Perinatal Anxiety: Symptoms, Risk Factors, and Treatment

Perinatal Anxiety: Symptoms, Risk Factors, and Treatment


Perinatal anxiety occurs during pregnancy or in the postnatal period (the first year after birth). Perinatal anxiety has a range of different symptoms, and can include some of the following:

  • Being plagued by worry, nervousness, or apprehension 
  • Feeling panicky or having panic attacks
  • Insomnia or sleep problems: such as difficulty returning to sleep after you have settled your baby, difficulty going to sleep, or waking up often during the night (even when your baby hasn’t woken you up). Or you may be getting enough sleep, but it is restless sleep, and you still feel tired in the morning
  • Irritability or anger
  • Restless tension, such as feeling wound up or on edge
  • Tense muscles, which may end up feeling sore
  • Fatigue or tiredness
  • Headaches
  • Lack of appetite, or abdominal distress
  • Difficulty concentrating or making decisions, or your mind going blank at times
  • Intrusive and distressing thoughts (for example, of harming your baby); sometimes people do repetitive rituals to help ‘neutralise’ or avoid worrying thoughts, anxiety, or harm
  • Impaired memory
  • Feeling overwhelmed or not coping
  • Feeling afraid to leave the house


Perinatal anxiety is more common than perinatal depression; one study even found that up to 39% of women reported anxiety during pregnancy or postpartum [1]. Anxious worry can concern a broad range of issues, such as worrying about work, social interactions, and more. Anxiety can also be pregnancy-specific (such as worrying about the risk of loss or abnormalities) or focused on birth (fearing this or experiencing ongoing difficulties regarding the birth well after your baby has arrived). It can also be focused on parenting-related issues, such as worrying about your baby’s sleep, feeding, or settling. 


Research [1][2]  has indicated that risk factors for perinatal anxiety include:

  • Socio‐economic disadvantage, including a lower education level, and financial difficulties or poverty
  • Pregnancy or birth difficulties
  • Hyperemesis during pregnancy
  • A subsequent pregnancy (not your first)
  • A poor relationship with your partner
  • Living with extended family members
  • A history of mental health issues
  • A family history of mental health issues
  • Having a sleep disorder
  • Oxytocin exposure


What can be done about perinatal anxiety?

The scientific literature regarding effective treatment of perinatal anxiety is not particularly strong; however, Cognitive Behaviour Therapy (CBT) does have an evidence base for improving perinatal anxiety [3]. CBT is a short term, practical skills-based approach that aims to change negative thinking and behaviour patterns, thus improving the way people feel. 



[1] Leach, L. S., Poyser, C., & Fairweather-Schmidt, K. (2017). Maternal perinatal anxiety: A review of prevalence and correlates. Clinical Psychologist, 21(1), 4-19. doi:

[2] Furtado, M., H.T. Chow, C. H. T., Owais, S., Frey, B. N., & Van Lieshout, R. J. (2018). Risk factors of new onset anxiety and anxiety exacerbation in the perinatal period: A systematic review and meta-analysis. Journal of Affective Disorders, 238, 626-635.  

[3] Maguire, P. N., Clark, G. I., & Wootton B. M. (2018). The efficacy of cognitive behavior therapy for the treatment of perinatal anxiety symptoms: A preliminary meta-analysis. Journal of Anxiety Disorders, 60, 26-34.

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