Anxiety during pregnancy

Anxiety during pregnancy

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It's very normal to worry a little more during pregnancy. Whether this is your first baby or you're adding to your family, your life is about to change dramatically in ways you can't control. Added to that, the hormone changes during pregnancy can play havoc with your emotions, making you more vulnerable to worry.

So it's no surprise that you may be feeling more anxious than usual. But if anxiety and fear start to take over, it may be time to get help. Here's what you need to know.

How do I know if my anxiety is a problem?

You might be worried about your baby's health, your family's finances, or whether you're going to be a good mom. And if you've already had a difficult pregnancy or delivery, it may be especially hard to shake the fear that things will go wrong again.

Anxiety becomes a problem when the feelings you experience are so powerful they don't go away or start to interfere with your daily life. If your thoughts stop you from doing things you would normally do, then it could be a sign that you have an anxiety disorder.

What is an anxiety disorder?

An anxiety disorder is a condition that makes you feel worried or afraid very often. Worry and fear are natural responses to certain situations. But if you have an anxiety disorder, your feelings are much stronger than what most people would feel in the same situation. An anxiety disorder can also cause physical symptoms, such as sweating, shakiness, or a racing heart.

Anxiety is the most common mental health problem, especially for women. It's estimated that women are 60 percent more likely than men to experience an anxiety disorder over their lifetime. It's hard to pinpoint exactly how common anxiety disorders are during pregnancy, but several studies have shown that many women experience anxiety during pregnancy.

There are many different types of anxiety, and it's not unusual to have more than one disorder at the same time. Anxiety disorders often coincide with other mental health issues, like depression. About half of women who eventually develop postpartum depression begin noticing the first signs during pregnancy.

Some of the most common anxiety disorders include:

Generalized anxiety disorder (GAD): If you worry a lot about everyday situations that other people seem to take in stride, you may have generalized anxiety disorder (GAD). GAD can make you feel apprehensive, irritable, or unable to concentrate. You may also have tension in your muscles and find it hard to sleep, even when you're tired. You may worry about the future and find it difficult to control these thoughts.

Panic disorder: Recurrent panic attacks that happen suddenly with no obvious cause are a sign of a panic disorder. A panic attack is an acute feeling of intense fear and is usually accompanied by physical symptoms which might include a racing heart, sweating, shaking, or nausea.

Panic attacks are very frightening. People who have panic attacks can sometimes worry that they're going to die.

Panic disorder can get worse during pregnancy, though this isn't the case for every woman. The risk of panic attacks increases in the postpartum period.

Phobias: A phobia is a feeling of extreme fear or anxiety about a specific object or situation. Sometimes the phobia relates to something that has a little bit of a risk, such as flying or heights, but the fear is out of proportion to any real danger. People with phobias go to great lengths to avoid the thing they are afraid of.

What other conditions cause anxiety?

Some conditions aren't considered an actual anxiety disorder but can cause symptoms of anxiety. These include:

Posttraumatic stress disorder (PTSD): Experiencing or witnessing something extremely traumatic, such as violence or sexual abuse, can result in strong feelings of anxiety. PTSD can cause flashbacks or nightmares that feel like you are reliving the traumatic event.

Losing a baby during pregnancy or experiencing a traumatic emergency delivery can cause PTSD, and a subsequent pregnancy and delivery can be extremely difficult for women with PTSD because it brings back feelings of powerlessness and fear.

Obsessive-compulsive disorder (OCD): Women with OCD can experience either obsessive or compulsive behavior, or both simultaneously.

Obsessions are having the same unwanted thoughts or urges over and over again. Compulsions are repetitive actions or mental rituals to keep the obsession or fearful situation from happening. Compulsions can temporarily relieve anxiety, but the fear soon returns and starts the cycle all over again.

It's not unusual to experience OCD for the first time in pregnancy, and the symptoms can get worse after your baby is born.

Other health conditions: In rare cases, another health condition can cause anxiety. For example, hyperthyroidism, heart disease, and respiratory illness sometimes produce anxiety. Depending on your condition, your provider may do tests to rule out another illness. If tests for these conditions come back negative, you'll likely be referred to a psychologist or psychiatrist for further evaluation.

How can anxiety affect my pregnancy and my baby?

It's difficult to say. Not much research has been done on anxiety disorders during pregnancy, and results have been inconclusive. Women with anxiety during pregnancy may have a slightly higher risk of preterm birth, but a definitive link hasn't been found.

