Letting Go of Expectations When You’re Expecting

Pregnancy Expectations

Local author and mother Amy Tiemann thinks it’s ironic that the most-read book on pregnancy is called What to Expect When You’re Expecting. “We are bombarded with expectations during our pregnancy. Birth is built up like it’s the biggest event of our lives. In some ways it is, but it’s also just the beginning,” says the Chapel Hill author of Mojo Mom: Nurturing Your Self While Raising a Family.

For many women, pregnancy and childbirth are wrapped in specific packaging. We visualize easy pregnancies that culminate in perfectly orchestrated births. Actors portray characters with charming baby bumps for a television season, leading up to the hilarious and touching birth episode. The baby is sleeping through the night by the time the credits roll.

“A lot of our misery as new moms comes from the tension between what we thought it would be like and reality,” Tiemann says. “It is not that our reality is that bad. It’s more about the gap between what we expected and what we are experiencing.”

And sometimes very specific circumstances rock parents-to-be perceptions of how pregnancies will proceed.

Laid up in bed

A Raleigh mother of three, Doris Matal is experienced in pregnancies gone awry. The former teacher was on bed rest from the time she finished teaching in July until she delivered in October.

“I was allowed to get my own food, but I wasn’t allowed to clean the house,” Matal says. “The mess is being made around me, and there was only so much I could do.”

She was also physically uncomfortable during her bed rest. “It’s like going on a long car ride and needing to get up and stretch [and you can’t],” Matal says.

Tiemann thinks part of maintaining sanity with pregnancy — or parenting — is perspective. “Keep your eye on the long-term goal. Even six weeks of bed rest will pass,” she says. “It’s worth it if it increases the chances of a healthy baby. I think ‘this too shall pass’ eventually becomes every mom’s mantra.”

Medical complications

As if prescribed bed rest weren’t enough of a derailment, Matal also suffered from a condition known as hyperemesis, which is characterized by uncontrollable nausea and vomiting throughout pregnancy. Basically, morning sickness on steroids.

“I thought I was the only person I knew who didn’t have a healthy, bouncy pregnancy,” Matal says. “Instead, I was nauseous and throwing up all the time.”

To get adequate nutrition and fluids, Matal was required to take medications and was even hospitalized periodically. The endless nausea caused Matal to worry about her twins.

“My doctor kept saying, ‘The sicker the mother, the healthier the babies.’ It’s true. They were born healthy, happy and ready to go.”

But Matal battled feelings of jealousy. From the time she was young, she had visualized the kind of mother she wanted to be and the process of being pregnant. She had never imagined her condition. Ultimately, however, she was able to focus on how fortunate she was as the mother of twin daughters and a stepdaughter.

“I have to think about how everything did turn out. I did have twins. I have three daughters and had one pregnancy,” she says.

Curbing excessive worries

Jon Abramowitz, associate professor of psychology at UNC-Chapel Hill and director of the Anxiety and Stress Disorders Clinic, sees the pressure to have a picture-perfect pregnancy weigh heavily on parents. “There is a lot of pressure to do this perfectly and be the best parent.”

And reality sometimes disagrees with the vision. “Naturally, when we set expectations very high, they don’t get met. People respond differently [when this happens],” he says. “Some people turn inward on themselves.”

Abramowitz sees patients who develop depression. The Anxiety and Stress Disorders Clinic specializes in anxiety during pregnancy, which can happen when soon-to-be parents exaggerate the potential for things to go wrong.

“They tend to overestimate the probability of awful outcomes. Overestimating something bad can make you anxious and depressed,” Abramowitz says.

The alternative is realism: creating a new story in the face of unmet expectations. “[Parents need] to figure out a way to cope, a plan of action,” Abramowitz says. “In our clinic, we identify overly negative thinking and help the person step back and correct those thoughts and beliefs with rational thinking.”

He encourages patients to look at difficult, distressing or disappointing situations and reframe them in a more logical, less catastrophic light. This way issues big and small don’t snowball into depression and anxiety.

Delivery detour

Most pregnant women are encouraged to create detailed birth plans, and they have a concept of how they want to bring their baby into the world. This plan looks different for each family. For some it involves family and support members in the delivery room; for others, just the partner and the health-care provider. Some women feel pain medications and other interventions are fine. Other women only want natural childbirth.

For Brandy Lemen of Durham, avoiding medical interventions during delivery was essential. After Lemen’s sister had a terrifying reaction to an epidural, Lemen was adamant about a completely natural experience.

“My sister was unable to move from the neck down for over two days. It truly scared me,” Lemen says.

In an attempt to determine the possibility of a familial response to anesthesia, Lemen participated in a class on prenatal anesthesia. “I spoke with an obstetric anesthesiologist at Duke at the class, and he did not take my concerns seriously,” Lemen says. The experience cinched her decision. “That was the final deciding factor for me. Our bodies are capable — they were designed to birth — and I didn’t feel pain medications were necessary for me,” she says.

Lemen and her husband wrote a birth plan with specific language about not wanting providers to talk about an epidural, pain medication, or any other medical or mechanical intervention. However, during the birth of her first son, things didn’t go smoothly.

First, her labor didn’t progress as expected. Then, she had to push for more than eight hours.

“I just got too tired. I had pushed for eight hours and labored for 20,” Lemen says.

After a shift change, things took another turn for the worse. “My new nurse was not supportive of natural childbirth, and I think that pushed me into panic mode.”

She felt scared when the nurse started talking about the need for a cesarean section and felt pressured to use intravenous medication to boost her contractions and, ultimately, vacuum extraction.

Initially, Lemen was upset by the birth experience. As a woman who wanted a very “low-tech birth,” she regretted that she had not chosen a birth center or requested a new nurse when she felt so uncomfortable. Later, she made peace with the experience by reflecting on the outcome: her healthy, beautiful son.

Part of healing is gaining perspective. Abramowitz, with the anxiety clinic, advises parents to listen to the messages they create and weigh them in context. It helps to look down the road when considering the outcome. Ask, “How will this seem a month from now? A year from now?” he says.

“Everyone is different, and you can’t predict everything,” Lemen says. “You have to be flexible and keep your eyes on the big picture.” Her advice for other moms is to plan and put support in place to get their ideal experience but understand that the unexpected can alter plans.

Pregnancies might proceed like a sitcom, or they may be pure drama, but ultimately the outcomes are the same: a baby. Keeping the long view helps parents weather even troubling circumstances.

Tiemann, whose book is based on personal experiences, says, “I thought if I was really competent, I would be able to control everything that happens in motherhood. Eventually, I realized that’s not how it works. That realization helped me not take things personally. And it’s liberating to let go.”

Robin Whitsell refers to pregnancy and laundry as “a journey, not a destination.” The Chapel Hill freelance writer can be reached at rwhitsell@gmail.com.

For more on this topic, read Specific Steps Stop Negative Thinking, also by Robin Whitsell.

Categories: Baby, Childbirth, Exceptional Child, New Parent, Organization, Planning, Pregnancy, Special Topics