“Psychology Works” Fact Sheet: Perinatal Anxiety - Canadian Psychological Association

What is Perinatal Anxiety?

Having a baby can be exciting and joyful—but it also brings big changes, new responsibilities, and a lot of uncertainty.

Anxiety is a natural response to feeling unsafe or threatened. We do not have to actually be in danger to experience anxiety. Even imagining something bad happening, like harm coming to ourselves or our loved ones (especially our baby), can trigger strong feelings of anxiety and unease.

It is very common for expectant and new parents to feel more worried or anxious during pregnancy and baby’s first year. For some, this is the first time they notice major anxiety. For others, their symptoms become stronger. About 1 in 5 pregnant or new parents experience anxiety or related disorders. This can affect anyone—not only moms, but people of all genders, ages, and backgrounds.

Anxiety can show up in many ways. It affects the way we think, feel, act, and notice things in our bodies. Here are some common examples:

Thoughts:

Worrying excessively or expecting the worst
Unwanted thoughts about harm coming to the baby or caregiver
Intrusive memories or dreams about a difficult birth, replaying past events
Underestimating our resources and coping abilities
Overanalyzing decisions or actions

Feelings:

Scared, panicky, nervous, irritable, overwhelmed, jumpy, numb, or frozen

Actions:

Doing things to try to control or block upsetting thoughts and feelings and reduce uncertainty
Performing rituals or habits that temporarily reduce anxiety
Avoidance (putting off or avoiding people, places, or tasks that trigger anxiety, withdrawing)
Overcompensating (excessive cleaning, constant reassurance-seeking, repeated checking, overpreparation, or spending long hours researching baby-related concerns)

Body:

Quick or shallow breathing, upset stomach, racing heart, muscle tension, jitters, trouble sleeping

How Does Perinatal Anxiety Affect Us?

During pregnancy, worries often center on the baby’s health or the upcoming birth, including fears around medical procedures. After delivery, they may shift toward concerns about feeding, sleep, or safety. Sometimes, there isn’t an obvious reason for the worry—it can simply feel like something bad might happen.

Some caregivers also experience distressing thoughts or memories after a difficult or traumatic birth. Other parents experience scary or unwanted thoughts and mental pictures about their baby getting hurt or about harming their baby—even though they would never want to experience or act on these thoughts.

While it’s natural to be concerned about a baby’s safety and one’s ability to be a good caregiver, anxiety can lead to spending excessive time focusing on unlikely dangers.

When anxiety rises, people often engage in behaviours that aim to reduce distress or regain a sense of control. These actions make sense in the moment, but they can unintentionally maintain or intensify anxiety over time.

Some people become extremely cautious, trying to control every detail to eliminate risk. Anxiety might cause people to avoid certain situations, tasks, thoughts, or even time with their baby. Others may clean and sanitize to excess, over-check, seek reassurance, or research constantly in an effort to feel safe.

This constant vigilance can become exhausting. Unfortunately, it’s impossible to remove all risk or feel 100% certain about safety. On the bright side, it is possible to learn to accept uncertainty while providing excellent care to the baby.

When Does Anxiety Become a Problem?

Some anxiety is normal—it can even help us stay alert in dangerous situations. But sometimes our body reacts like there’s danger when there isn’t. This can make anxiety hard to control and get in the way of our daily life.

Perinatal anxiety is a problem when it feels intense, happens frequently, causes significant distress, or gets in the way of daily life. You might need help if you:

Feel anxious, on edge, or worried a lot, most days
Feel overwhelmed by upsetting thoughts or worries
Avoid people, places, or tasks others would consider safe
Have difficulty letting others care for the baby, even close loved ones
Have trouble doing everyday activities
Find it hard to enjoy pregnancy or your baby
Notice more tension in your relationships

What Can Help with Perinatal Anxiety?

There are several ways to feel better, depending on your needs and what you prefer:

Psychotherapy
Medication
Social support (help from friends, family, or support groups)

A trained health professional can help decide what’s best for you.

What Type of Psychotherapy Works?

Research shows that cognitive behaviour therapy (CBT) is helpful for perinatal anxiety. CBT teaches you new ways to think and act that help reduce anxiety. It can help with worries, panic, obsessive thoughts, trauma, and stress. It can also help you feel more confident as a parent.

You can do CBT with help from a trained healthcare professional, or you can learn and practice some of the techniques on your own using self-help materials.

How Can Psychologists Help?

