Anxiety & pregnancy

As many as thirty per cent of pregnant women will experience some level of anxiety. A smaller number of women will have more severe symptoms and will be diagnosed with an anxiety disorder.

Anxiety disorders are categorised according to their symptoms. These include:

• generalised anxiety disorder
• obsessive compulsive disorder (OCD)
• post-traumatic stress disorder (PTSD)
• panic disorder
• agoraphobia
• social phobia.

Most women have symptoms or a diagnosis of a particular disorder before they get pregnant. Some women will develop symptoms for the first time during pregnancy. Some symptoms will worsen with pregnancy.

Symptoms that are common to each disorder include:

• worry, stress or being on edge most of the time
• muscle tension and difficulty staying calm
• difficulty sleeping
• recurring worrying thoughts that will not go away
• panic attacks.

What causes anxiety?

You may be genetically predisposed to worry and anxiety or you may have been subject to a stressful event or both.  When the anxiety is pregnancy-related it is likely that you have an anxious temperament and a general tendency to worry. Your anxiety will be focused on the baby’s health, fear of the birthing experience or concern about your weight gain and body shape.

Women who are victim/survivors of sexual assault may also have particular anxieties during pregnancy. For this group of women there is also likely to be anxiety in the lead up to the birth and further anxiety about being a parent. Women who have been sexually assaulted can find it very difficult to be touched. Medical check-ups can be very stressful, especially check-ups that involve the vagina. This group of women can also be very fearful of the birth process; they can suffer from muscle tension during the birth, which in turn can impact on their ability to manage the pain of labour.

Women who have different kinds of pre-existing anxiety disorders can find pregnancy challenging for any number of reasons. Pregnancy and the birth experience can put women into situations outside their comfort zones, which can induce anxiety. There are also symptoms that women may have in late pregnancy such as shortness of breath, dizziness, an increased heart rate and feeling hot and sweaty which can be mistaken for panic attacks or, in some instances, can lead to a panic attack. It is important to seek treatment early during pregnancy so that your experience of pregnancy and motherhood is positive rather than filled with dread, and also so that you can get quality antenatal and postnatal care for you and your baby.

Anxiety is effectively treated with psychological therapies. These include relaxation training, cognitive behavioural therapy, and mindfulness practice. Lifestyle modifications such as stress reduction and exercise are also helpful. Sometimes in more severe illnesses, medication may be needed, preferably in conjunction with psychological therapies. 

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