Perinatal Anxiety: Anxiety During Pregnancy and Baby’s First Year

A baby! A beautiful new little bundle of joy. Pregnancy and early parenthood can indeed be a joyful period for some. Unfortunately, for many new moms, the time during pregnancy and immediately after the birth of a child is less about coochie coos and more about anxiety and the blues. Anxiety Canada aims to raise awareness about what perinatal anxiety is and how to effectively deal with it.

What is perinatal anxiety?

The perinatal period generally refers to the time a woman is pregnant and includes up to one year following birth. Anxiety is a natural response people experience when they feel unsafe or threatened. So, perinatal anxiety involves the changes to one’s thoughts, actions, feelings, and bodily sensations during pregnancy and after the baby is born.

Whether the threat is real (e.g., the baby is diagnosed with a serious health problem) or imagined (e.g., thoughts of harm coming to the baby), people will have a similar bodily response. Bodily sensations associated with anxiety include increased heart rate, tight chest and throat, shallow breathing, loss of appetite, stomach issues, muscle tension, and sleep disruption. You can imagine that it’s hard to “sleep when the baby sleeps” when one is feeling anxious.

Anxious negative thoughts about the future may include imagining the worst-case scenario, worrying, and doubting. New moms may doubt their ability to be a good parent. Some will seek reassurance – others will keep their thoughts to themselves. Some mothers will worry about harm coming to their baby while others will have unwanted, intrusive thoughts about harming their baby.

Anxious actions may include avoiding places, people, or activities. Some people may avoid leaving the house, because they are concerned that the baby might be exposed to germs. Others become over-controlling, having trouble letting others take care of or even touch their baby. Some people will check a lot (e.g., frequently checking to see that baby is still breathing when sleeping). Other possible signs of anxiety during the postpartum period include irritability, difficulty concentrating, and forgetfulness.

With more responsibilities and less sleep, most parents have some difficulties coping during the perinatal period. While the experiences described above can be fairly common – if they are causing distress, happening much of the time, or interfering with daily living, then it is time to take action. Support from family, friends, and neighbourhood groups can be helpful. But for some new parents, they will require more help.

A recent review and meta-analysis of 58 studies indicated that postpartum anxiety disorders are more common than is generally recognized (Goodman et al, 2016).  In a study of 310 Canadian women, BC Psychologist Dr. Nichole Fairbrother and colleagues (2016) found anxiety and related disorders affected more than 15% of pregnant and postpartum women. Anxiety and related disorders were found to be even more common than depression among the women studied. Fathers can be affected too with as many as one out of every ten reporting troubling anxiety or depression (Ref: http://postpartum.org).

What do you do if you are concerned that you or a loved one may have perinatal anxiety?

The first step is for the new parent to talk to a healthcare provider about how she or he is feeling.  There are many different kinds of treatments that can help, including psychotherapy and medications. It is important to seek treatment as soon as possible so that symptoms do not continue or worsen.  Some new moms are afraid to tell other people about what they are going through because they are afraid of being judged negatively and, even worse, that someone might try to take their baby away. Others are worried that there are no safe medications for pregnant or breastfeeding women. If medications are needed, there are reproductive mental health specialists who can choose the safest, most appropriate medications for women.

Want to learn more about how to effectively manage anxiety during pregnancy and the postpartum period using self-help resources?

Anxiety Canada’s website has evidence-based information for moms-to-be and new moms. The “Feeling Anxious?” section describes the different ways anxiety can show and feel in new moms. The “Taking Care”, “Thinking Flexibly”, and “Facing Fears” sections offer strategies to help provide relief from anxiety.  Anxiety Canada will be adding additional resources for fathers on anxiety during the perinatal period.

Untreated perinatal anxiety can have negative consequences for mothers and families. With help, parents can spend less time dealing with their anxiety and more time enjoying their adorable babies.

Dr. Melanie Badali, R.Psych.

Dr. Melanie Badali is a Registered Psychologist and is CACBT-ACTCC certified in Cognitive Behaviour Therapy. She is on the Scientific Advisory Committee at Anxiety Canada and practices at the North Shore Stress and Anxiety Clinic.