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 natural response to a situation we perceive as threatening or where we feel overwhelmed or out of control, 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 on anxiety.

We know that anxiety can be helpful in certain situations, such as when we need to respond to an emergency 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 and 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 and 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)
  • Numb

  • Racing thoughts
  • Unable to concentrate
  • Constant worrying
  • Thinking of the worst case scenario
  • Doubting yourself
  • Going over the same worries/thoughts
  • Believing that other people know you 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
  • Finding it difficult to finish off one thing
  • Eating less (or more)
  • Being snappy/increased irritability

We know that talking about how you are feeling can 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 options 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 Shropshire, Telford and Wrekin here.
  • Your GP
  • Shropshire Community Perinatal Mental Health Team (PMHT) - The PMHT provides specialist assessment and support for women across Shropshire and Telford & Wrekin, providing both support to those women experiencing mental health difficulties, and those at risk of developing mental health difficulties up until a year after baby's birth. The service supports women experiencing moderate to severe mental health problems
  • Click here to find your local talking therapies service
  • The Lighthouse Service supports women, birthing persons and support partners in Shropshire and Telford & Wrekin whose mental health has been adversely affected by their birth or maternity experience. They may be experiencing loss, grief or trauma, or have a fear of childbirth.

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.

Self help:

Further reading: