Coping with the idea of a premature birth

Managing anxiety

If you’re likely to give birth early, you may be feeling quite anxious. This is completely understandable, but it’s important to try and manage how you feel. 

Pregnancy can be a very emotional experience, and this can be made harder if you might have an early labour. Being on high alert for symptoms of preterm labour and needing to attend extra hospital appointments can also cause additional anxiety and stress. 

Anxiety in pregnancy is very common. More than 1 in 10 pregnant women have it. It is important that you try not feel like you are a failure because you feel like you are not coping.

Anxiety is a feeling of unease, worry or fear, that can be mild or severe. Some people can also have depression in pregnancy, which can be increased because of anxiety.

Anxiety symptoms can include:

• feeling on edge all or most of the time and not being able to control it
• restlessness
• feeling very worried (for example, in pregnancy you may feel constantly worried about your baby)
• feeling a sense of dread
• being unable to concentrate, or feeling like your mind goes blank
• feeling irritable
• difficulty falling or staying asleep. 

You must tell your doctor, midwife or GP if you are feeling anxious. If you need more help, you may be referred to a specialist mental health team for pregnant women. You may also be offered therapy, such as cognitive behavioural therapy (CBT), mindfulness and relaxation techniques with a professional therapist. You may also be offered medication, such as antidepressants. 

Find out more about anxiety in pregnancy.

Will anxiety affect my baby?

Being concerned about whether anxiety or stress will affect your baby is understandable, but it can also create a vicious circle of thoughts. You may be feeling anxious during your pregnancy, then begin to worry if it this is affecting your baby and so become even more anxious.

It is very unlikely that your baby will be affected by stress or anxiety, if you get the right treatment and support. So try to focus on asking for help and finding ways to manage your symptoms. The first step is to talk to your midwife or doctor about how you’re feeling. They will do their best to reassure you and answer any questions you may have. They will also be aware of support available in your areas and be able to signpost you to helpful services. 

Bonding with your baby in the womb

You may be feeling anxious or nervous if you’ve been told you are at risk of having a premature birth. Bonding with your baby during pregnancy may give you some comfort and give you something positive to focus on. 

The early relationship you have with your baby is very important and this starts during pregnancy. Your baby can hear your voice from at least 16 weeks, and perhaps earlier. They can hear their mum’s voice most clearly, but anyone can talk or sing to them. 

Talking or singing to your baby helps them: 

• get to know voices, which will help them feel safe and secure
• help them practice their hearing and get ready for when they will eventually talk.

There are other ways that you, your partner and older siblings can bond with your baby, such as:

• gently touching, rubbing or massaging your tummy
• playing music to your baby (but don’t put headphones on your stomach as this is too loud for them)
• responding to your baby’s movements – say hello and feel the baby kicking
• reading a favourite story or nursery rhymes to your baby
• doing things that help you relax and create a calm, peaceful environment for you and your baby – you could try having a long bath, reading a book or going for a walk
• setting aside time each day to sit and focus on your pregnancy – this is more about finding time to sit and think about your growing baby rather than writing to-do lists or buying things for your baby 

If you don’t feel like you’re bonding with your unborn baby yet, don’t worry or feel guilty. Pregnancy can be a difficult time even under normal circumstances and you have extra worries to cope with about the possibility of your baby coming early.

Many people can feel silly talking or singing to their baby during pregnancy, but this will not impact on the connection between you and your baby at birth. It can be hard to bond with someone you’ve never met and it doesn’t mean that you won’t ever feel a strong connection. Lots of women find that they fall in love with their baby after the birth. Instead, try to focus on spending some quiet, quality time with your unborn baby. 

Going to antenatal classes

If you can, it’s helpful to go to antenatal classes. The NHS offers some for free or there may be classes you can pay for in your area. They are a great way to prepare for the birth of your baby and you will also get some tips on how to look after your new baby. Antenatal classes can also be a good way to meet other expectant families in your area. Ask your midwife, health visitor or GP about NHS classes locally, or find a National Childbirth Trust (NCT) course near you.

Dealing with other people’s reactions

Most people, especially close friends and family, will usually do their best to be supportive during your pregnancy. 

Occasionally, other people’s reactions may not always be helpful. Although people usually mean well and want to help, reactions or comments from your family, friends or colleagues may leave you feeling more upset and isolated.

We’ve heard from many people who have been hurt by well-meaning but unhelpful insensitive comments or questions about what they are going through. For example, women we’ve spoken have had unhelpful comments such as “at least you won’t have to be pregnant for as long as me”, “perhaps labour will be easier if your baby is smaller” or “at least you won’t get too big”. 

This can be difficult to cope with but try to keep in mind that most people are trying to be kind and may feel nervous about what to say to you and end up saying something upsetting. They may be so anxious to say something, that they ask questions or make comments without really thinking it through. However, this doesn’t mean that it’s your job to make them feel better. 

Try to focus instead on the people who are offering support, who care and understand. We hope that for any upsetting comment or reaction you have, there is someone else who says the right things and helps you through this difficult time.

If you don’t have a support network or if you’re feeling isolated or alone, there is help available.

You can also call our pregnancy line to speak to one of our midwives for free on 0800 014 7800 (Monday to Friday, 9am to 5pm), or email us at [email protected].

