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The Emotional Highs and Lows of Pregnancy – How Doulas Can Help

March 16, 2022

pregnancy highs and lowsPregnancy can be a time of joy and excitement, but it can also be a challenging time. There can be emotional highs and lows throughout pregnancy. Each person has a unique experience, but there are common things many experience.

During training at the International Doula Institute, doulas learn about the physiological process of pregnancy. There are social impacts, physical, and emotional impacts of pregnancy which influence the highs and lows.

Here are some common emotional highs and lows of pregnancy and how you, as a doula, can help:

#1: Finding Out About The Pregnancy – Often A Pregnancy High

For those planning or open to pregnancy, finding out about the pregnancy is often an emotional high. Certainly, there are times this can be scary.  However, for many of our clients, finding out about pregnancy may be a high.

#2: First Trimester Anxieties – A Pregnancy Low

Some parents find the concerns of loss, genetic testing, etc., to be anxiety inducing. This combined with hormonal changes trigger morning sickness and other ailment can make for a pregnancy low.

As doulas, it can be important we validate that pregnancy isn’t always rainbows and butterflies for everyone. We should validate that it is perfectly okay to dislike aspects of pregnancy. Disliking ailments, experiencing anxiety, feeling low, none of those have any bearing on how their love for their baby.

If a client is experiencing significant anxieties or lows, it is important to remind them of resources. While many are aware of PPD, Perinatal Mood and Anxiety Disorders (PMADs) include anxiety and depression during pregnancy. Remind clients they needn’t struggle alone.

#3: Reaching The Second Trimester and Good Prenatal Screenings

When parents reach the second trimester, many breathe a sigh of relief. The fears of miscarriage tend to lessen, and the pregnancy feels more real. They may also have NIPT testing complete and feel better about getting beyond prenatal screenings.

There is also often excitement in sharing the news with their family and friends. While there is no right or wrong time to share, many parents choose to share the news around the second trimester.

As a doula, share in their joy and excitement. This is a fun time to be their hype person.

#4: Body Changes and Possibly Disappointment – A Pregnancy Low

During the second trimester, many begin to notice more body changes. Weight gain, stretch marks, and a growing belly can be a low for some people. It can be eerie to have such little control over how your body is functioning and changing during pregnancy.

There may also be disappointment related to gender, possible congenital conditions, and more.

As a doula, you can validate their feelings, point them to resources, and remind them it is okay to dislike aspects of pregnancy. If you have a client with a past history of eating disorders, body dysmorphia, a non-binary or trans person, these lows could be quite difficult. This is a good time to be aware of inclusive providers in your area equipped to provide empathetic and supportive care.

#5: Reaching The Third Trimester – Excitement and Pregnancy Highs

Reaching the third trimester brings immense relief for many. They’re so close to meeting their baby! This can be a huge milestone for anyone at risk for pregnancy loss as they’re now well into viability.

Many parents get excited discussing names, painting the nursery, etc.

As a doula, this is an excellent time to use their excitement for planning their birth preferences. Help them target that excitement into evidenced based learning so they can prepare for their birth. There’s no right or wrong way to give birth, but parents who are active participants in planning and birth decision making often report a more positive birth experience.

#6: Third Trimester Worries

Along with the excitement of getting ready to meet baby, some parents are scared to meet baby. There may be fears about birth or parenting. There could be unhealed traumas surfacing.

Perhaps there’s significant fatigue and physical discomfort taking away from what they hope would be a fun time. Whatever the reason for your clients third trimester lows, be an empathetic ear. It isn’t always about solving problems, but simply holding space and supporting them through a difficult time.

Pregnancy is filled with highs and lows and they vary person to person. As a doula, hold space, refer to resources as necessary, and simply be there for your clients.

Aliza Juliette Bancoff
Author: Aliza Juliette Bancoff

Aliza Juliette Bancoff is a well-known doula and doula trainer who has been providing doula services to families for over a decade. She is the founder of Main Line Doulas, a doula group providing doula support in the great Philadelphia area for the last decade, the International Doula Institute, which provides online doula training and lactation training and certification programs and  the International Breastfeeding Institute which provides lactation training and certification.   She is the co-founder of United Birth, a company devoted to increasing access to doulas across the country to make the perinatal time safer both physically and emotionally. “Every birthing person deserves access to quality doula support. And we are working to make that a reality across the country. The work we are doing to get doulas to every birthing person will decrease the black infant and maternal mortality rate significantly by 2030.” Says Bancoff. Aliza is known for her compassionate and empowering approach to doula work, and she has been featured in numerous media outlets, including United Nations Maternal Health Report,  Parent Magazine, CafeMom, theBump and many more. Aliza's journey into doula work began when she gave birth to her first child and felt a strong calling...

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