Anxiety and panic attacks in pregnancy

What causes anxiety?

During pregnancy your brain goes through changes to help you get ready to be a parent. This can cause increased levels of anxiety. It can come from feeling unsure about what’s going to happen, and the feeling that you want to protect your baby and yourself.  Many people also feel anxious about giving birth. 

Anyone can develop anxiety, but you are more likely to have it if you have: 

• a family history of anxiety or depression
• had anxiety or panic attacks in the past
• gone through trauma or abuse
• used illegal drugs
• a long-term or painful condition
• been under extra stress due to things like relationship problems, money worries or job loss.

 “My anxiety was very much a ‘black dog’. It was always in the background, niggling away. It felt like an unknown risk, an uncontrollable fear that would catch me unaware.” 

Amber, mum of one

Phobias during pregnancy

A phobia is an extreme fear of something. Some women and birthing people have a phobia of giving birth – this is called tokophobia. Sometimes, this happens because of a past bad experience in pregnancy or childbirth.  In this case, they may have post-traumatic stress disorder (PTSD).

A needle phobia may also cause problems in pregnancy. That’s because it can cause some people to avoid having vital blood tests or treatments.

If you think you have a phobia, talk to your midwife or GP. They can refer you for specialist treatment.

Does anxiety affect my baby?

Being concerned about whether anxiety or stress will affect your baby is natural, but it’s not hugely helpful because it can cause a cycle of thinking that makes you feel worse. You may be feeling anxious during your pregnancy, then begin to worry that this might affect your baby, and so become even more anxious.

Getting treatment and support for your anxiety can help to break this cycle and reduce any risk to your baby. Try to focus on asking for help and finding ways to manage your symptoms. That way, you can be proud that you are doing all you can to take care of your baby.

What should I do if I have anxiety in pregnancy?

Pregnancy and childbirth are major life events, so don’t be hard on yourself for having these feelings. Talking to your midwife and doing some positive things to prepare for labour may help.

Talk to your midwife or doctor if you:

• feel anxious most of the time for more than 2 weeks
• have anxiety symptoms like a fast heartbeat, rapid breathing, sweating, feeling faint, feeling sick or diarrhoea
• think you might have had a panic attack
• have unpleasant thoughts that keep coming back and you can’t control them
• find yourself repeating an action (like washing, checking or counting) to feel better
• are so afraid of giving birth that you don’t want to go through with it
• are so afraid of blood tests that you avoid having them.

Tell your midwife or GP if you have had anxiety before, even if you aren’t feeling anxious right now. The more they know about your mental health history, the better they can support you during your pregnancy.

The midwife or doctor will not judge you for having these feelings. They know that anxiety is common during pregnancy and they will focus on finding the right treatment to help you feel better.

If you find anxiety hard to talk about, you could write down how you feel before your appointment, or take someone with you for support. 

What’s the treatment for anxiety in pregnancy?

Your midwife or GP will talk to you about your options, and the benefits and risks of each treatment. What’s best for you will depend on:

• how bad your symptoms are
• what has help you in the past (if you’ve had anxiety before)
• what services are local to you.

The first step is often a self-help treatment based on cognitive behavioural therapy (CBT). 

"I didn't think CBT would work, but I found it so helpful. I had a little guidebook so if I was feeling anxious at work or at home, I could refer to it for tips and pointers to get me through certain situations.” 

Katie, mum of one

If you need more help, your doctor may refer you to a pregnancy mental health team. They may also offer you talking therapy, such as CBT.

If you already take medication for anxiety, your doctor will explain how it may affect you and your baby. They may suggest you carry on with your current medication, or they might suggest slowly changing to a talking therapy or a different medicine. Do not stop taking your medication before speaking to your doctor.

You may be referred to a mental health professional who specialises in tokophobia if you have a fear of giving birth.

Find out more about treatment and support for mental health.

How can I prevent or manage anxiety in pregnancy?

• Talk to someone you trust, such as your partner, family member or a friend about how you are feeling.
• Make a plan to help prepare for and prevent any anxiety triggers. You can try our Wellbeing Plan for this. 
• Try not to feel guilty or ashamed. These feelings are not your fault.
• Look after yourself. Try some of our top tips for looking after your emotional wellbeing.
• Do some gentle physical activity.
• Avoid caffeine, smoking and drinking alcohol. (These can also harm you and your baby.)
• Try some simple relaxation techniques, such as breathing exercises.

Make a wellbeing plan

Our Wellbeing Plan is a tool that helps you start thinking about how you feel and what support you might need in your pregnancy and after the birth.

You can use it to help you talk to your partner, family, friends or midwife about how you are feeling.

More information and support

Anxiety UK has information about perinatal anxiety. 

NHS UK’s Every Mind Matters website has tips on managing anxiety.

No Panic offers advice and support to people living with anxiety, panic attacks or phobias.

MIND has information about perinatal mental health, including anxiety.