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Why some women develop anxiety during pregnancy or following the birth

Some anxiety during pregnancy and after the baby’s birth is usual, particularly for first time parents.  However, many women are surprised and disappointed when they find themselves feeling very anxious during pregnancy or following the birth of their baby.  After all, most people expect that this will be an exciting and joyous time — and for some women it truly is.  However, there are a lot of changes happening during this period that can make debilitating anxiety more likely than at other times in a woman’s life.

For some women, this is the first time they have experienced anxiety that has interfered with their normal life.  Other women who have had problems with mood or anxiety in the past may find that their symptoms return or worsen during pregnancy or after the birth. Signs and symptoms of anxiety during pregnancy or following the birth can be grouped into four areas

Feelings

Upsetting thoughts
  • fearful, scared or upset
  • irritable
  • keyed up or on edge
  • unrealistic or excessive worry about the baby
  • worry about being a good or competent parent
  • worry about life issues – finances, getting things done, relationships
  • recurrent thoughts or images of harm occurring to the baby

Behaviours

Physical symptoms
  • overdoing activities like washing or cleaning excessively
  • excessively checking, seeking reassurance or excessive online information seeking, especially about health
  • avoiding people, places or activities
  • trembling, twitching, feeling shaky, being restless or easily startled
  • tiring easily, difficulty in concentrating or mind going blank
  • sleeping difficulties
  • intestinal problems such as diarrhea
  • feeling short of breath, sensations of being smothered, racing/pounding heart.
  • sweating, cold clammy hands, dizziness or light headedness.

The risk of anxiety during pregnancy and following the birth is greater if a woman has a prior history of a mood or anxiety disorder or is experiencing other stressors, such as:

  • recent stressful life events (e.g., death of a parent, moving house or location, changing jobs)
  • relationship problems
  • unrealistic expectations of motherhood by the woman or others around her
  • lack of social support
  • pregnancy complications
  • infant health problems

Getting help

Getting help is important because untreated anxiety can have effects not only for the woman and her pregnancy but also for her relationship with her baby following the birth.  Many women find it difficult to talk about the things they are experiencing, fearing not being taken seriously or being labelled, worrying about talking to a professional about the scary thoughts they may be having of harming the baby, feeling so anxious that they are unable to get to appointments.   Support is often needed from partners, family, and friends to encourage a woman to seek help. 

The healthcare provider will want to find out about symptoms and women should share with them all that they are experiencing and are concerned about, even if the symptoms seem contradictory.  Sometimes symptoms of anxiety and depression appear together so it is important to tell your healthcare provider if you are feeling depressed as well as anxious.