Anxiety and panic attacks in pregnancy

It’s natural to have some feelings of anxiety when you’re pregnant. But if you are feeling anxious most of the time and finding it hard to relax, you may need support.

What is anxiety?

Anxiety is a feeling you get when you’re doing something you find stressful or tough. It can be mild or severe. Some pregnant women and birthing people feel upset or guilty about feeling anxious when they think they should be happy. But it’s normal to feel anxious sometimes, no matter what is going on in your life. 

If you find it hard to control your worries, or you’re having panic attacks, you may be struggling with an anxiety disorder. Be sure to ask for support from your midwife or doctor. While a level of anxiety is normal, it can become a problem. This is not a sign of weakness, something that will go away on its own, or something that you should be able to ‘snap out of’. 

Anxiety symptoms that you may need support to manage can include:

  • feeling anxious all or most of the time
  • not being able to control or manage your anxiety
  • being restless
  • feeling very worried (for example, about your baby)
  • feeling a constant sense of dread
  • finding it tough to focus your thoughts
  • feeling like your mind goes blank
  • feeling tetchy
  • feeling like you’re always on edge
  • having trouble falling or staying asleep.

Panic attacks can come on very quickly and for no clear reason. Symptoms can include:

  • a racing heartbeat
  • a feeling of dread or a fear of dying
  • chest pain
  • shortness of breath
  • feeling dizzy
  • sweating
  • feeling faint
  • shaky limbs
  • tingling fingers
  • a churning stomach.

Most panic attacks last for between 5 and 20 minutes, but they can last up to an hour. They can be scary, but they will not cause you harm.

Some people also get depression in pregnancy if their anxiety goes on for a long time.

“I was doing well, and then at 24 weeks it hit me like a ton of bricks that maybe this pregnancy was a bad idea. I was so anxious… but all the stops were pulled out for me, and as well as the midwives I saw a health visitor who helped me.” 

Simone, mum of one

How common is anxiety in pregnancy?

Anxiety in pregnancy is common. Almost 1 in 5 pregnant women or birthing people have it.

Pregnancy can lead to you feeling a range of emotions. It can be hard to know whether you can cope with your feelings, or whether you could do with some extra support. Trust yourself. You are the best judge of whether your feelings are normal for you. If you feel anxious a lot, or have panic attacks during pregnancy, make sure you ask for help.

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?

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.

1.    McAllister N et al (2021) Pregnancy outcomes in women with severe needle phobia. European Journal of Obstetrics, Gynecology and reproductive biology. 2012 Jun;162(2):149-52. doi: 10.1016/j.ejogrb.2012.02.019. Epub 2012 Mar 23.

2.    McCarthy M, Houghton C, Matvienko-Sikar K (2021) Women’s experiences and perceptions of anxiety and stress during the perinatal period: a systematic review and qualitative evidence synthesis. BMC Pregnancy Childbirth 2021; 21: 811.

3.    Mersey Care NHS Foundation Trust. Perinatal anxiety. (Page accessed 17/10/2023) 

4.    NHS. Overview: Generalised anxiety disorder in adults. (Page last reviewed: 05/10/2022. Next review due: 05/010/2025)

5.    NHS. Self-help – Generalised anxiety disorder in adults. (Page last reviewed: 05/10/2022. Next review due: 05/10/2025)      

6.    NHS. Panic disorder. (Page last reviewed: 22/08/2023. Next review due: 22/08/2026)

7.    NHS. Overview: Phobias (Page last reviewed: 27/07/2022. Next review due: 27/07/2025)

8.    NICE (2023) Generalized anxiety disorder: What are the risk factors for the development of generalized anxiety disorder? National Institute for Health and Care Excellence Clinical Knowledge Summary   

9.    NICE (2020) Antenatal and postnatal mental health: clinical management and service guidance: Clinical guideline 192. National Institute for Health and Care Excellence

10.    Pan-London Perinatal Mental Health Networks (2018) Fear of Childbirth (Tokophobia) and Traumatic Experience of Childbirth: Best Practice Toolkit

11.    Royal College of Psychiatrists (2022) Anxiety and generalised anxiety disorder (GAD). (Published: May 2022. Review due: May 2025)

12.    Royal College of Psychiatrists. Mental health in pregnancy. (Published: Nov 2018. Review due: Nov 2021)  

13.    Traylor CS, Johnson JD et al (2020) Effects of psychological stress on adverse pregnancy outcomes and nonpharmacologic approaches for reduction: an expert review. Am J Obstet Gynecol MFM. 2020; 2(4) :100229.

Review dates
Reviewed: 04 February 2024
Next review: 04 February 2027