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Question
Posted by: shelley | 2010/06/18

panic attacks in pregnancy / birth

Hi there

I wonder if I could please have some advice regarding panic attacks during pregnancy and during birth.

I have suffered from quite severe panic attacks for the last few years. My husband and I want to start a family but I am terrified that having attacks while pregnant or while giving birth will do harm to both me and the baby

Please can you give me all the advice you have on coping with attacks during pregnancy - can you still take the anti depressant medication? (I am on Leximal 20mg) How are attacks treated during pregnancy? One thing that really makes me panic is vomiting - honestly I am completely phobic about it - I was told it is called emetiphobia? Anyway I can''''t hear it or see it or be around anyone who is sick! I know you can get morning sickness - how can I cope with that?

With regards to labour is it better to go for a planned C section or natural? Which is safer and what will the nurses and doctors do if I have an attack while I am in labour? Could it kill the baby?

I have heard you will be paralyzed and can get very nauseas when you have a c section - I will certainly panic then!

I am desperate for this advice - please help me

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Our expert says:
Expert ImageCyberShrink

I would, ideally, have wanted you to work with a really skilled psychologist doing CBT ( Cognitive-Behaviour Therapy ) to learn how to gain control over your anxiety and panic attacks. In advance of pregnancy, medication can also help, such as drugs also used for depression, and some other sedative tranquillizers which one can dissolve under the tongue when you feel a panic coming on. One would if possible prefer to get the medication part of treatment complete before embarking on pregnancy, if possible.
Do see a really good local psychiatrist for a thorough assessment of your fears and concerns, to plan effective treatment which could clear this up before you embark on pregnancy.
During labour you're likely to be so fully involved in he labour itself, as to hardly have time to panic, and actual harm to you or the baby is really unlikely - but these specific questions ened to be discussed in detail with a psychiatrist who has fully assessed you and knows your situation in all its details.
Durign a C section, of course, you would be under anaesthetic, and unable to panic, anyway

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Our users say:
Posted by: cybershrink | 2010/06/20

I would, ideally, have wanted you to work with a really skilled psychologist doing CBT ( Cognitive-Behaviour Therapy ) to learn how to gain control over your anxiety and panic attacks. In advance of pregnancy, medication can also help, such as drugs also used for depression, and some other sedative tranquillizers which one can dissolve under the tongue when you feel a panic coming on. One would if possible prefer to get the medication part of treatment complete before embarking on pregnancy, if possible.
Do see a really good local psychiatrist for a thorough assessment of your fears and concerns, to plan effective treatment which could clear this up before you embark on pregnancy.
During labour you're likely to be so fully involved in he labour itself, as to hardly have time to panic, and actual harm to you or the baby is really unlikely - but these specific questions ened to be discussed in detail with a psychiatrist who has fully assessed you and knows your situation in all its details.
Durign a C section, of course, you would be under anaesthetic, and unable to panic, anyway

Reply to cybershrink
Posted by: Purple | 2010/06/19

Good ante-natal classes will help you a lot as what makes people nervous about birth is fear of the unknown.

With a natural birth, you use breathing to calm yourself down and help you to cope. There are lots of options for pain relief and if you have a doula with you and your husband then she will be there to support you both through everything.
The calmest wasy to give birth and remain in control the whole way through is to have a midwife birth, this means that your own midwife will be with you the whole way through and not rush through the process and want medical intervention when it isn''t necessary.

I don''t know about c-sections, except that surgery makes a lot of peole nervous. a spinal block is used and can make some women nauseus.
If you are in an absoloute state about it, you can ask for a planned c-section with a general anaesthetic but you will probably regret not having been a part of baby''s birth or delivery if you do this.

Most women get nausea during pregnancy, but about a quarter of pregnant women don''t get. Of those with nausea, a few do vomit a bit, and a very few vomit a lot. There is safe medication that can be taken to help ease this, though it doesn''t stop it completely.
What does help is sipping water, keeping your tummy full by eating lots of small meals, not being around the smell of cigarette smoke, coffee, alcohol or meat.
Ginger biscuits help, as does ginger tea.
Vitamin B helps too, so the essential hangover pills are often suggested by gynaes.
Avoiding fatty food also helps.

Why don''t you see your gynae now and ask these questions.
IF he is dismissive of your feelings, find someone else who you feel comfortable with.
Start searching around for good ante-natal classes now.
The good ones cover natural birth, c-section, care of newborns, vaccinations, breastfeeding, parenting and such. The good medical aids pay a portion of the costs.

There is an excellent series of books called What to Expect - a lovely one for pregnancy is What to Expect when you are expecting. Its in a quesiton and answer format and is divided up into each month of pregnancy and the questions women commonly have at that time. You will be surprised to see how common many of your fears are.

You can take certain anti depressants during pregnancy, discuss this with your gynae. I''m on anti depressants now, but wasn''t during my first pregnancy and I had depression during my pregnancy and then got fairly bad post natal depression too. Its been a long road to find an antidepressant that doesn''t make me put on weight and could be used during pregnancy (the side effects that can occur don''t occur in everyone and so each one will be different for you than for someone else) and I''m now on Cipralex and can honestly say that I definitely feel soooo much better than on any other anti depressant. I''ve got a new gynae and we''ve agreed I''ll stay on it and will see a psychiatrist during my next pregnancy and they will adjust my dosage if necessary.

I also get panic attacks, though they don''t just happen out of hte blue, they have all been at the time of big worries (though I got such a fright with the first one and didn''t know what it was that I posted here asking CS what could have made me feel like I couldn''t get any air in). I didn''t have any panic attacks during pregnancy or during the birth. They are very scary, but you are actually breathing so I don''t htink baby comes to any harm.

Being a mother is just the most fulfilling experience you will ever have, and feeling those little toddler arms wrap around your neck, and that little baby smile for you rather than other people is an experience everyone should get to have.

Good luck.

Reply to Purple

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