I'm a Mom and a Reproductive Psychiatrist: Here's How I'm Coping With the Fact No One Saw Me Pregnant

The pandemic stole the pregnancy experience I always thought I'd have.

The author during her pregnancy.
The author during her pregnancy. Photo: Sarah Oreck, M.D.

In my line of work, I'm acutely aware of the realities of a biological clock. I'm a reproductive psychiatrist, which means I treat women throughout their reproductive life cycle. One of my primary focuses is pregnancy through postpartum, a developmental period, just like adolescence, called matresence.

But like many other professional women, I delayed childbirth. Then, last year, approaching my mid-30s, my husband and I decided to try to conceive. In January 2020, just before the COVID-19 pandemic began, I got pregnant.

I was thrilled but I was also apprehensive. I'm highly aware of the risks of early pregnancy loss and my medical training has made me more aware of all the things that can "go wrong." My first trimester was spent incredibly sick with hyperemesis gravidarum (HG), an extreme form of nausea and vomiting during pregnancy, too. I wasn't able to see friends and family, I cut back on work, and I wasn't able to exercise (a big form of stress relief for me).

And even as a reproductive psychiatrist, I'm grappling with the fact that barely anyone saw me pregnant.

While I told some family and friends about my pregnancy early on, it was mostly because I needed support. The social norms of waiting until the second trimester can be very isolating for an expecting parent, especially if they are having any medical issues or experience loss.

By the time that I started feeling like myself again in March, the pandemic was in full swing and we were under stay-at-home orders. I had imagined being able to go about my life as usual during pregnancy and sharing the experience (my baby's movements or laughing about cankles) with my best friends and extended family.

I lived in New York City for a long time and I remember fantasizing that if I were pregnant, some nice person might give up their seat on the subway.

When I moved to Los Angeles, before getting pregnant, I would envision using one of the special parking spots meant for "expecting mothers" (though I never understood how someone might argue with a person in their first trimester who wasn't showing).

But during my pregnancy, I did not use special parking spots, no one gave up their seat for me on a busy subway, and there was no walking around the world as a pregnant person. There was no baby shower, there we no in-person prenatal yoga classes either. Walking around my beachside neighborhood during my third trimester—a big source of stress relief—was even halted due to the poor air quality as a result of fires around Southern California.

Instead, loved ones were repeatedly asking for pictures of me pregnant. I'm a private person and this often felt like a chore (not to mention, slightly uncomfortable). After moving my psychiatric practice online, I also often felt too tired to do more video calls after a long day at work. I was "Zoomed out."

As quarantine continued, I quickly learned that my pregnancy wouldn't be what I thought it would be.

I regularly oscillated between feeling that it was the best and the worst time to be pregnant.

On one hand, I knew I would get to spend more time than I usually would "nesting" at home. I also knew that I would get to spend most of my days at home with my baby between patients once I returned to work.

But I felt more anxious than reassured by going into my OB-GYN appointments due to fears of COVID transmission. Hearing the heartbeat and seeing your baby on ultrasound can be some of the most joyous experiences during pregnancy but in a mask, alone, with the constant fear of transmission, some of the joy is taken out of that experience.

The social norms of waiting until the second trimester can be very isolating for an expecting parent, especially if they are having any medical issues or experience loss.

We are still learning about the risks of pregnancy in a pandemic, specifically around COVID-19. Some early research out of the University of Calgary shows significant increases in depression and anxiety among pregnant patients, which I have also noted in my clinical practice.

Building strong support systems has also always been integral to my work with pregnant and postpartum patients as a very important tool in the prevention and treatment of perinatal mood and anxiety disorders (PMADs). But the pandemic has made this exceedingly complicated; the most effective tool in stopping the spread of COVID-19 is physically distancing and staying separated from our loved ones. Since none of my close friends were pregnant, I was hopeful about forging new friendships with those who were expecting or had children recently, but COVID-19 made this more challenging if not impossible.

I missed sharing my pregnancy with others in the way I had imagined.

Some early research out of the University of Calgary shows significant increases in depression and anxiety among pregnant patients, which I have also noted in my clinical practice.

While I did attend prenatal yoga classes and a birth class online, I found it difficult to connect with other women individually in a group Zoom setting. In real groups, you can strike up a conversation; on Zoom, there really isn't a way of doing that. I wound up depending more on my husband and mother for support.

I coped by focusing on nesting and organizing (I'm a big fan of The Home Edit and Marie Kondo). I continued with my own therapy. I took meditation classes. It wasn't ideal but it helped me normalize my experience.

Then, in late September 2020, I gave birth to my child, Emil. I was not able to have my mother at my birth (something I always expected). My mother is South American, and in Latin culture, madre looms large.

Our family was not excitedly waiting to meet our new baby after the birth. My husband's family is in New York and we didn't feel comfortable with them traveling.

Now, my baby is almost 3 months old. We are mostly staying at home, especially with a recent spike in COVID-19 cases in Los Angeles. My baby has met some of his extended family from a distance but has only been held by his father, my mother who currently lives with us, his pediatrician, and me. We're managing, but now I'm overwhelmed with the loss of sharing him with loved ones. We're thankful for video technology—but it's another thing to be able to hug and smell a baby.

Ultimately, much like the work I do with my patients, I was able to integrate my contrasting emotional experiences and realize that this was my pregnancy and postpartum experience. It was not the worst and it was not the best, but it was "good enough."

You don't have to have a perfect pregnancy or postpartum experience—and nobody does even in the best of times—for parents and kids to be alright. That's advice that I often give soon-to-be parents and now I personally know it to be true.

You are also not alone. We are in this together. It's never too late to reach out for help if you're mourning the loss of the pregnancy you thought you'd have. I've been there, so have many others, and there are many different ways to feel better.

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