Pregnancy can be a widely variable experience for many people. It is completely normal for expecting mothers to feel anxious during this significant time in their lives with the upcoming life changes in addition to the hormonal and physical changes occurring in their body. Sometimes the anxiety might reach levels where it feels distressing or too much. This is not uncommon and there are tools, resources, and support available. 

Understanding Pregnancy Anxiety

Pregnancy anxiety can present in a variety of ways, such as cognitive from worrying about the health of the baby, fear of childbirth, and uncertainty about parenting, to concerns about the impact of pregnancy on one's body image and relationships. You are not alone in these feelings; many expectant mothers experience anxiety to varying degrees.

While a certain level of apprehension is natural, excessive anxiety can significantly impact your mental and physical well-being. Studies have shown that high levels of stress and anxiety during pregnancy can lead to complications such as preterm birth, low birth weight, and even developmental issues in children.

It can be helpful to understand and explore what might be contributing to the anxiety for you personally. For example, if you struggle with the unknown, if circumstances like financial or family stress are weighing on you, if you are lacking support, if you have a tendency to jump to the worst case scenario, anxious about how motherhood might impact your relationships or career, or maybe you have had negative experiences in the past with trying to grow your family. Pay attention to when you are feeling the most anxious and explore if there are any patterns or triggers. Is the anxiety always centered around the same things, is it more cognitive or somatic, does it always feel the same in your body, does it feel constant or come in waves? Therapy can help you gain insight into contributing factors, offer tools to cope and process how your past experience might be impacting you in the present.

Coping Strategies for Pregnancy Anxiety

  1. Name how you are feeling with others - This could be a partner, trusted friend/family member and/or therapist! Empathy can go such a long way in lessening the intensity of what we are feeling or just knowing we are supported! Choosing who to share these feelings with could be worth giving thought to as you want someone who can validate but not add to your worries. 

  2. Practice Self-Compassion: I often hear clients say “I don’t know how to be kind to myself”. Oftentimes our internal dialogue is so automatic and negative we don’t even know we are beating ourselves up or people report it feels ridiculous or self-indulgent to extend compassion to oneself. Here is a place to start with basic steps: acknowledge that you are doing your best during this unique journey and that this is HARD. Ask yourself how you would speak to a loved one or friend in this situation (the words you would use but also the tone of voice in which you would speak to them). Remind yourself that you are not alone in this experience and check in with what you might need in that moment. 

  3. Utilize healthy coping tools: read more below to see some of my favorite coping skills for anxiety. 

  4. Find a Perinatal Mental Health Therapist - Talk with someone who can create a safe space and understand your unique experiences. Don’t underestimate how beneficial this can be to be able to have a space fully devoted to you and be able to talk through some of these worries without someone dismissing you or making it about themselves. Therapy for pregnancy anxiety can help you gain insight into where these worries are coming from, ways to cope with them, and empower you to access your supports and step into your role as a mom with confidence. 

  5. Educate Yourself (within reason) with Reliable/Trustworthy Sources - Seek out reliable sources of information about pregnancy, childbirth, and parenting. Gaining knowledge about the various stages of pregnancy and what to expect can alleviate anxiety stemming from the unknown. However, it is important to strike a balance. Avoid excessive online research, as it may lead to information overload and increased worry. If needed, set limits for yourself on how much time is spent on this and where your information is coming from. 

  6. Limit/Filter Social Media Consumption - While social media can sometimes be a helpful platform to increase awareness or provide some basic education, it can also amplify feelings of inadequacy and comparison. Pregnancy can be a great time to do what I call a social media cleanout. Unfollow any accounts or people that you notice reinforce feelings of anxiety or comparison. Consider following accounts that promote body neutrality, self-care, and a realistic portrayal of pregnancy experiences. It can be helpful to take regular breaks from social media all together as well. While it can be helpful to have realistic experiences portrayed, even these can have an impact on us. Our brains are not meant to be able to consume that many different stories, experiences and people. 

  7. Establish Necessary Boundaries - While most people are well intentioned, we have all been in situations where someone says something that does not land well. Remember that you can request someone to refrain from making certain comments and communicate your needs. A boundary is generally something you are in control of. While we can’t control the comments someone makes (we can try), the amount of time you spend with them could be more in your control depending on the situation. 

  8. Talk to your doctor if you feel you could benefit from medication - We have come a long way in how we treat pregnant people in terms of medication options. While there are still some medications that should be avoided when possible in pregnancy, there are some safe options to support your mental health during this time. 

Some of my favorite skills for anxiety:

  • Deep breathing: Maybe you have heard this in a yoga class…your breath is always available to you. As cliche as it may sound, this is why this is one of my favorite ways to regulate ourselves. There are a variety of breathwork techniques to try and figure out what works best for you. The more you practice them, the more readily available they will feel in your body and in a time of need. This can help activate our parasympathetic nervous system and let our mind and body know that we are safe and can relax. 

  • Scheduled Worry Time - This is an awesome way to redirect thoughts when you notice the thought spiral happening. You can remind yourself that you have time towards the end of the day (ideally not the 30 minutes right before bed though) to devote to those worries. Set aside 10 minutes to devote brainspace to those worries IF they are still feeling important when that scheduled worry time rolls around at the end of the day. During that time you can problem-solve or let. Oftentimes, by the time it rolls around at the end of the day, the thoughts/worries have lessened. If not, talk them through with someone or utilize some of the other skills listed here. 

  • Progressive Muscle Relaxation - There are great guided options for this on youtube and mindfulness apps. 

  • Rule of 5 - This is when we notice an automatic negative thought, we acknowledge that it is just a thought (not a fact) and challenge ourselves to come up with 5 alternative thoughts. I generally try to encourage at least 2-3 of the alternative thoughts to be neutral or positive. It's okay if the automatic thought still feels the most powerful or real at the moment, this is a good practice of cognitive flexibility and reminding our brain that our automatic thoughts are not the only way to see a situation. Over time, it can become much easier to implement some cognitive flexibility or not always jump to the worse case scenario. 

  • Journaling- There is no right or wrong way to journal. Some people find it helpful to have prompts, some people just want to jot down what is in their head via bullet points and others like to write letters or have a conversation with themselves via journaling. Journaling can help us release some distressing thoughts, gain insight into certain patterns of thought and process through our emotions free of judgment. 

  • Gentle Movement - This could be yoga, walking, lifting, jogging, or any form of movement you find enjoyable! 

There are also alternative methods like acupuncture and massage as many of us tend to hold our anxiety in our bodies and it manifests as physical tension as well!

Pregnancy is undoubtedly a time of anticipation, physical and emotional changes, so it is so common to experience anxiety, worry or apprehension along the way. Pregnancy can also be a catalyst that makes us more aware of some of our pre-existing underlying anxieties. It can be so helpful to have a space to talk through these experiences, gain insight into their origins, develop ways to cope, and feel seen in your experiences. Pregnancy anxiety therapy can help you find relief and prepare for motherhood. Remember, you are not alone – embrace the power of community, educate yourself, and prioritize your well-being. Together, we can create a safe space where pregnancy anxiety is understood, acknowledged, and compassionately supported!

As a Perinatal Mental Health Certified Therapist, I specialize in supporting women struggling with anxiety in pregnancy and postpartum. If you would like to schedule a consultation call or discuss any questions you may have regarding pregnancy or postpartum anxiety therapy, reach out via the contact page.

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