Whether you’re a first-time parent or are adding to your family, struggled to get pregnant or got lucky without trying, nine months of pregnancy can raise all sorts of concerns.

You may wonder: Why is the baby kicking so much … or so little? How will I bear the labor pains I've heard so much about? How can I be a good mother if I have no clue what it’s like to take care of an infant?

These are all normal worries, since joining the first-time moms’ club means you’ll have plenty of questions only experience can answer. The reality is that nearly every woman — behind that baby belly and “pregnancy glow” — is a bit anxious, worried or hesitant about some aspect of pregnancy, childbirth or parenting.

But when should anxiety be a cause for concern? And how can it be treated during pregnancy? The answers are information that every expecting woman should hear.

What’s a normal amount of pregnancy anxiety?

Anxiety is not only part of being pregnant, it’s part of being human. We all worry, and pregnancy can often amplify those worries.

Studies show that about 15 percent of pregnant women have anxiety disorders, about as common as depression during pregnancy

Some women — especially those who've had previous pregnancy losses or fertility problems — worry about whether their babies are healthy. Others might worry about whether they’ll be good parents, how their relationships with their partners will change, how siblings will react to a new baby or the financial aspects of having a child.

Even if you worry about all these things, that’s normal too.

But there’s a difference between normal worrying and all-consuming anxiety during pregnancy, also known as antenatal anxiety. It’s time to talk to a health care provider if your anxiety is preventing you from concentrating, causing you to have trouble functioning, making you extremely panicky or causing some physical symptoms including rapid heartbeat and shortness of breath.

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What are the signs and symptoms of anxiety during pregnancy?

The following are symptoms of more serious anxiety during pregnancy: 

  • Experiencing a frequent sense of panic, fear or restlessness
  • An inability to concentrate on your day-to-day life
  • Trouble functioning at work or home
  • Having obsessive thoughts
  • Not enjoying things that used to make you happy
  • Heart palpitations
  • Muscle tension
  • Rapid breathing (hyperventilation) or shortness of breath (which is a normal symptom of pregnancy, so don't worry if you're not noticing any of these other signs of pregnancy anxiety)
  • This level of anxiety goes beyond the normal, everyday form of worrying — but treatment can help.

What causes anxiety during pregnancy?

Anxiety during pregnancy is a complicated condition — one even researchers don’t fully understand — that can have more than one cause. 

It can be caused by an underlying health issue, such as diabetes, thyroid problems or chronic pain, or it may be a hereditary disorder, since anxiety can run in the family.

Or it may stem from a fear of giving birth (you may have heard a scary delivery room story), or a stressful situation at home or work (like relationship problems or financial troubles). It may even be triggered by the pregnancy itself, especially if it was unplanned.

Regardless of what’s behind these feelings or thoughts, know that anxiety during pregnancy is a medical condition — it isn’t the result of anything you did.

What are risk factors for anxiety during pregnancy?

Just about anyone can develop anxiety during pregnancy. That said, there are a few criteria that put you at higher risk for a severe anxiety disorder, which means that you should pay extra-close attention to how you’re feeling when you’re expecting, including:

  • A previous diagnosis of an anxiety disorder
  • Anxiety during a past pregnancy
  • Previous pregnancy loss or fertility struggles
  • Pregnancy with complications or bed rest (though practitioners rarely prescribe strict bed rest anymore, in part for this reason)
  • Age (younger pregnant women can be more likely to have anxiety than older pregnant women)

All of these factors can contribute to a heightened risk of anxiety during pregnancy.

Why seek help for pregnancy anxiety?

Many women are under the mistaken impression that the best way to deal with anxiety is just to struggle through it. But if your anxiety is severe, there are a few reasons it’s best to seek help.

Although you might tell yourself “I’ll just feel better once the baby is here,” research has actually shown that women who have anxiety during pregnancy are more likely to have postpartum depression after their baby is born.

So although anxiety and depression don’t necessarily occur together, they are closely related — and by learning ways to control your anxiety before your new little one arrives, you’ll increase the odds that you’ll be able to enjoy those joyful first few months.

Another reason to explore treatments: Long-term, severe anxiety during pregnancy can affect your baby’s development.

Studies have shown that anxiety or depression during pregnancy can increase the odds of preterm birth and low birth weight and even make it more likely a child will, down the road, have emotional or behavioral challenges.

What anxiety medication is safe for pregnancy?

Most drugs that treat anxiety fall into the same class of pharmaceuticals as antidepressants, which means that some can be tricky to prescribe during pregnancy. The American College of Obstetricians and Gynecologists (ACOG) cautions that prescribing these types of medications during pregnancy should always include a careful risk-benefit analysis. 

Though some anxiety meds are considered relatively safe during pregnancy, you'll need to work closely with your practitioner to determine which ones are right for you if medications are necessary to ensure your well-being and/or your baby’s.

Your doctor and a qualified therapist can work with you to decide which drug offers the most benefits for the fewest risks (and how low a dose you can take and still get those benefits). If you’ve been on a medication for panic attacks, anxiety or depression pre-pregnancy, you may need to change or adjust your dose, too.

Tips to calm anxiety while pregnant

While medication is one solution to anxiety disorders, it certainly isn’t the only one. In fact, going to therapy sessions with a psychologist, psychiatrist or counselor is usually the first and best way to help pinpoint what’s causing your anxiety and develop a plan to help you ease your worries or learn relaxation techniques.

The following anxiety-alleviating strategies can help too:

  • Catch more Zzzs. Some research has found that lack of sleep could exacerbate anxiety, so aim for seven to eight hours a night whenever possible. If lifestyle changes haven't helped you sleep better or problems persist, talk to your doctor about sleep aids. Some medications during pregnancy, including Unisom, Tylenol PM, Sominex and Nytol, are generally considered okay for occasional use during pregnancy but be sure to check with your OB/GYN or midwife before taking anything.
  • Eat whole, fresh foods. A growing amount of research has shown that what you eat can have a big effect on your mental health. Eating a well-balanced diet — nutrient-dense, whole and unprocessed foods (including fruits, vegetables, fish, nuts, dairy and whole grains) — instead of processed and fast foods is thought to support healthy bacteria in the gut, which in turn may help lessen anxiety.
  • Stay active. Something as quick and easy as a 10-minute walk can decreases levels of tension. People who get regular exercise are less likely to develop anxiety or depression.
  • Arm yourself with knowledge. Learning the ins and outs of pregnancy and parenting can go a long way in helping you feel prepared. So read up and consider taking a childbirth class.
  • Build a support system. Spend time with experienced parents or friends who are also expecting. You can also join an online community to connect with others who are coping with the same feelings as you are.
  • Schedule time in your day to relax. Scientists have found that regular meditation and acupuncture have benefits for people with anxiety. Or try yoga, listen to music or get a massage from a professional or even just your partner. Meditation and deep breathing exercises can help, too.
Lastly, try to learn to remind yourself that you really will know what to do when your bundle of joy arrives. Even if you've never held a baby, instinct is on your side — and what your little one will really need more than anything is simply your love.