Preparing for birth when your husband has anxiety

In the five years between our two children’s births, my husband (who is a combat veteran), was diagnosed with a generalized anxiety disorder. While he had always struggled with anxiety, things that he went through in the Army and panic attacks leading to an emotional breakdown on his second deployment (just after our first child was born) have left him with a daily struggle of fighting crippling anxiety, depression, negative thinking, and mild paranoia.

During Ezra’s pregnancy, he was at every appointment and ultrasound. We participated in a Centering Pregnancy course together. When Ezra was born, Russ was by my side nearly the whole time.

I squeezed his hands and legs during contractions. We danced. He held me while I screamed. And after they cut me open, he came and stood right by my head while I was sewn up.

Ezra’s birth was traumatic for me emotionally because of how desperately I wanted a natural birth, the pain of the contractions, and then the obvious trauma of getting unexpectedly cut open.

But my husband was afraid that I was dying. Literally dying. Had it not been for my brother who drove two hours to be with him while I was in late labor, I don’t know if my husband would have even been able to handle being in the operating room with me.

For him, me trying for VBAC wasn’t a problem – or even a matter of discussion. Rather, he was absolutely terrified of me going through surgery again.

As we navigated our way through the pregnancy, we struggled to communicate. Because of his work schedule, I attended most appointments and ultrasounds alone. When I would try to talk to him about the things I was doing to prepare for my VBAC, he would mask anxiety with humor, rush to the worse-case-scenario, or simply change the subject and ask to not talk about it anymore.

I began to have worries too. Because being his designated caregiver isn’t just this hat I put on when he has a bad day. It’s an all-consuming role. I’m constantly managing our environment, making sure he’s okay, and asking him about his medication — and when I’m not doing all of that, I’m worrying about him freaking out about things.

I knew that this was NOT a role I could handle while in labor. I was also worried about him undermining my birth plans because of his anxiety (such as going to the hospital too soon because he was worried or pressuring me into unnecessary interventions because he’s scared of me dying). I knew that I would need him, for this 24+ hours, to either be strong for me or leave me alone. I would need him to trust me, the doula, and the medical team to make the best decisions based on our hours of research and discussion.

I tried to lovingly communicate this to him over the course of a few weeks. At 25 weeks, he told me that he had decided to take a more passive role in this birth.

“I’m just going to be like a 1950’s dad and pass out cigars in the waiting room.”

He also said things like this: “It sounds like you have a plan, and it doesn’t really include me. You seem to know what you are doing. I’ll just go to work, and you can call me when it’s really time to have the baby.”

I was both relieved and distressed. In some ways, because of his anxiety and my concerns about how he would handle the birth, having him OUT of the room and having space to work with baby without worrying about him seemed like a good plan. But I also remember how much I relied on him during Ezra’s birth. I wanted him to know that, no matter how much preparation I had done or outside support I had, I still did – in fact – need him.

I tried to share this with him, saying, “I still need you…I just need you to not freak out when I’m having the baby.”

His response was, “I don’t know if I can do that.”

That’s when I knew that we weren’t exactly on the same page and that we needed to process this a lot more before baby’s birth. So here’s some of the things that we did to prepare.

1) I gave my husband space to process the primary cesarean birth.

I let him know that I recognized it was probably traumatic for him too and that I had never really given him a chance to process it. We talked about it briefly, which was all he really wanted. He said something like this, “It was scary as crap. I don’t really want to talk about it. I just want to move on.” 

I had to be careful not to project my own emotions onto him. I’m a woman and I think that the best way to heal from the past is to process it. Ad nauseam. He’s a guy so he doesn’t think that way. And that’s okay. I gave him the space to do so, if he desired. And that’s what mattered the most.

Later on in the pregnancy, more details about my cesarean birth (from his perspective) came out and were able to process those memories together. (I’ll be discussing this in an upcoming post).

2) We continued to talk about it together, even though the conversations were difficult.

While I was still in my freaking-the-crap-out headspace, I continued to badger him bring this up with him – how I felt like we weren’t on the same page and how it scared me. In a later conversation, things were a little bit more clear.

It wasn’t that he necessarily felt excluded (or hurt from that exclusion) from my plans. He just realized that I was “attacking this birth” very realistically and proactively, and he mostly just wanted to stay out of my way and let me do my thing.

He reiterated to me that he simply didn’t know how he was going to handle my birth. “They might cut you open and I’ll be fine – or I could freak out the minute they try to take your blood pressure. I just don’t know.”

I realized that giving him “permission” to be more passive in his role of birth partner would actually do a lot to ease his anxiety surrounding it.

He also made some great points to me about his work schedule, how much time he would be able to take off, and given my history of postpartum depression how important it was to him to be there for me in the immediate recovery and postpartum time. If labor was to drag on for 40-60 hours, he didn’t want to “waste” that time bumming around the hospital. He wanted to be there for me once I was home trying to adjust to managing two kids.

I felt more heard and understood by him, and he reassured me that he would be there for me how, when, and where I needed him. But until I needed him, he just wanted to stay out of my way.

3) My doula and I gave him very specific jobs to do.

This is a guy thing, in general, but paramount for my husband. When his anxiety is high, he is literally stress-paralyzed until someone tells him exactly what to do.

At 34 weeks, I sat down and wrote out a very short list of simple things I wanted him to do for me in labor (like keeping track of my lip balm and helping me remember to drink).

4) I made sure I had backup help.

On top of hiring the doula, I made sure I had a backup driver and friend to help me out in early labor if I needed. (I ended up not using this, but it relieved stress to have an additional person lined up).

5) We let the hospital and support staff know of my husband’s needs.

