Medicines for Anxiety in pregnancy

What it is

Anxiety in pregnancy (antenatal anxiety) is anxiety experienced during pregnancy. Some worry and anxiety during pregnancy is common and understandable — pregnancy is a time of big changes and uncertainties, and it is natural to have some worries about the pregnancy, the birth, the baby, and becoming a parent. However, for some women, anxiety in pregnancy becomes more persistent, intense, or overwhelming, and starts to affect their wellbeing and daily life, at which point it is more than everyday worry and is a form of perinatal mental health difficulty that can be helped. Anxiety in pregnancy can take various forms, including generalised anxiety (persistent, excessive worry), panic attacks, specific fears (such as a fear of childbirth), obsessive-compulsive symptoms, or anxiety alongside low mood or depression, which can also occur in pregnancy. The symptoms can include: persistent or excessive worrying that is hard to control; feeling restless, on edge, or unable to relax; physical symptoms of anxiety (such as a racing heart, tension, or feeling sick); difficulty sleeping (beyond the normal discomforts of pregnancy); difficulty concentrating; and, sometimes, avoiding things or seeking a lot of reassurance. Anxiety in pregnancy is common and nothing to be ashamed of, and it is important to know that it can be treated and that seeking help is a positive step — both for the woman’s own wellbeing and because supporting a mother’s mental health also supports the pregnancy and the baby. Support and treatment are available, ranging from self-help and talking therapies to, in some cases, other support, and perinatal mental health services provide specialist help where needed. The key messages are that anxiety in pregnancy is common, that persistent or troubling anxiety is a recognised difficulty that can be helped, that support and treatment are available and effective, and that asking for help is important and encouraged.

How it is treated

Anxiety in pregnancy can be helped, and management involves support, self-help, and talking therapies, with specialist perinatal mental health support where needed — and asking for help is an important and positive step. The first step is often recognising the anxiety and talking about it: sharing how you feel with your midwife, GP, health visitor, or a trusted person is important, as it can be a relief and opens the door to support; midwives and other maternity professionals are used to supporting women’s mental health in pregnancy, and asking for help is encouraged and nothing to be ashamed of. Support and treatment options include: self-help resources and strategies for managing anxiety (such as understanding anxiety, relaxation and breathing techniques, staying active, and looking after general wellbeing, sleep, and support); talking therapies, particularly cognitive behavioural therapy (CBT), which are effective for anxiety and are often a first-line treatment in pregnancy — these can usually be accessed through the GP or self-referral to talking therapy services; and, where anxiety is more severe or not helped by these measures, specialist perinatal mental health support, which is available for women with more significant mental health difficulties in pregnancy and after birth. In some cases, medication may be considered, and any decisions about medication in pregnancy are made carefully with the doctor, weighing the benefits and any risks, and with specialist input where appropriate; untreated significant anxiety or depression also carries risks, so treatment is important. Support from partners, family, and friends, and connecting with other sources of support, also help. It is important to seek help promptly if anxiety is persistent, intense, or affecting daily life, if there is significant low mood or depression, or if there are ever thoughts of harming oneself (which need urgent help). The reassuring and encouraging messages are that anxiety in pregnancy is common and nothing to be ashamed of, that it is a recognised difficulty that can be treated effectively (with self-help, talking therapies such as CBT, and specialist support where needed), and that seeking help supports both the woman’s wellbeing and her pregnancy and baby — so reaching out is a positive and important step.