How To Navigate Burnout In Pregnacy, Childbirth & Motherhood
The picture was taken in Milan, 6 months pregnant.
Pregnancy And Burnout
Can you get pregnant when you are burned out? How does a high stress level affect childbirth? And can you be a good mother when you are or have been burned out? These are some questions I am going to dive into in this article since they are at the forefront of my mind as I am now 7 months pregnant with our first child. At the same time as I am really truly looking forward to this upcoming and life-changing adventure of motherhood, I can’t help but worry about how my brain is going to react to and cope with the stress that it undoubtedly will entail.
So let’s start with some facts and evolutionary history. Burnout is a diagnosis that you, at least in Sweden, which is one of the few countries in the world where burnout is a clinical diagnosis, require you to have been under high stress for at least six months and to fulfill a long list of symptoms. It is a stress-related illness. In Sweden alone, on average 2 people per day die (!) from stress-related illnesses, which indicates to us that stress is not only something that is happening in our minds, but that has a tremendous effect on our bodies. So much that the bodies can completely shut down and it can take many years to recover. In addition to potentially being lethal, burnout is usually connected to a long list of severe illnesses, such as type 2 diabetes, chronic heart disease, gastrointestinal issues, and high cholesterol. Burnout is physical.
Perhaps you recognize the feeling of having a stomach ache or pain in your chest when you are stressed. This is the bodily reaction to a situation we are facing or oftentimes even just a thought that we find stressful. Mind and body are undoubtedly intertwined, and the sooner we realize this interconnectedness the sooner we can also start helping ourselves to realize when we enter the dangerous grey zone of burnout. For this to happen we need to be able to read and interpret the bodily signals. Usually, our bodies are telling us, or even screaming to us, to stop the stress and to take a break, but since many of us have never been taught or practiced how to listen to the bodily signals, our mind and body can be aligned without us having the ability to know it since we can’t feel it, and thereby we miss the opportunity to prevent burnout from occurring.
This used to be me, and I would always come up with my own alternative (and very convincing!) theories or excuses for why I had stomach aches or pain in my heart, but I never connected it to stress. Of course, if we are very often facing stress in our lives, this state is becoming our default and perhaps not at all something out of the ordinary, hence nothing we would react to. We are simply so used to this level of stress. We will just face the consequences, but not knowing the root cause since we are not trained to see the link: a stressful thought – leads to the feeling of stress – leads to a physical reaction to stress. Put in “evolutionary language”, if our brains think that a tiger will soon come and eat us, the body will not prioritize taking care of the food in the stomach. As a consequence, the gastronomical system will be shut down temporarily while we are “running from the tiger” in order to survive, which is a great evolutional heritage motivated by survival. However, if we are put in this survival / “fight or flight” mode for too long, a malfunctioning gastronomical system will become an issue with a stomach ache as the symptom.
So what does this have to do with pregnancy one may wonder? Please bear with me for a few more sentences while I unfold my thoughts further and I will soon reach my point. In order to understand the effect that stress has on the body today, I do believe it is important to dig deeper into our primitive heritage from back in the days when homo sapiens lived our lives in the savanna. Back then, stress didn’t appear when we missed the bus (there were no busses!) or when our corporate manager was putting pressure on us to deliver better or faster work (there were no corporations!). Instead, our bodies experienced stress when we were under the potential threat of getting eaten by a tiger as described above, and we were put in the fight or flight mode. With this in mind in combination with the fact that our brains’ stress systems have not developed since we lived on the savanna many many thousands of years ago, it doesn’t matter whether we think we can outsmart our brains by having efficient technical tools or apps to enable multitasking and enhance productivity. When we experience stress, our brain’s response system is sent right back to the savanna, right back to basic to a place where no technical advancements can be of assistance.
When it comes to burnout and pregnancy, or even burnout and motherhood, since this is something to bear in mind for as long as we are parents – it is vital to remember that we do get burned out because we have been stressed for too long without any pauses. Our fight or flight alarm systems have been “burning” so much and so often that every “hint of smoke” will trigger the “fire alarm” to go off, if you follow my analogy. The response from our bodies will not be proportionate to the situation, since our brains have developed a sensitivity to the stress triggers. The alarm system is burned out. I am a strong believer that if we do wish to get pregnant, our bodies can’t be in the fight or flight stressful mode where the alarm is constantly, and also many times incorrectly, shouting out loud for any trigger or potential danger. We can only get pregnant when we are feeling safe. Anything else would go against the basic evolutionary principle of survival. Therefore, just like the gastronomical systems are shut down under stress, also reproductional systems are not prioritized when running away from a tiger.