We discussed my husband’s anxiety extensively with our doula and included a paragraph about it in our birth plan (including a list of things they should look for to know if he was on the verge of an anxiety attack). We also decided that, in the event of a cesarean birth, he would not want to be present for me until recovery. We discussed alternative arrangements with our doula, as well as informing several staff members at the hospital, my care providers (including the head obstetrician), and the nurses weeks ahead of time. When I went into labor, we informed them, again, of all of this information.

(The people we had spoken to in charge of the OR actually came to our room to introduce themselves when I was in early labor to let us know that they were on top of what we wanted for our cesarean plan and would do everything they could to make sure we all had a good experience if it came to that!)

5) I let go of our expectations and just let it happen, regardless of how we had envisioned or even planned for it to happen.

Honestly, things went about as well as they could have gone.

Russ was by my side from the time we arrived at the hospital until I was taken for my cesarean (29 hours). He offered physical support during labor (doing the stuff on his list as well as giving me hip squeezes, assisting me in and out of bed, rubbing my back and holding my hands during contractions, and offering resistance during the pushing phase).

He accepted the cesarean quicker than I (after a private chat with the doctor) and helped me through my acceptance of it (albeit a bit forcefully, but that’s what I needed).

There were several moments of stress, for sure.

During active non-medicated labor, the shower kept overflowing and he got very stressed about water being everywhere and flowing out into the room. I was very annoyed, because I was going through very intense labor and could have cared less about the water, but I just did my best to block out his anxiety and let the doula “manage” the stress.

Apparently, when I asked for the epidural, he got incredibly stressed out. I went into birth with a very open mind toward the epidural and planned to ask for it if I got too tired or things got too difficult for me to handle. I had talked this over with both him and my doula a few times, but somehow, he didn’t grasp it. So when I asked for the epidural in labor, he was worried that I was derailing my plans and asking for the epidural when I didn’t want it. He was afraid that things were “spiraling out of control and headed for a c-section” – when in reality, the epidural probably allowed me to labor longer and more effectively than had I not received it. He ended up calling his mom during the wee hours of the morning to help him process the stress, and I was blissfully unaware that this all had happened until after the fact.

My mother-in-law ended up coming to the hospital the next morning and coming back to support him while I was in surgery (again, I was unaware of this until after the fact).

There were also moments when his intensity frustrated me. I got very snappy with him during transition especially, because he kept asking me questions when I really wanted him to just be quiet and leave me alone. At one point I told him this very forcefully and he sat down on the couch. I could tell he was frustrated and didn’t know what to do. I felt awful and I remember apologizing and telling him that I loved him. Now I find this so humorous because that’s TOTALLY normal for transition!

During the pushing phase, while offering me a lot of physical support, he was also very coach-like. I had been so worried about the hospital staff being forceful with coached pushing (as opposed to mother-directed pushing), but it ended up being my husband who was the most vocal and forceful with the coaching.

His coaching was helpful at times (he helped me figure out how to breathe during the pushing), but it was frustrating and stressful at others – like when he was trying to coach me to push through a contraction when I needed a break and was ready to wait for the next one. Sometimes I just had to ignore his intensity and do what I needed to do regardless of what he was saying.

What I didn’t expect or plan for at all was managing his anxiety during the postpartum period. I could probably write a whole post about this, but I’ll try to be brief:

He was barely sleeping, even with his sleep and anxiety medication. The first night he stayed in the hospital with me and the alarm on the IV kept going off every 30 minutes, waking him with a startle.

Because he had slept so little and was so supportive during the labor, my caregiver instincts kicked in, and I ended up not asking for as much help during the recovery stay. (Or when I asked him for help, he would quickly get frustrated with the baby being fussy, and I would take back over.) We also kept the recovery room dark during the day (something I wish we hadn’t, because I ended up getting very depressed the second day) – hoping that it would help him sleep. At another point during the 48-hour recovery stay, he misplaced his anxiety medication, and that was stressful. I honestly could not wait to get home because I knew once we were in a more familiar environment and he was sleeping better, he would be more helpful.

Once we were home, the anxiety and sleep issues persisted, especially for the first ten days. He worried about things about the baby that seemed minuscule to me (like his skin peeling or his head being a bit floppy in the car seat). I minimized the things he was stressed about as nothing because I remembered dealing with them with Ezra and had a lot of 2nd-time-mom instincts already. But whether it be the 5-year-gap, his memory problems, or the fact that he deployed when Ezra was 3 months old–this baby was like having the first baby all over again.

Adding Ezra and his emotional disregulation and acting out to the mix and we had several REALLY rough days as a family.

He also expressed a lot of negative emotion about the birth experience in general. I viewed it as healing and empowering, but for him, it was very stressful and caused serious panic at several points during the labor experience. The dichotomy in how we felt about the experience led us to seek out our marriage counselor that second week we were home (around 2 weeks postpartum).

This ended up being probably one of the best sessions we have ever had. He was able to explain to me how he needed me to be with him in the moment, rather than dismissing his anxiety as nothing OR panicking about how I was going to “fix” or “manage” it. And, while he did view the birth differently than I did, he didn’t need me to fix that either or force him to process it in certain ways.

Honestly, what it came down to is me relaxing and giving him space to be anxious about things instead of being anxious about his anxiety that ultimately allowed us BOTH to relax. Also, getting him back to work and us both into our routine as best as we can helped immensely.

Also, naps and Netflix binging…

I am so thankful for the planning that we put into helping him through the experience. Our doula was also incredible about helping him (and taking that burden off of me).

While I wish we had prepared more for the postpartum period and the anxiety that would bring, I feel like we did the best that we could given what we deal with.

Living with anxiety and loving someone with anxiety are messy things. We’ve learned how to deal with it, in spite of that mess. There was so much beauty in the experience, for both of us.