The American College of Obstetricians and Gynecologists says anxiety and stress during pregnancy have been linked to complications such as having a very fast or slow labor and a forceps delivery. But again, more research is needed.

Also, some research suggests that children of moms who experienced anxiety during pregnancy may be slower to reach developmental milestones in the early years.

What's the treatment for an anxiety disorder during pregnancy?

Treatment for an anxiety disorder depends on the type of anxiety you're experiencing. Talk therapy is usually the first treatment for an anxiety disorder. You may also need medication if talk therapy alone doesn't work, or if your anxiety is severe.

Talk therapy

Sometimes just talking to someone can help you feel better. Your provider can refer you to a psychologist or psychiatrist who specializes in women's health if necessary.

It's hard to discuss your deepest fears, especially if you worry what others may think. But try to be as honest as possible with your therapist about how you're feeling.

Your provider may suggest a type of talk therapy known as cognitive behavior therapy (CBT). CBT is effective at treating anxiety disorders because it teaches you new ways of thinking, reacting, and behaving in stressful situations.

With CBT, you and your therapist will discuss your thoughts, emotions, and reactions to hypothetical or real situations. Your therapist will point out any unhelpful patterns of thinking or behavior and work with you to recognize them and respond in a different way.


Medication for anxiety crosses the placenta, so your provider will be cautious about prescribing it during pregnancy. Taking any medication during pregnancy involves some risk – which may be especially hard to deal with when you have anxiety.

Your provider will weigh the risks with the benefits of any medication. In complex cases that involve other conditions (like depression), or when talk therapy doesn't work, it may be safer to take prescription drugs than not to.

If medication may be the right choice for you, discuss the pros and cons with your provider to determine which drug and dose is right. If you're on medication already, don't stop taking it without talking to your provider first. Stopping medication suddenly can lead to a relapse or cause side effects.

What medications are used to treat an anxiety disorder?

Types of medication often used to treat anxiety disorders include:

Selective serotonin reuptake inhibitors

Like depression, anxiety during pregnancy is usually treated with drugs called selective serotonin reuptake inhibitors (SSRIs). The risks associated with taking SSRIs during pregnancy are considered small. The SSRIs most commonly used to treat anxiety are:

  • Fluoxetine
  • Sertraline
  • Citalopram
  • Paroxetine


Some pregnant women take benzodiazepines to manage severe anxiety or panic attacks, but these drugs have been associated with birth defects in a small number of women. Benzodiazepines taken close to delivery also can cause problems for a baby after birth, including withdrawal symptoms, difficulty breathing, and feeding problems.

If you're currently taking a benzodiazepine, your provider may try to gradually reduce your dose or switch you to a different medication now that you're pregnant to lower the risk to your baby.

Whether you continue to take your usual dose of medication or taper off, your provider will monitor your progress closely throughout your pregnancy and after the birth of your baby to make sure you stay healthy.

If at any point you feel that you can't cope or have thoughts of harming yourself, contact your provider right away.

Herbal remedies

Kava is a root known to alleviate anxiety, but it's not safe to use: Kava has been linked to liver damage, and during pregnancy it can weaken the muscles of the uterus.

It's best to avoid all herbal remedies during pregnancy anyway unless your provider suggests one. There's very little research on the safety of herbal remedies, especially during pregnancy. Herbal remedies are also mostly unregulated, and many times don't contain the ingredients they say they do.

What can I do to cope with my anxiety disorder?

Constant anxiety can be exhausting. In addition to getting help from a mental health care provider, look for coping strategies you can do yourself. Here are some ideas:

Take care of yourself. Make sure your own basic needs are met by eating well, getting some gentle exercise, and resting as much as you can. These will go a long way to helping you manage your anxiety.

Try yoga. There's some evidence that yoga can help you relax and reduce feelings of anxiety. Find a class specifically for pregnant women.

Share feelings. Tell someone you trust how you feel. You could talk to your partner, call a sympathetic friend, or chat with other moms in the our site Community.

Get some rest. You may not be able to sleep well, but try to rest or take breaks during the day, even if you just read a magazine or watch TV. Your body needs plenty of downtime when you're very stressed.

Exercise. Regular exercise is good for your general well-being and prompts the brain to release hormones that may alleviate feelings of anxiety and depression.

Visit the Society for Maternal-Fetal Medicine's website for more information and to find an MFM specialist near you.

Watch the video: My Anxiety Story. Anxiety During Pregnancy (May 2022).

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