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Perinatal Anxiety: How To Manage Antepartum and Postpartum Anxiety

Life transitions can be stressful for anyone, and becoming pregnant and having a baby are some of the most major changes some women experience in their lifetime. From the physical changes your body goes through to the transformation of your life after birth, it can feel impossible to find your bearings when everything in your life (and your body) is constantly shifting. As you prepare for these life-altering experiences, your anxiety is likely to reach its peak.

Perinatal anxiety refers to disruptive, excess anxiety in women during pregnancy and up to one year after birth. This can include antepartum anxiety, which occurs during pregnancy, and postpartum anxiety, which begins after childbirth. Some level of anxiousness and anticipation during these major life events is normal. However, perinatal anxiety becomes an issue when anxiety symptoms start to interfere with your quality of life. If you’re struggling with anxiety in pregnancy or beyond, we’re here to help.


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Understanding the Different Types of Perinatal Anxiety

Anxiety disorders are very common during the perinatal period. One study by the Journal of Clinical Psychiatry found that one in five pregnant women has an anxiety disorder. While postpartum anxiety is less researched than its counterpart postpartum depression, one study found that 17 percent of women reported having symptoms of postpartum anxiety. Additionally, the rate of comorbidity of postpartum anxiety and depression was 75 percent.

For women with general antepartum or postpartum anxiety disorders, it can feel like every day is filled with stress and fear. Anxiety can feel like a constant stream of intrusive, worried thoughts that are difficult to drown out. You may constantly feel like something bad is going to happen or picture the worst-case scenario outcome. For many soon-to-be and new moms, your anxiety may revolve around the health and safety of your baby. While every parent feels some level of stress about their baby’s wellness, perinatal anxiety can take this to the extreme, causing you to obsessively worry your baby’s life is being threatened.

Anxiety’s effects go beyond just feelings of stress and fear. You’ll likely experience physical symptoms that can be hard to manage and make you feel sick. You may experience frequent dizziness, nausea, and hot flashes. You may feel restless and struggle to stay still. You may also notice major changes in appetite and have difficulties sleeping at night.

Miscarriage, Birth Trauma, and Perinatal PTSD

Another common source of perinatal anxiety is postpartum post-traumatic stress disorder. PTSD is intense anxiety caused by experiencing a traumatic experience. It causes symptoms such as:

  • Intrusive thoughts and flashbacks
  • Nightmares and difficulties sleeping
  • Loss of pleasure in activities
  • Emotional detachment and social isolation
  • Hypervigilance and increased startle response
  • Irritability and hostility
  • Avoiding events, people, or places that trigger intrusive thoughts

While PTSD symptoms can be caused by any activity that someone perceives as traumatic, perinatal PTSD is often caused by a previous miscarriage, ectopic pregnancy, stillbirth, pregnancy complications, or birth trauma.

Prenatal Anxiety

If you’ve experienced a miscarriage or ectopic pregnancy in the past, becoming pregnant again can sometimes trigger symptoms of PTSD. Miscarriage can be a very traumatic, painful loss, and lead to long-term post-traumatic stress. There is also evidence that pregnancy can unearth symptoms of PTSD from other past traumatic events, such as experiencing child abuse or sexual abuse.

Postpartum Anxiety and Birth Trauma

One of the most common causes of perinatal PTSD is birth trauma. About 50% of new mothers described the childbirth of their baby as traumatic. Factors like having an unplanned C-section, experiencing major blood loss, fetal distress or complications, and using forceps can all make birth an incredibly distressing event.

If you’ve experienced a traumatic birth, you may develop symptoms of PTSD. This can involve reliving the birth through flashbacks and nightmares. You may avoid the hospital where you gave the birth or the doctor who did the delivery, and you may have difficulties bonding with your baby.

Perinatal Panic Disorder

Panic disorder is a type of anxiety disorder that causes frequent panic attacks. In pregnancy and after birth, perinatal panic disorder can lead to intense episodes of panic that make you like you are having a heart attack or being smothered. Your heart rate will go up and you may sweat, get hot flashes, have shaking hands, and feel numbness in the hands and feet. You may also feel as if you might faint and get intense nausea. Panic disorder can cause you to avoid certain activities or places because you fear they can trigger a panic attack.

Getting Treatment for Antepartum and Postpartum Anxiety

Living with constant anxiety can make it difficult to complete everyday tasks and may interfere with your ability to take care of yourself and your baby. Increased stress during pregnancy can also lead to certain complications, such as increasing your chance of infection, causing sudden weight changes, contributing to gestational diabetes and preeclampsia, or leading to premature birth. Treatment for perinatal anxiety includes psychotherapy, antianxiety medication, antidepressant medication, and other alternative forms of treatment.


When pregnant or breastfeeding, medication may only be used in more severe cases as it’s possible for medications to affect your fetus or newborn and cause certain side effects. However, these medications are used to help reduce anxiety, stabilize your mood, and make it easier to eat and sleep normally.

Cognitive Behavioral Therapy

Cognitive-behavioral therapy is one of the most common treatments used to address anxiety. It is a type of talk therapy that allows you to identify negative, anxiety-producing thought behaviors and better regulate your emotions. There are several essential aspects of CBT, including:

  • Introspection: The first step of CBT is to identify the thoughts and behaviors that are contributing to your anxiety.
  • Practice: Next, you will learn new skills in therapy to better cope with and manage your triggers. You’ll practice these techniques in the real world.
  • Goal Setting: You will set short- and long-term goals to track your recovery and make important life changes. You can track these goals by keeping a journal.
  • Substitution: When a negative thought or problem comes your way, you will learn to deal with the trigger by coming up with a list of solutions and evaluating the effectiveness of each option. This includes looking for evidence against negative thoughts and choosing more beneficial solutions and thought patterns.

Stress-Reduction Techniques

Making time to relax, de-stress, and take care of yourself can help prime your mind for receiving anti-anxiety treatment. If you consistently don’t get enough sleep at night, live a stagnant lifestyle, or eat a poor diet, you’ll struggle to manage your anxiety. Of course, as a new mom, it can be difficult to find time to take care of yourself and do what you need to stay healthy. However, making small steps toward a healthier lifestyle will better your mental health and make you more emotionally and mentally available to care for your baby.

In addition to making healthy lifestyle changes, find time in your day to unwind and practice mindfulness. Practices like yoga, meditation, and breathing techniques all teach your mind and body to relax and release stress.

Find Help for Anxiety at Thriving Lane

Thriving Lane is a women’s teletherapy service dedicated to helping women thrive in every stage of life, including major life transitions like pregnancy, birth, marriage, loss, and retirement. Our psychiatrists take an integrative approach to treating anxiety, blending conventional practice with holistic approaches. We offer women’s online counseling so you can access therapy without the stress of leaving your home.


Struggling with stress and anxiety? Learn how we can help.  


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