Psychologists trained in CBT can teach skills to manage anxiety and make life feel easier. Some helpful strategies include:

Psychoeducation: Learning about common symptoms of anxiety, available treatment options, and effective management strategies.
Self-Care: Eating well, resting, moving your body, and taking time for yourself.
Flexible Thinking: Noticing unhelpful thoughts and learning to talk to ourselves in kinder, more realistic ways.
Facing Fears: Gradually facing situations you’ve been avoiding so anxiety decreases over time.
Relaxation: Using calm breathing or muscle relaxation to manage bodily symptoms that are part of anxiety.
Mindfulness: Untangling ourselves from anxious thoughts by paying attention to what is happening in the present moment.
Communication skills: Practicing how to ask for help and say no.

What is Postpartum OCD?

Obsessive Compulsive Disorder (OCD) is an anxiety-related mental health problem. People with OCD have unwanted, intrusive (pop into your mind) thoughts, which can include both words and images. They feel the need to do certain actions to relieve their anxiety or to prevent something negative from happening.

After birth, many parents have scary thoughts about their baby being hurt in some way. It is common to think about your baby being harmed by accident or even on purpose. Although some thoughts of harm can be problematic, thoughts that are part of OCD are not dangerous. OCD thoughts are unwanted, intrusive, and go against your values and wishes.

CBT can help parents with postpartum OCD learn that their intrusive thoughts are part of an anxiety problem that can be treated effectively.

Learn more from the CPA’s OCD Fact Sheet (html version; you can find the PDF version by going to the Fact Sheets home page)

Can I Have Trauma Related to Pregnancy or Birth?

Having a baby can be a wonderful experience, but it can also be incredibly hard and frightening. For some parents, the birth itself can be very scary and bring on feelings of helplessness. There can also be traumatic experiences such as miscarriage, stillbirth, or needing intensive medical care. Past trauma can also resurface during the perinatal period.

Some parents may develop post traumatic stress disorder (PTSD). This can cause symptoms like reliving the trauma through unwanted memories or nightmares, actively avoiding things that remind them of it, feeling numb, or being tense and easily startled. CBT can help people manage these symptoms and lessen the impact on their daily lives.

Learn more from the CPA’s PTSD Fact Sheet (html version; you can find the PDF version by going to the Fact Sheets home page)

Remember: Becoming a caregiver is a huge life change. Feeling anxious is common, but we can learn psychological strategies to help us manage our anxiety.

Where Can I Go for More Information?

A CBT expert can help us learn new skills to use in our daily life leading up to the birth and after the baby arrives. For the names of certified CBT Therapists in Canada, go to: https://cacbt.ca.

If you can’t find a trained CBT therapist in your community, you can use CBT self-management guides to help you learn these skills. Below you will find free resources on anxiety for expecting and new parents:

References

Fairbrother, N., Challacombe, F. L., Green, S. M., & O’Mahen, H. A. (2025). Anxiety and related disorders during the perinatal period. Annual Review of Clinical Psychology, 21(1), 465–496. https://doi.org/10.1146/annurev-clinpsy-081423-020126

Li, X., Laplante, D. P., Paquin, V., Lafortune, S., Elgbeili, G., & King, S. (2022). Effectiveness of cognitive behavioral therapy for perinatal maternal depression, anxiety and stress: A systematic review and meta-analysis of randomized controlled trials. Clinical Psychology Review, 92, Article 102129. https://doi.org/10.1016/j.cpr.2022.102129

Fairbrother, N., & Woody, S. R. (2008). New mothers’ thoughts of harm related to the newborn. Archives of Women’s Mental Health, 11(3), 221–229. https://doi.org/10.1007/s00737-008-0016-7

https://www.med.ubc.ca/news/thoughts-of-harming-baby-a-normal-but-unpleasant-part-of-postpartum-experience/

You can consult with a registered psychologist to find out if psychological interventions might be of help to you. Provincial, territorial, and some municipal associations of psychology may make available a referral list of practicing psychologists that can be searched for appropriate services. For the names and coordinates of provincial and territorial associations of psychology, go to https://cpa.ca/public/whatisapsychologist/PTassociations/.

This fact sheet has been prepared for the Canadian Psychological Association by Registered Psychologists Drs. Melanie Badali¹, Martha Capreol², Nichole Fairbrother³⁴, Michelle Haring¹, Sarah Newth¹, and Adrienne Wang².

¹North Shore Stress and Anxiety Clinic, ²Private Practice, ³University of British Columbia, ⁴University of Victoria.

Revised: November 2025

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