Anjali is a 28-year-old married woman in her second trimester of pregnancy.
She has no other children, but a year ago experienced a miscarriage early on in the pregnancy. Anjali was devastated by this loss, believing that she would be unable to conceive again. Gradually she was able to pull herself out of this difficult time with support from her husband and friends. However, feelings that she somehow could have prevented the miscarriage and that she should have done things differently continued to plague her for a long time.
A year later, Anjali and her husband were overjoyed that she was pregnant again. Anjali felt really anxious during the first trimester, anticipating the worst. Yet her prenatal exams continued to go smoothly and all signs pointed to a healthy pregnancy. Nevertheless, her anxiety continued to increase over the weeks. Now well into her second trimester, Anjali still finds it difficult to allow herself to believe she actually is pregnant. She says to herself that she “hopes” that she has a baby.
Many times throughout the day, Anjali experiences a racing heart and a clenching sensation in her chest, and generally feels restless and on edge. She often feels that she cannot “shut her brain off” and is consumed with worries about the growing baby. She feels particularly anxious the few days before a routine ultrasound and can barely sleep the night before, convinced that the technician will see an anomaly or worse, that the baby won’t have a heartbeat.
Anjali worries that she isn’t “showing” enough yet and that the baby isn’t growing, despite reassurance from her physician. If she does not feel the baby move for a few hours, she will sit or lie still until she feels movement. She has constant urges to call her doctor to ask questions, and she frequently asks her husband and sisters to reassure her that the baby will be okay. Anjali’s family is at a loss because their reassurances do not seem to help Anjali feel more at ease.
Anjali spends two or three hours every day looking up miscarriages, genetic defects, and other issues on pregnancy websites, believing that she can somehow prevent “something bad” from happening if she has enough information. She worries in the middle of the night and feels an intense need to go check something online before she can go back to sleep. Rather than reducing her worries, these Internet searches mostly lead to new concerns and more searches.
In addition to worries about the baby and her pregnancy, Anjali also worries about finances. She worries they will not be able to afford everything they want for the baby. She also worries something bad may happen to her husband and she would have to raise the child by herself. She has vivid images of him getting hit by a car on his way home from work. She calls her husband about five times a day to make sure he is okay.
She is also worried about her own safety. Anjali frequently imagines someone jumping out from the bushes and grabbing her. As a result, Anjali is starting to avoid certain streets, and will not walk outside at night alone anymore. She realizes that a lot of these worries are irrational, but this sense that something bad will happen to her or her husband is making her feel especially frightened.
Aware of her high anxiety, Anjali is concerned that her anxiety will stop her from being a good mother. Her family and friends are supportive, but Anjali worries they secretly think she will be a terrible mother because she is such a “basket case.” When she is out in public, she is embarrassed that others may sense her distress and think she will be an unfit mother. Because of these worries, she finds it increasingly difficult to be around others, even her close friends and family.
Anjali looks longingly at the photos of happy, glowing, peaceful pregnant women in magazines, but doesn’t recognize herself at all in those cheery glossy photos. She finds that people don’t really understand what she is going through. The few times she has let others know how stressed and worried she feels, friends respond, “You should be enjoying this special time! Relax!” Her husband is also confused and frustrated by her anxiety, and doesn’t understand why she does not seem happy to be pregnant again.