Anxiety in pregnancy

Pregnancy anxiety is worry that will not switch off. It is common, it is not your fault, and it responds well to help.

What it is

Pregnancy anxiety is when you can't stop worrying. You may be worried about miscarriage, about the baby's health, or about birth. Some worry is part of every pregnancy. Anxiety is worry that takes over your days and nights.

About 1 in 5 pregnant women meet the bar for an anxiety disorder. Many more have anxiety that is hard but not diagnosed. It is one of the most common problems of pregnancy, and one of the least talked about.

Why it happens is partly hormones and partly the stakes. You are growing a person you cannot see. Past loss, a hard first pregnancy, money stress, and a history of anxiety all raise the odds.

What's typical

Worry about miscarriage is strongest in the first 12 weeks. After 12 weeks the chance of loss is small, around 1 to 2 in 100, and many mothers feel the knot loosen. A second peak often comes in the last weeks, when birth gets close. Normal worry comes and goes. It eases when you get an answer or a good scan. Anxiety stays. It shows up as a racing heart, a tight chest, trouble sleeping even when you are tired, and checking the same thing again and again. Panic attacks can happen too. They peak in about ten minutes and pass.

What's known

ACOG now recommends that every pregnant woman be screened for anxiety at least once. Untreated anxiety is linked in studies to poorer sleep, preterm birth, and postpartum depression. Talk therapy, especially CBT, works well for most. Some providers prescribe medication in pregnancy; many options have been studied, and your provider can walk you through them. Many cultures have long guarded pregnant women from bad news and frights. The reason they give is that a calm mother grows a calm baby. Science does not say it that simply, but it agrees that lowering stress helps.

What helps

Pick one trusted source for pregnancy questions and close the rest. Late-night searching feeds the loop.
Name the worry out loud to someone. Said aloud, most worries shrink.
Move your body most days. A walk after dinner is enough to take the edge off for many mothers.
Protect sleep. Anxiety and lost sleep feed each other.
Try slow breathing: in for four counts, out for six. Do it for two minutes when the spiral starts.
Ask your provider for a therapist who works with pregnant women. You do not need to be in crisis to ask.

When to call someone

Nowthoughts of hurting yourself, or of not wanting to be here. Call or text 988. The National Maternal Mental Health Hotline is 1-833-852-6262, any hour.
Todaypanic attacks, several nights without sleep, or you cannot eat because of worry.
Todayanxiety has filled most of the day for two weeks or more.
At your next visitworry you cannot shut off, or you want a referral to a perinatal therapist.

Who helps

Perinatal therapistOB-GYNMidwife Doula

Tools: My Birth Team · Birthworker Directory

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Sources

American College of Obstetricians and Gynecologists — Clinical practice guideline on screening and diagnosis of mental health conditions during pregnancy and postpartum
Postpartum Support International — Pregnancy and postpartum anxiety fact sheet
Health Resources and Services Administration — National Maternal Mental Health Hotline information page
NHS — Mental health in pregnancy

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