What is Perinatal Anxiety

When a woman feels excessive tension or worry (anxiety) during pregnancy or during the first 12 months after she gives birth, she has a condition called perinatal anxiety.

Anxiety can interfere with work, school, relationships, and other everyday activities. If it is not managed properly, it can also cause problems in the mother and her baby.

If you are pregnant and you have symptoms of an anxiety disorder, it is important to talk with your health care provider.

What are the causes?

The exact cause of this condition is not known. Hormonal changes during and after pregnancy may play a role in causing perinatal anxiety.

What increases the risk?

You are more likely to develop this condition if:

• You have a personal or family history of depression, anxiety, or mood disorders.
• You experience a stressful life event during pregnancy, such as the death of a loved one.
• You have a lot of regular life stress, such as being a single parent.
• You have thyroid problems.

What are the signs or symptoms?

Perinatal anxiety can be different for everyone. It may include:

• Panic attacks (panic disorder). These are intense episodes of fear or discomfort that may also cause sweating, nausea, shortness of breath, or fear of dying. They usually last 5–15 minutes.
• Reliving an upsetting (traumatic) event through distressing thoughts, dreams, or flashbacks (post-traumatic stress disorder, or PTSD).
• Excessive worry about multiple problems (generalized anxiety disorder).
• Fear and stress about leaving certain people or loved ones (separation anxiety).
• Performing repetitive tasks (compulsions) to relieve stress or worry (obsessive compulsive disorder, or OCD).
• Fear of certain objects or situations (phobias).
• Excessive worrying, such as a constant feeling that something bad is going to happen.
• Inability to relax.
• Difficulty concentrating.
• Sleep problems.
• Frequent nightmares or disturbing thoughts.

How is this diagnosed?

This condition is diagnosed based on a physical exam and mental evaluation. In some cases, your health care provider may use an anxiety screening tool. These tools include a list of questions that can help a health care provider diagnose anxiety. Your health care provider may refer you to a mental health expert who specializes in anxiety.

How is this treated?

This condition may be treated with:

• Medicines. Your health care provider will only give you medicines that have been proven safe for pregnancy and breastfeeding.
• Talk therapy with a mental health professional to help change your patterns of thinking (cognitive behavioral therapy).
• Mindfulness-based stress reduction.
• Other relaxation therapies, such as deep breathing or guided muscle relaxation.
• Support groups.

Follow these instructions at home:

Lifestyle

• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• Do not use alcohol when you are pregnant. After your baby is born, limit alcohol intake to no more than 1 drink a day. One drink equals 12 oz of beer, 5 oz of wine, or 1½ oz of hard liquor.
• Consider joining a support group for new mothers. Ask your health care provider for recommendations.
• Take good care of yourself. Make sure you:
  • Get plenty of sleep. If you are having trouble sleeping, talk with your health care provider.
  • Eat a healthy diet. This includes plenty of fruits and vegetables, whole grains, and lean proteins.
  • Exercise regularly, as told by your health care provider. Ask your health care provider what exercises are safe for you.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Talk with your partner or family members about your feelings during pregnancy. Share any concerns or fears that you may have.
• Ask for help with tasks or chores when you need it. Ask friends and family members to provide meals, watch your children, or help with cleaning.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You (or people close to you) notice that you have any symptoms of anxiety or depression.
• You have anxiety and your symptoms get worse.
• You experience side effects from medicines, such as nausea or sleep problems.

Get help right away if:

• You feel like hurting yourself, your baby, or someone else.

If you ever feel like you may hurt yourself or others, or have thoughts about taking your own life, get help right away. You can go to your nearest emergency department or call:

• Your local emergency services (911 in the U.S.).
• A suicide crisis helpline, such as the National Suicide Prevention Lifeline at 1-800-273-8255. This is open 24 hours a day.

Summary

• Perinatal anxiety is when a woman feels excessive tension or worry during pregnancy or during the first 12 months after she gives birth.
• Perinatal anxiety may include panic attacks, post-traumatic stress disorder, separation anxiety, phobias, or generalized anxiety.
• Perinatal anxiety can cause physical health problems in the mother and baby if not properly managed.
• This condition is treated with medicines, talk therapy, stress reduction therapies, or a combination of two or more treatments.
• Talk with your partner or family members about your concerns or fears. Do not be afraid to ask for help.