Anxiety and panic attacks in pregnancy

What causes anxiety?

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

• a family history of anxiety or panic attacks
• had anxiety or panic attacks in the past
• experienced a traumatic event or abuse
• used some illegal drugs
• depression
• a long-term or painful condition
• been under extra stress due to things like relationship problems, money worries or unemployment.

Pregnancy-specific anxieties and phobias

You may feel a bit anxious about or afraid of giving birth. This is very common. 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.

A phobia is an overwhelming and debilitating fear of something. It is rare, but some women are so afraid of giving birth that they don’t want to go through with it, even if they really want to have the baby. A severe fear of childbirth may also affect their decision on how to give birth to their baby. This is called Tokophobia.

Some women develop a fear of childbirth because they have had a traumatic birthing experience, miscarriage or neonatal death. In this case, they may have post-traumatic stress disorder.

A needle phobia may also cause problems in pregnancy because it can cause some women to avoid having important blood tests or treatments.

If you are having overwhelming feelings of anxiety or terror about anything to do with your pregnancy or that may affect your pregnancy, it’s very important to talk to your midwife or GP. This needs to be treated by a mental health specialist.

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

Amber, mum of one

Does anxiety affect my baby?

Being concerned about whether anxiety or stress will affect your baby is understandable, but it can also create a vicious circle of thoughts. You may be feeling anxious during your pregnancy, then begin to worry if it this is affecting your baby and so become even more anxious.

It is very unlikely that your baby will be affected by your anxiety, particularly if you get the right treatment and support. So try to focus on asking for help and finding ways to manage your symptoms.

Be confident that you are doing everything you can to take care of your baby.

Find out more about stress and your baby.

What should I do if I have anxiety in pregnancy?

Talk to your midwife or doctor if you:

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

Tell your midwife or GP if you have experienced 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 won’t criticise you or judge you for having these feelings. They know this happens to many pregnant women, and they will focus on finding the right treatment to help you recover.

If you find anxiety difficult 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 all your options and the pros and cons of each treatment. What’s best for you will depend on things like:

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

Anxiety, phobias and panic attacks are usually treated using self-help treatments based on cognitive behavioural therapy (CBT). 

"I didn't think CBT would work but I found it so helpful. I had a little guide book 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. Read more...

If you need more help you may be referred to a specialist mental health team for pregnant women. You may also be offered therapy, such as cognitive behavioural therapy, mindfulness  and applied relaxation with a professional therapist. You may also be offered medication, such as antidepressants.

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 or a friend about how you are feeling.
• Try not to feel guilty or embarrassed. These feelings are not your fault.
• Look after yourself - try some of our top tips for looking after your emotional wellbeing.
• Exercise
• Avoid caffeine
• Eat well
• Avoid smoking  and drinking alcohol. This can harm you and your baby.
• Try learning about simple relaxation techniques and practise them regularly.

You could also try a self-help book

The Royal College of Psychiatrists recommends these:

• Overcoming Anxiety by Helen Kennerley
• Overcoming Anxiety, Stress and Panic: A Five Areas Approach by Chris Williams
• Feel the Fear and Do It Anyway by Susan Jeffers
• Overcoming Panic and Agoraphobia by Derrick Silove and Vijaya Manicavasagar
• Panic Attacks: What They Are, Why They Happen and What You Can Do About Them by Christine Ingram
• An Introduction to Coping with Phobias by Brenda Hogan

Make a wellbeing plan

Our online 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

No Panic

MIND