Anxiety during pregnancy: how common it is, what it looks like, and what helps
An article by Moha Chaturvedi, RCC
It’s natural to feel uncertain during pregnancy, especially about your health and your baby’s wellbeing. Sometimes, though, the worry doesn’t let up. It can keep you up at night, put strain on your relationships, and make it hard to enjoy the everyday moments.
About one in five women report anxiety symptoms during pregnancy. A review of 102 studies covering more than 220,000 women in 34 countries found that 18% reported anxiety symptoms in the first trimester, 19% in the second and 25% in the third, and that about 15% met the criteria for a diagnosable anxiety disorder at some point in pregnancy (Dennis et al., 2017). Anxiety in pregnancy is easy to miss, partly because some worry is expected, so the point where it has become more than that often goes unnamed.
Ordinary worry and anxiety that has taken over
Almost everyone who is pregnant worries. Whether the scan will be clear, whether the baby is moving enough, whether you'll cope with the birth and with what comes after: these are reasonable questions about something that matters enormously.
Anxiety is a different pattern. It tends to be persistent rather than tied to a particular appointment, it is hard to settle even when you're reassured, and it starts to shape your days: checking and rechecking, searching symptoms late at night, avoiding things that feel risky, or being unable to enjoy any part of the pregnancy because the next worry is already arriving. It shows up in the body too, as a racing heart, tight chest, poor sleep or a stomach that never quite settles.
How anxiety in pregnancy can show up
A few forms of anxiety come up again and again in my perinatal work.
Worry focused on the baby's health. Constant scanning for signs that something is wrong, needing reassurance from a midwife, doctor or partner and finding that it only lasts a few hours.
Fear of giving birth. Sometimes this follows a previous difficult or traumatic birth. Sometimes it is there from the first pregnancy, shaped by stories, by feeling out of control, or by past experiences of not being listened to in medical settings.
Intrusive thoughts. Sudden, unwanted images or thoughts about harm coming to the baby. These frighten people badly and are often kept secret. They are a recognized anxiety symptom, including in perinatal obsessive-compulsive disorder, and having them is not a sign that you would act on them.
Anxiety about everything else changing. Money, work, a relationship under new pressure, your body, and for many families in Burnaby and Vancouver, doing this far from parents and the support that would have been close at hand at home.
Why it's worth taking anxiety seriously during pregnancy
It's common to hear that anxiety will pass once the baby arrives. Sometimes it does. It can also carry on into the postpartum period, where the demands grow and sleep disappears, and the same review study also found anxiety symptoms in 15% of women in the first six months after birth (Dennis et al., 2017). There is also a simpler reason: nine months is a long time to spend frightened.
What helps with anxiety during pregnancy
Psychological treatment for perinatal anxiety has a reasonable evidence base. A meta-analysis of 13 studies found that cognitive behavioural therapy reduced anxiety symptoms in pregnant and postpartum women compared with control conditions, with larger improvements from the start of treatment to the end (Maguire et al., 2018).
In practice, the work usually has a few parts. We explore what your anxiety is focused on and what keeps it going, including the checking and reassurance patterns that bring relief in the moment and more worry later. We work on the body's side of it: sleep, breathing, and getting some ground under you on a hard day. Where fear of birth follows a previous traumatic birth, EMDR can reduce the charge of that memory without you needing to retell it in detail. And where the strain has landed on your relationship, a partner can join some sessions.
Medication during pregnancy is a conversation for your doctor, midwife or psychiatrist, and therapy and medication can work together.
Support in BC beyond private counselling
Pacific Post Partum Support Society runs a telephone support line for parents, including people struggling during pregnancy, and offers referrals to support groups in the Lower Mainland.
BC Reproductive Mental Health, based at BC Women's Hospital in Vancouver, provides assessment and treatment for mental health concerns related to pregnancy and the period after birth. Your doctor or midwife can advise on how to access it.
If you ever feel unable to keep yourself safe, call or text 9-8-8, the Suicide Crisis Helpline, or go to your nearest emergency department.
Common questions about pregnancy and anxiety
Is it normal to have anxiety during pregnancy?
Some worry is normal, and anxiety is also very common: around one in five pregnant women report anxiety symptoms, rising to about one in four in the third trimester. When worry is constant, hard to settle and shaping your days, it is worth talking to someone.
Can anxiety during pregnancy harm my baby?
This is one of the most common worries anxious parents carry, and it often adds to the anxiety itself. Your doctor or midwife is the right person for questions about your pregnancy specifically, and getting support for the anxiety is a reasonable step for both of you.
What's the difference between pregnancy anxiety and perinatal OCD?
Both can involve intrusive thoughts, but in OCD the thoughts are usually followed by rituals such as checking, avoiding or seeking reassurance to make them go away. A counsellor with perinatal training can help you work out which pattern you're dealing with.
Can I have counselling online while pregnant?
Yes. Online sessions can be easier to fit around appointments, fatigue and work, and they carry on working once the baby arrives.
About the author: Moha Chaturvedi, RCC
I'm Moha Chaturvedi, a registered clinical counsellor at the Burnaby Therapy Collective and a therapist at Moha Therapy. I see clients in person in Burnaby and in Kitsilano, Vancouver, and online across British Columbia, Ontario, Alberta, Saskatchewan, Yukon, the Northwest Territories and Nunavut.
My work centres on pregnancy, birth and postpartum, eating disorders and body image, and sexual health and relationships, and I work in English and Hindi.
About the Burnaby Therapy Collective
The Burnaby Therapy Collective is a small practice located at Metrotower II, 4720 Kingsway, near Metrotown in Burnaby, with online sessions available across British Columbia. Our therapists work with the concerns most people come in with, including anxiety, depression, trauma, stress, life transitions and relationships.
We offer all new clients a free 20-minute consultation to see whether one of our therapists is a good fit before booking a first session.
