Anxiety During Pregnancy

By Temma Ehrenfeld @temmaehrenfeld
June 20, 2018

It’s easy to feel guilty about anxiety during pregnancy — you’re supposed to be thrilled, aren't you? Don’t beat yourself up. Pregnancy anxiety is common.

One day you were ecstatic to see your pregnancy test emerge positive. The next day worries flooded in and began to take up too much of your attention. Know you’re not alone: pregnancy anxiety may hit more than 18 percent of women in the first trimester and nearly a quarter by the third, according to a 2017 survey of research covering more than 220,000 women from 34 countries.

One reason for anxiety in pregnancy is the changes in your hormones. You also may have realistic concerns about money, your career, your daily job performance, and the effect of a new infant on your marriage or other children.

This can happen to anyone, but it’s more common if you have a history of anxiety or depression or either run in your family.


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The main symptom is getting caught up in fearful thoughts. Mention the problem to your doctor and loved ones if you also have trouble concentrating, irritability or agitation, tense muscles, or disturbed sleep. You may have bouts of panic when you feel you can’t breathe, worry that you’re going “nuts,” and are overwhelmed with dread.

If your anxiety levels are high, your chances of a pre-term birth or an underweight infant may go up.

So, what can you do?

Talk about your fears and how you’re feeling. Some women don’t want to burden the people closest to them. But find someone who will listen. If you need complete confidentiality, look for a therapist.

Move. Just because you’re carrying around a big belly doesn’t mean you shouldn’t walk, do prenatal yoga, swim, or even run. Aim for at least a half hour of activity three to five times a week. Frequency is most important. Even five minutes of aerobics can calm you down.

If you haven’t been exercising, talk to doctor and plan to start slow. But stick to the plan; exercise will get easier, and your anxiety will decrease. Classes or an exercise buddy help people stay consistent.

Drink water. Not taking in enough food or water sets up changes in your body that feel like the beginning of a panic attack. Dehydration pushes down your blood pressure, and your heart rate goes up to compensate. If your mouth feels dry or sticky, you’re suddenly tired, or you have a headache — do yourself a favor and get a glass of water. Once you’re thirsty, you’re dehydrated.

Eat regularly. Low-blood sugar can also make you agitated and foster anxiety. Don’t rely on high-carb, high-sugar snacks to tide you over. Aim for regular balanced meals.

Breathe. Twenty to thirty minutes a day of deep belly breathing can also help. You’ll learn to elicit and recognize the relaxation response, which slows down your heartbeat, blood pressure, and metabolism.

Rest. If you wake up during the night, be kind to yourself and plan for a nap during the day. Sleep is essential to manage anxiety during pregnancy.

Write your thoughts. A journal can help you identify the triggers of your most intense worries. Writing down your thoughts can feel like confiding in a friend. Your thinking may be more organized and less repetitive once you’ve done.

Empower yourself. Do whatever makes you feel strong and more confident that you can handle things. A birth class can help you deal with fear of childbirth. See a financial planner if you’re stressing about the cost of a child.

Cut back on alcohol and caffeine. Both can aggravate anxiety, and drinking during pregnancy can do serious harm to your baby.

Should you take medication to treat anxiety in pregnancy? It’s best to avoid it, but don’t let your anxiety go unchecked either. The well-known SSRIs such as Celexa, Prozac, and Zoloft, are considered an option during pregnancy, but they may increase the risk of heavy bleeding after birth and a pre-term baby. Paxil is not recommended. The SNRIs Cymbalta and Effexor XR are also possible, though again your medication may increase the risk of bleeding.

What about a benzodiazepine like Klonopin or Ativan? Know that these drugs are addictive, and some doctors say they are overprescribed. If you are taking one near delivery, your baby may undergo withdrawal, which includes breathing problems. Make sure your doctors know what medications you are taking.


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April 08, 2020

Reviewed By:  

Janet O’Dell, RN