Anxiety in the perinatal period

Anxiety is something we all experience from time to time. It includes both physical sensations and emotional reactions. Anxiety is a response to a situation we might see as a threat to us or a situation we feel we have no control over, for example moving house, being in a difficult relationship or giving birth. In these situations it's understandable to be worried and you may even find it hard to sleep, concentrate or eat for a brief period. These feelings of worry usually stop when the situation has resolved.
Click to the right to watch a video from Best Beginnings with Dr Alain Gregoire on anxiety.

We know that manageable levels of anxiety can be helpful in certain situations such as in emergencies or when we need to meet a deadline; we all have different tolerance to stress/anxiety. However if your feelings of anxiety are very strong or last a long time you need to access help to learn how to deal with it.

Perinatal anxiety is anxiety experienced during pregnancy or in the year after childbirth. You might hear it called:

  • prenatal or antenatal anxiety if you experience anxiety during pregnancy
  • postnatal anxiety if you experience it after giving birth
  • some women may have severe anxiety around childbirth also known as tokophobia
  • you may experience panic attacks
  • if your anxiety leads you to experience unwelcome thoughts, images, urges or doubts, or there are repetitive activities that you feel you have to do you may have Obsessive Compulsive Disorder.

Many women experience anxiety during the perinatal period. The National Institute for Health and Care Excellence (NICE) suggests that 13% of women experience anxiety during pregnancy, this is higher than figures for depression. Perinatal anxiety is less well known about, but far more prevalent that we had first thought.

  • Anxious
  • Frightened
  • Worried
  • Stressed/on edge
  • Unsettled
  • Detached
  • Strange (not feeling yourself)
  • Feel numb

  • Racing thoughts
  • Unable to concentrate
  • Constant worrying
  • Thinking the worst case scenario
  • Doubting yourself
  • Going over the same worries/thoughts
  • That other people know your are anxious and are watching you

  • Headaches
  • Unexplained aches and pains
  • Decrease in appetite
  • Difficulty sleeping
  • Sweating
  • Stomach churning
  • Tight chest

  • Unable to sit and relax
  • Constantly on the go/pacing
  • Find it difficult to finish off one thing
  • Eat less (or more)
  • Being snappy/increased irritability

We know that talking about how you are feeling can often be very difficult, however there is help out there, you do not have to feel like this. We hear that women often worry that they will be judged or seen to be 'not coping', this is a common misconception. Health professionals are aware of how common anxiety is during the perinatal period, and are able to support you and your family.

There will be a range of treatment options available to you:

Self help - offers you the option of exploring how you might be feeling through workbooks which you can download or print off. Reading well books are available from most libraries, they promote the benefits of reading for health and wellbeing.

Talking therapy is a NICE recognised therapy delivered by a therapist either face to face, over the telephone or in groups. The therapy is available wherever you live via the NHS and is completely free. Women in the perinatal period (antenatal and up to 1 year post-birth) will be prioritised for talking therapy treatment. There are many different types of therapy available including Cognitive Behavioural Therapy (CBT), which has proved very effective. You should receive your treatment within 6 weeks of the initial referral (NICE 2014).

Medication - You will need to seek the advice of your GP. For mild to moderate depression, talking therapy is the first choice of treatment and medication won't usually be considered until you have undertaken some therapy. The medications for treating depression are called antidepressants and there are lots of different ones to choose from. If you are pregnant or breastfeeding there are still antidepressants that you can take, but you need to discuss this with your GP. Please see further advice. It is not generally recommended that you take holistic medication without speaking to your GP in the first instance.

Here are some of the different ways you can access support locally:

  • Your local Health Visitor in South West London click here for further informtion
  • Your GP (Perinatal Mental Health Teams are accessible via GP referrals)
  • Click here to find your local talking therapies service

Self help:

Useful services & resources:

  • PANDAS Foundation
  • Baby Buddy is the multi-award winning free app that guides you through pregnancy, birth, parenting and beyond. You can explore the web version of Baby Buddy or download the full version of the app for free on the App Store and Google Play. There is a lot of information including videos about your physical and mental health.

Further reading: