(Anxiety during pregnancy and baby’s first year)

What is perinatal anxiety?

Having a baby is typically a wonderful time in our lives. It is also a time of great change and uncertainty. No wonder nearly all of us have an increase in worry and anxiety. Anxiety is a natural response we experience when we feel unsafe or threatened. We do not have to be in danger to experience anxiety. Even the idea of harm coming to ourselves or our loved ones —especially our baby— can make us feel anxious. During pregnancy, we may worry about the baby’s health and childbirth. After birth, we may worry about the baby’s eating, sleeping, and safety. Sometimes we don’t have specific worries. Instead, we have a vague feeling of dread that something bad will happen. We may start avoiding situations, tasks, or even our own baby. We can also become extra careful and do more than is necessary (e.g., spend lots of time searching for information related to our worries). Although everyone experiences anxiety differently, changes in how we think, feel, and act are common.

Anxiety can affect our:

thoughts(e.g., worrying too much, imagining the worst, trouble concentrating and focusing)
actions or behaviours(e.g., avoiding, excessive planning, checking over and over again)
feelings (e.g., scared, on edge, irritable, numb, frozen)
bodies(e.g., upset stomach, racing heart, tense muscles, jumpy, not hungry, sleep trouble)

When is anxiety a problem?

Although anxiety can seem very scary, it is normal. It can even be helpful. Anxiety can help our body become stronger to deal with danger. However, sometimes we have a lot of false alarms (we react as if there is danger when there is no real danger). When anxiety becomes upsetting and affects how we live our lives, it can become a problem or disorder. Approximately 20 percent of pregnant and new moms experience anxiety and related disorders. But perinatal anxiety does not only affect moms. Expecting and new parents of all genders, ages, and backgrounds can experience perinatal anxiety.

It is time to seek help when we…

feel anxious, on edge, or worried a lot, most days
notice anxiety is really upsetting us or getting in the way of daily life such as
- avoiding places, activities, people or situations that may bring anxiety
- doing too much of certain things (e.g., asking for a lot of reassurance)
- trouble carrying out routine activities
- difficulty enjoying the pregnancy or new baby
- more tension in close relationships

What helps people with perinatal anxiety get better?

People with perinatal anxiety may benefit from the following options (alone or in combination):

psychological therapy
pharmacological treatment
psychosocial support

The best ways to get better will depend on the severity of the symptoms of perinatal anxiety and personal preference. Decisions are best made with the support of a trained health professional.

What psychological approaches are proven to treat perinatal anxiety?

The primary psychological treatment that helps people with perinatal anxiety is Cognitive Behaviour Therapy (CBT). CBT involves learning new ways of thinking and behaving that can help reduce anxiety.

Scientific research shows that many people who receive CBT will experience improvements in anxiety. CBT works for many anxiety problems including excessive worry, obsessions, panic, and post-traumatic stress. CBT can also help us feel more confident about our ability to cope with anxiety related to becoming a parent and caring for our baby.

What can psychologists do to help people with perinatal anxiety?

Psychologists help people take an active role in positive change. They can help us feel better and reduce how much anxiety is getting in the way of living our lives to the fullest.

A psychologist can help us to learn and practice skills to manage anxiety. Some examples are:

PSYCHOEDUCATION: Learning about anxiety is an important first step. It is often very comforting to know that we are not alone and it is not our fault.
SELF-CARE: If we are going to have the energy to take care of a new life, we need to take care of ourselves. This includes eating well, exercising, getting as much rest as we can, and taking time for ourselves (even if it is only a few minutes).
FLEXIBLE THINKING: When we are anxious, our thinking is sometimes unhelpful. The first step is to learn to recognize these unhelpful thoughts. Next, we develop more helpful ways of looking at our situation and ourselves. This will often include learning to be kinder to ourselves.
FACING FEARS: Anxiety tends to change our behaviour in unhelpful ways (e.g., avoiding situations that trigger our anxiety). This makes us feel better in the short term but increases anxiety over time. Facing fears helps us learn that the things we fear are not as dangerous as we think.
RELAXATION & MINDFULNESS:. Learning skills such as calm breathing, muscle relaxation or mindfulness can help us reduce or better manage the bodily symptoms that are part of anxiety. Mindfulness techniques can also help us look at our thoughts differently. Mindfulness can help us notice and get untangled from our anxious thoughts so our thoughts have less power over us.

What is postpartum OCD?

Obsessive Compulsive Disorder (OCD) is an anxiety-related mental health problem. People with OCD experience thoughts that they don’t want to have and engage in behaviours they feel compelled to do.

The unwanted thoughts in postpartum OCD are often about harm to one’s baby. These thoughts can be frightening to ourselves and others. However, OCD thoughts are not associated with an increased risk of violence or harm to the baby. CBT can help improve the lives of mothers experiencing postpartum OCD.

Becoming a parent is a big change in our lives. Experiencing anxiety is often part of it. Fortunately, we can learn psychological strategies to help us manage our anxiety.

Psychology Works for Perinatal Anxiety!

Where can I go for more information?

You can consult with a registered psychologist to find out if psychological interventions may be helpful to you. Provincial, territorial and some municipal associations of psychology often maintain referral services. For the names and coordinates of provincial and territorial associations of psychology, go to https://cpa.ca/public/whatisapsychologist/ptassociations/.

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. You can find free resources on anxiety for expecting and new parents at:

This fact sheet has been prepared for the Canadian Psychological Association, in cooperation with AnxietyBC, by Registered Psychologists Drs. Melanie Badali¹², Martha Capreol³, Nichole Fairbrother⁴, Michelle Haring², Sarah Newth², and Adrienne Wang³.
¹AnxietyBC, ²North Shore Stress and Anxiety Clinic. ³Changeways Clinic, ⁴University of British Columbia.

Date: March 23, 2018

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