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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 been resolved.

Watch the video on the right from Best Beginnings on anxiety.

'Antenatal' is the period of time during pregnancy and 'postnatal' is the period of time after pregnancy.

Anxiety is a condition that affects the fight, flight, or freeze response within the body. It is a feeling we all get in a situation that we see as 'life-threatening' or difficult. Normally, this anxiety stops when you get used to the situation, when the situation changes, or if you leave the situation. However, with an anxiety disorder/mental illness, the feeling of dread and imminent danger doesn’t go away. If left untreated, this can lead to depression and a paralysing fear of normal activities.

Although some people find a particular situation triggers their anxiety, many do not always know what they are feeling anxious about. Not knowing what triggers your anxiety can intensify it and you may start to worry that there’s no solution.

Your symptoms may cause you to withdraw from social contact (seeing your family and friends) to avoid feelings of worry and dread.

Early recognition, support, and treatment can be a huge benefit to the health and well-being of the whole family unit, so it is important to seek professional help/guidance from a GP or midwife as soon as you think that you or someone you know might be affected by any of these symptoms.

More information about anxiety and generalised anxiety disorder (GAD) from the Royal College of Psychiatrists.

If you experience anxiety, you may feel:

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

You may also experience:

  • Racing thoughts
  • Feel unable to concentrate
  • Be constantly worrying
  • Thinking the worst-case scenario
  • Doubting yourself
  • Going over the same worries/thoughts
  • other people knowing you are anxious and feel they are watching you.

You may also experience physical symptoms such as:

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

You may be:

  • Unable to sit and relax
  • Constantly on the go or pacing
  • Finding it difficult to finish off one thing
  • Eating less (or more)
  • Snappier or have increased irritability.

We know that talking about how you are feeling can often be very difficult, however, there is help out there, and 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 can 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 well-being.

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 one 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 six weeks of the initial referral (NICE 2014).

Medication can be offered 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.  You will need to seek the advice of your GP.

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 seek further advice.

It is not generally recommended that you take holistic medication without speaking to your GP in the first instance.

You can access support locally through:

Self help:

Useful services and resources:
  • PANDAS Foundation
  • Baby Buddy is a 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. Here, you can find a lot of information including videos about your physical and mental health.
Further reading