Getting Pregnant When Having A Burnout
I remember so clearly the day I sat at my doctor’s office in Dublin crying uncontrollably and worrying about my future as I had just been diagnosed with General Anxiety Disorder (since “Burnout Syndrome” was not a clinical diagnosis in Ireland). After speaking to me for merely 15 short minutes, my doctor wanted to prescribe antidepressant medication to me. I refused to take the pills having read that it could affect my ability to get pregnant. He looked at me and said: “No offense, but I hope that getting pregnant is not something you are thinking about right now. I think you should focus on taking care of yourself and getting healthy first.” Of course, I was not planning a pregnancy at that time, in fact, I was happy if I could only survive the day! If I could manage to take care of myself I would be very happy; taking care of another human being was not at all on my mind at the time! However, somewhere deep inside of me, I knew that there could be a light at the end of this very dark tunnel (I have always been a disgustingly positive person, who have had a superpower to always see life from the bright side!). In this light, I also sensed that there could come a day when I would be at a place in my life where I would wish to get pregnant and create a little “Mini-Me”, and I didn’t want to risk that potential future scenario. I declined the antidepressants (based on fear of the side effects mentioned on the package and in combination with the lack of information from my doctor in this regard) and found other ways to deal with my burnout. Keep in mind here that this is in no way criticism towards antidepressants, but merely an illustration of my very ill state of being at this time of my life, when I could not take even the smallest of decisions (such as spending 30 minutes in the supermarket trying to decide whether to buy a green or blue toothbrush!), I was simply not able to take the huge decision of whether or not to start with antidepressant medication.
A couple of years after my second burnout (when I had moved from Dublin and was now living in Sweden), I had found my life partner, and reached a stable place in my life with a super nice place to live right by the water (very much appreciated by my brain after my burnouts with the silence and closeness to nature), had found balance in my everyday life, inner peace and a feeling of gratitude and strong sense of purpose – I had reached a point in my life where a pregnancy would be welcomed and a child desired. We wanted to start a family.
It was very interesting to see that although we didn’t try to get pregnant more than two times/months before succeeding on the third, the successful time happened as I took a two months pause from my not-so-stress-free lawyer job in order to participate in a pain rehab center to learn to handle my chronic back pain deriving from my years as a semi-professional athlete. It was not until my body and mind took distance from the stress of lawyer life and entered a safe environment at this pain rehab center with no stress and only focus on mental and physical well-being surrounded by calm people who were speaking slowly, walking slowly, and giving me time for reflection and the ability to connect with my soul and inner values – that I would manage to actually allow my body to get pregnant. I really don’t think this timing was a coincidence, I think it’s pure biology. The primitive fight-or-flight response had to be shut down completely in order for my body to feel secure enough to allow a pregnancy, to create a new life.
Stress and Childbirth
When it comes to stress in relation to childbirth, we can just look at the behaviors shown by animals when giving birth. They always look for a calm and secluded space where they will be out of threat and optimize the relaxation hormones to flow in order for a delivery to take place. The same goes for humans – in the pregnancy yoga course I’m currently attending as well as the water gymnastics course, the pregnancy books and podcasts I’m consuming, the theme is common: a pregnant woman has to practice relaxation and breathing techniques for a successful birth. Why? Because if the pregnant woman feels stress, the fight-or-flight system is triggered, which in turn will trigger the production of stress hormones such as cortisol, and as a result, the body will start fighting against the natural automatic physical movements of childbirth.
Instead, we want to boost the “feel good” hormone oxytocin, which is produced when we feel love, relaxation, security, and trust. It is best boosted through hugs, sex, closeness, breastfeeding, and similar. Slow and controlled breathing, massage, and trust during childbirth can boost oxytocin, which will enable an easier birth experience and a higher sense of control. To me, who has yet to give birth, it is astonishing how technology and medicine and other new advancements definitely can help in a birth situation, but that it all comes down to our ability to control our hormone levels derived from our ancestors and developed over millions of years to get to where it is today to optimize the survival of our species. Whether we want it or not, whether we live technologically advanced lives or not, childbirth throws us back to the savanna and the animal kingdom. I find this very fascinating – we are animals and we are primitive. It’s a refreshing realization, and I look forward to digging deep into this feeling and using my breathing and acceptance practiced in meditation to my advantage when giving birth in order to boost the oxytocin levels and optimize the ability for a nice birth experience – both for me and the baby!
Burnout and Motherhood
So, what about the future – when the baby is out here in our world? How will a previously double-burned-out woman be able to handle motherhood? I will be honest and vulnerable now as I will express my fears. I am always honest, and when we dare to be vulnerable to open up about our fears, we will also be able to break the fear(s) down into manageable and approachable pieces that we can handle one by one (as opposed to having fear controlling us as one big unmanageable cloud holding us down). I fear not being able to handle the stress, since reaching a balanced way of living has been vital for me and undoubtedly become my rescue for surviving during the last couple of years. I am scared that I won’t be able to handle the lack of sleep, since allowing myself to sleep as much as needed has been my core success factor for recovery and getting back on track after my burnouts. And I’m scared that I will burn out again. Not because I don’t have the tools for how to stay in balance and remain on track with my core values, but because I am going to experience something completely out of my control – which is everything that motherhood and taking care of a baby is all about!
I won’t be able to control when my baby wants to eat or sleep, which will affect how much I can control my own sleep. I won’t be able to control how much my baby is going to scream and cry, which will affect the stress levels I feel due to sensitivity to stimuli in the form of high sounds that I have developed a sensitivity toward during and after my burnouts. Things that I have learned to take control over in order to get into a wonderful state of mind with balance, purpose, and routines will now come to a big test. To let go of control of what I know is good for me and keeps me balanced and happy. There are many questions spinning around in my mind: How balanced am going to be when I don’t get at least 9 hours of sleep per day? How will my cognitive ability be affected when I will not be able to have silence around me the times it feels like my brain is going to explode due to an overload of impressions and sounds? The last time it happened, it resulted in severe memory loss, and the inability to read or write or understand the simplest of institutions, so of course, there is real substance behind my fear. But what I fail to remember here is my disgustingly positive mindset and ability to always see the blue sky behind the dark clouds, so I have decided that I will now put this personality trait to use again.
A New Superpower
I’m always up for a challenge and this time I will have to adjust the coping mechanisms I have learned to get well from my burnouts, and adapt them to this new upcoming challenge of motherhood. I have learned the hard way the fantastic news that our brains are plastic, meaning that they have the ability to adapt to new situations and to do it very well. To recover when “broken” and enable for “shrunken” areas of the brain to heal and grow back to their normal size (or even larger than before!) since the neurons have the ability to find new connections!
If I look back at the brain capacity and cognitive ability I had during my first doctor visit in Dublin on my very first day of sick leave it was definitely not the same as I have now, 6 years later, when I feel stronger, more vital and balanced than ever. I have gone from having no ability to remember the name of my best friends to remembering complex legal matters so well that I would score max on a law exam. I have gone from having an extremely sensitive brain (Amygdala, the center in our brain controlling emotions) that wanted to cry every day to getting a healthy mind that wants to smile every day. I have gone from being able to focus for maximum 2 minutes to be able to work a full day with complex cognitive matters. I am the living evidence that the brain indeed is plastic.
I am now pregnant and happy and very content with myself and the life and world I have created for my baby to enter. Most importantly, I feel very confident that my brain is going to be able to cope with also this upcoming challenge of motherhood. On my very last appointment with my therapist in Dublin before I moved back home to Sweden he asked me what my biggest takeaway was from healing from this burnout. I answered that it feels like I have gotten a new superpower: Earlier in life I wanted to control everything and wanted to plan the outcome in detail. I have now, during my burnout, learned to be comfortable with the uncomfortable. To be OK with the unknown, and even think that this is the beauty of the future!
As humans, we have an amazing ability to cope with challenges thrown at us, and I am now throwing myself into this beautiful unknown called the future with a positive realization that if my brain has been able to recover (and even get stronger than ever before!) after going through the burning hell of living with a burned-out brain, I’m truly looking forward to the challenges that motherhood will bring, and the strengths and personal growth that will come with it.
In all the uncertainty that the future holds, one thing is certain and that is that I have prepared for the role of a mother in the least expected ways. My 4 years long burnouts with two additional years to get back on track in life and at work have taught me compassion, and empathy, patience, to set boundaries, to follow my heart and intuition, an enormous resilience, and an ability to bounce back no matter what challenge that comes my way. I feel happy that I have gone through what I have in order to be who I am today, and I think I have made long and mental preparations in order to be a balanced, calm and present mother for our child with clear values and boundaries. They always say that you have to love yourself to be able to love someone else. In the past couple of years, I have truly learned to love myself and appreciate and embrace everything that makes me unique. Therefore, I now feel extremely ready to, truly and unconditionally, love our little baby girl, and to be honest I couldn’t be more ready to take on the wonderful challenge of motherhood!