Managing relationships 

If you have a partner, pregnancy can sometimes change your relationship with them. Some people cope with these changes easily, but some find it harder.

Your relationship with your partner can affect your emotional health and vice versa. A positive relationship can make you feel loved and supported, and more able to deal with stressful situations. A difficult relationship may make you feel bad about yourself, or increase  anxiety or depression.

You may be feeling especially vulnerable at the moment. You’re trying to cope with the physical symptoms of pregnancy as well as perhaps feeling an overwhelming sense of responsibility to keep your baby safe for as long as possible. Your partner may be feeling a sense of helplessness, anxiety or a lack of control. Some partners may even feel side-lined as healthcare professionals, friends and family usually concentrate on the person carrying the baby.

Even the healthiest relationships can be under strain in stressful situations, so try not to let any worries about you as a couple overwhelm you. It’s really important that you stay open and honest with each other about how you feel. Try to understand things from each other’s point of view, give each other time to talk about how you feel and give each other some space when needed.  

It may also help to talk to someone outside of the situation. This could be a family member, friend or even a trained relationship counsellor. This could be together or on your own if you want.

You can:

• get relationship advice and support from The Couple Connection 
• get information about couple’s counselling at Relate – they also offer a live web chat service where you can talk to a relationship or family counsellor for up to 30 minutes for free
• find a private counsellor in your area though the British Association for Counselling and Psychotherapy (BACP).

Feeling like you’re missing out on having a normal pregnancy

Knowing that you’re at risk of premature birth can be very upsetting and you’re probably feeling a mix of emotions such as confusion, sadness, shock and fear. This is all normal. 

Many people also find themselves grieving for the pregnancy they wish they had. Or they feel a sense of unfairness and questioning why is this happening to me? Again, this is natural and understandable. Every parent-to-be hopes for a straightforward pregnancy with no complications, so it can be very difficult to accept when there are problems.

You may find yourself feeling frustrated or disappointed. Many people feel guilty or wonder if they could have done something to prevent the early delivery of their baby. Feelings of failure are also common. Some women feel like their body has failed them or that they have failed at motherhood before they have even started.

All these feelings can be made worse by comparing yourself to other women who, from an outsider’s perspective at least, seemed to glide through pregnancy effortlessly. This may be family, friends, or even celebrities you follow on social media. 

It can be a lonely experience when it feels like no one around you understands what you are going through. It may be helpful to talk to your partner or trusted family members or friends.

Remember that you can tell your midwife or doctor how you feel. They will do their best to reassure you and answer any questions you may have. 

You can also speak to one of our midwives for free by calling our pregnancy line on 0800 014 7800 (Monday to Friday, 9am to 5pm), or email us at [email protected].

If you are struggling to cope, there is professional support available. Don’t suffer in silence. Tell your midwife or GP how you feel. They will help you access the support you need.

Looking after yourself 

Here are some things you can try to help you stay as calm and relaxed as possible:

• Take time out for yourself every day. Take a warm bath, listen to some music, close your eyes, gently massage your bump – whatever makes you feel peaceful.
• Talk to someone you trust, such as your partner, family or a friend about how you are feeling.
• Rest when you need to.
• Be realistic about how much you can do. You may not be used to saying no, but now is the time to take care of yourself. The people around you will understand if you need to say no.
• Eat a healthy, balanced diet and stay well hydrated.
• Learn some relaxation techniques. NHS has details of breathing exercises for stress.
• Try to avoid caffeine, which may disrupt your sleep and make you anxious. 
• Don’t smoke or drink alcohol. Both can increase the risk of premature birth.  

It may help to stay active by doing some gentle exercise, such as swimming or walking. This can help you sleep better, improve your mood and lowers stress levels. If you have been told you are at higher risk of premature labour, talk to your GP or midwife before starting an exercise plan.

Although exercise alone does not cause premature birth, it is possible that it could complicate an existing problem, such as a weak cervix.

Always listen to your body and if something does not feel right, speak to your doctor, midwife or GP.

When and where to get support

Many parents-to-be feel ashamed or guilty about feeling low. But the reality is that mental health problems can affect anyone at any time. It doesn’t mean you are a bad parent.

Don’t hide your feelings or suffer in silence. You are not alone. Tell you partner, family or friends how you feel, as well as your GP and midwife. They will help you access the support you need.

If you need more help, you may be referred to a specialist mental health team for pregnant women. You may also be offered therapy, such as cognitive behavioural therapy (CBT), mindfulness and relaxation techniques with a professional therapist. You may also be offered medication, such as antidepressants. 

What you are offered will depend partly on what your symptoms are, how severe they are, and what’s available locally.

Pregnant women and their partners can also call our pregnancy line on 0800 014 7800 (Monday to Friday, 9am to 5pm), or email us at [email protected].

Other organisations that may be able to help include:

Anxiety UK, which is run by people with anxiety disorders, offers information, support and therapies for people experiencing anxiety.

No Panic provides Online and telephone support for people suffering from panic attacks, phobias, Obsessive Compulsive Disorder, and anxiety disorders.

MIND is a mental health charity providing information, support, local groups and an online chatroom.