to count kicks on the internet. Which is the most effective/practised widely?

• One of the most widely practised methods is the “count to ten” method, where a mother counts her baby’s movement and times how long it takes to get to ten movements. One should be able to feel ten movements within two hours. Most of the time, you will get to ten kicks much earlier than that.

Maternal Anxiety and Stress: What Expectant Mums Could Face

What are the most common mental health concerns women face during pregnancy?

• While a lot of emphasis is placed on physical wellness during pregnancy, mental health concerns during pregnancy are more common than one may expect and should not be overlooked. Pregnancy is both an exciting and challenging time and anyone (both individuals with a history of mental health concerns as well as previously well individuals) can face mental health issues.

Antenatal depression and anxiety are some of the most common mental health issues seen. The World Health Organization (WHO) estimates that up to 1 in 10 women will experience antenatal depression.

Pregnancy may also make dealing with other pre-existing mental health issues, such as bipolar disorder, psychosis, or eating disorders, more challenging.

The WHO estimates that up to 1 in 10 women will experience antenatal depression. | Photo: iStock

What usually triggers/what are often the causes of anxiety and stress in women during pregnancy?

• Women face anxiety about their upcoming changes in their life roles such as motherhood, taking on new responsibilities, career changes, how motherhood may impact their existing relationships. They may also face worries about the pregnancy itself – fearing possible complications or health problems during the gestational period or during childbirth.

Do all women experience these during pregnancy or are some women just more prone to experiencing added levels of stress and anxiety during pregnancy than others?

• Pregnancy is a period of change and some degree of trepidation is normal. However, it can become a problem if anxiety and stress become overwhelming. While stress and anxiety issues can affect anyone, there are certain at-risk profile groups.

Women with ongoing mental health issues may be more fragile and at risk. Pregnant women without a proper social support system or who have unsafe home environments including exposure to violence are hit harder by these concerns. How a pregnant woman feels about her pregnancy, on whether it is an unexpected or unwanted pregnancy or a planned pregnancy, can also contribute to stress.

Having complications during pregnancy or having previously experienced complicated pregnancies or miscarriages can contribute to increased stress.

Let’s talk about cause and effect. What are the negative stress and anxiety during pregnancy effects on baby for the mother, and for her unborn baby’s health?

• Stress and anxiety during pregnancy can have a negative impact on the mother’s health and affect sleep, eating and general wellbeing, which in turn can potentially affect the unborn foetus’ growth and the length of gestation. It can also potentially result in neurodevelopmental issues or diseases for the baby after childbirth.

Maternal anxiety during pregnancy effects on baby — would there be adverse effects on the baby later on in his/her life?

• There is increasing research evidence to suggest that anxiety during pregnancy can affect the unborn foetus. This is known as foetal programming, where the womb environment which the foetus is exposed to affects foetal development. These effects can continue through childhood development and possibly into adulthood.

Stress results in increased production of the hormone cortisol through the hypothalamic-pituitary-adrenocortical axis, which is a hormonal regulating system in the body. Research does suggest that elevated maternal levels of cortisol can affect the foetus’ own hypothalamic-pituitary-adrenocortical axis, leading to an increased risk of developmental problems later in life. There may also be other mechanisms through which maternal stress affects foetal health which we do not fully understand yet.

Anxiety during pregnancy effects on baby: These effects can continue through childhood development and possibly into adulthood. | Photo: iStock

Maternal stress has been linked to possible issues such as cognitive developmental issues, difficult temperament and behavioural problems and physical diseases like asthma.

At what point should a pregnant woman consult a doctor if she is experiencing stress/anxiety? What symptoms would she be experiencing in order to prompt her to seek medical help? 

• While emotional ups and downs are part and parcel of pregnancy, some possible red flags or signs to look out for include feeling consistently anxious or bad most or all the time, negative thoughts and emotions that are affecting your daily life and functioning, panic attacks, possible symptoms of depression such as a loss of interest in everything, feelings of hopelessness, thoughts of self-harm or obsessive/compulsive behaviours.
• You should see a doctor for further evaluation and possible treatment if you have any concerns about your mental wellbeing.

How can pregnant mums with existing mental health issues such as diagnosed anxiety and depression, bipolar disorder, and other illnesses, cope with counting kicks as it can be stressful and may sometimes trigger panic attacks?

• In some situations where formal kick counting may result in more maternal stress, your doctor may instead recommend that you pay attention to your baby and do some loose counting throughout the day rather than a formal count.

Instead of obsessing about numbers, highly anxious mothers can instead relax and enjoy feeling their baby’s movements. Kick-counting is beneficial in high-risk pregnancies but for anxious women with average-risk pregnancies, formal kick counting may not necessarily be an absolute must. If you feel that formal kick counting is taking a toll on your mental health, speak to your doctor about alternatives.

There are techniques that can help curb anxiety during pregnancy effects on the baby. | Photo: iStock

Is medical treatment for anxiety, stress, and other mental-health related issues safe during pregnancy?

• Treatment of anxiety and other mental-health related issues during pregnancy may involve medication and your psychiatrist or doctor will speak to you to weigh the risks and benefits of taking medication and explore pregnancy-safe options.

Psychological therapy like counselling can also be helpful and may be used in conjunction with taking medication.

What would your advice be for women who suffer from anxiety and stress? What techniques can they employ to keep their stress and anxiety at bay?

• Set aside time to look after your own mental wellbeing – to do something you enjoy or that helps you relax. Meditation can also be helpful in reducing anxiety. Taking good care of one’s physical health (a healthy diet, good sleep and exercise) can also help with mental health. Sharing your anxiety or worries with your support circle (spouse, family, friends) can help alleviate the burden.

If you ever feel like your mental health is at risk, do not hesitate to speak to your doctor.

Dr Grace Huang, the resident doctor at DTAP Clinic Robertson is a general practice clinic with a special interest in Men’s, Women’s, and Sexual Health. She has a keen interest in Women’s health and wellness medicine. 

ALSO READ: Why counting the kicks is so important: A first-time dad’s story