Perinatal Anxiety 101: An Introduction
Authors: Brynn Stagg, MSc Student, University of British Columbia; Claudia Cargnelli, MSc Student, University of British Columbia; Nichole Fairbrother, Ph.D., RPsych, Clinical Associate Professor & MSFHR Health Professional-Investigator, University of British Columbia | Editors: Romina Garcia de leon, Shayda Swann (Blog Coordinators)
Published: February 24th, 2023
Are you pregnant, recently given birth, or know someone who has? If so, chances are you or someone you know has experienced anxiety during or after their pregnancy.
Anxiety is a normal human experience.
We all feel anxious, worried, or afraid some of the time. Often, anxiety serves a useful purpose. For example, when heights make us anxious, this feeling serves as a warning to be careful in this potentially dangerous situation. Because of this fear, we take precautions to protect ourselves.
When does anxiety become a problem?
Sometimes, however, we become fearful of something that is not dangerous, or more fearful than we need to be. If anxiety becomes severe enough to cause significant distress or interference in a person’s life, it may have developed into an anxiety or anxiety-related disorder (AD).
There are several different ADs, including panic disorder, generalized anxiety disorder, social anxiety disorder, and anxiety-related disorders like obsessive-compulsive disorder and posttraumatic stress disorder. Given the diversity of ADs, it is no surprise that these are important to diagnose — especially when you add in the everyday stress that comes with parenting!
What about anxiety during pregnancy and the postpartum?
Anxiety is especially common (and normal) among pregnant and postpartum people. Often, the anxiety experienced during this time is related to one’s pregnancy (will my baby be healthy?), the childbirth (will childbirth be painful?), and one’s newborn (what if something happens to my baby?).
Although anxiety during the perinatal period is common, and in many cases, a normal and healthy part of becoming a parent, sometimes perinatal anxiety becomes a problem. If you are experiencing substantial anxiety and fear, and these feelings are making you upset or affecting your ability to parent and live your life, you may be experiencing symptoms that meet criteria for an AD.
Most importantly, we want you to know that you are not alone! There are things you can do (like talking to your healthcare providers, for starters).
Why does perinatal anxiety matter?
Over one in five (21%) pregnant and postpartum people suffer from at least one AD during the perinatal period. Believe it or not, this number is more than postpartum depression — which, at most, 10–16% of birthing people experience.
ADs, when they occur during pregnancy, have been associated with adverse obstetrical and neonatal outcomes, such as increased risks for pre-eclampsia, preterm birth, and low birth weight. These can have consequences for the infant and developing child.
What can be done?
It’s important to ask for help. You are not alone. Some treatments really work, including self-help materials, group or individualized therapy, and/or medication.
Cognitive Behavioural Therapy (CBT) is the recommended first-line treatment for most ADs. It is the talk therapy for anxiety with the most scientific support. It’s safe, effective, and is often the treatment of choice for pregnant or postpartum parents as it works as well or better than medication does.
CBT works to reframe thinking patterns and behaviour. In other words, CBT focuses on how you are thinking (cognitive), what you do about those thoughts (behavioural), and then works on changing these to help your feelings. Lots of research has been done on the effectiveness of CBT in general populations, and we hope to see even more studies focused on perinatal people in the future!
If talk therapy is not helping, individuals may benefit from medication instead of, or in combination with, talk therapy. Selective serotonin and selective norepinephrine reuptake inhibitors (SSRIs and SNRIs), also known as antidepressants, are used to treat anxiety. While many are hesitant and fearful of using medications while pregnant or breastfeeding, not treating more severe perinatal anxiety greatly overshadows the risks associated with using medication, so it’s important to weigh the pros and cons.
If you think your anxiety has become a problem, you may want to speak to your primary healthcare provider. You can also seek the services of a psychologist.
What’s next for this area?
The team at the Perinatal Anxiety Research Lab hopes that by spreading knowledge of anxiety during pregnancy and the postpartum, we can work to make sure that perinatal anxiety becomes easily recognized so everyone can get the support they need during such a stressful time.
Coming up, we will teach you about some important steps that are crucial in making sure parents are getting the support and resources they need. Stay tuned for our next feature on Screening for Perinatal Anxiety Disorders.
Reflecting & Resources
If you are pregnant or have been pregnant, what has your experience been like? Did you know anxiety is this common during the perinatal period? Is there someone that could benefit from this knowledge?
Let us know your thoughts, questions, or ideas for future posts in our Perinatal Anxiety 101 feature.
Click here for resources and additional support!