7 Ways To Ease Anxiety During Pregnancy

Some biological causes of anxiety during pregnancy include hormonal changes that are essential to maintaining a healthy pregnancy. “Women produce more cortisol and estrogen during pregnancy, which can cause anxiety,” explains Kenosha Gleaton, M.D., a board-certified OB-GYN and medical advisor of Natalist.

“In the first trimester specifically, progesterone and estrogen levels rise, which may result in anxiety, irritability, depression, fatigue and feelings of sadness,” she adds.

Those changes in hormone levels can affect areas of the brain that control anxiety and emotional regulation, emphasizes Kristin Yeung Lasseter, M.D., a board-certified reproductive psychiatrist and faculty member at the University of Texas at Austin’s Dell Medical School.

Additionally, a previous personal or family history of anxiety or other mental health conditions, childhood trauma or a history of pregnancy loss or complications with pregnancy, labor or delivery can all be contributing risk factors for anxiety during pregnancy, according to the American College of Obstetricians and Gynecologists (ACOG).

And of course, there’s the understandable anxiety and worry around having a child, which is a huge life event. “It may be related to significant mental stress, such as from stress of an unplanned pregnancy, limited support around such a big life transition or feeling ambivalent about being pregnant,” adds Dr. Lasseter.

Symptoms of Anxiety During Pregnancy

Anxiety during pregnancy can present itself in a variety of ways. Here are some of the main symptoms of anxiety during pregnancy, according to Dr. Lasseter and Georgia Witkin, Ph.D., a clinical psychologist and head of patient services development for Progyny:

• Feeling on-edge, jumpy, nervous or on high alert due to higher levels of the hormone adrenaline
• Excessive worries about the health of the pregnancy, the baby or the preparation for the birth
• Difficulty falling or staying asleep
• Heightened fearfulness in large crowds or other typically anxiety-provoking settings
• Trouble relaxing and tenseness
• Feeling distracted or disoriented
• Having less energy, lower sex drive or lower mood
• Having panic attacks or racing, intrusive thoughts

Many pregnant people will feel at least a little bit jittery throughout their pregnancy, as there’s a sense of a loss of control over their body and the circumstances around the pregnancy, says Dr. Witkin.

“When you are pregnant there’s a lot of re-living the past: ‘Did I eat right? Did I drink too much? Did I eat enough protein?’” says Dr. Witkin. “There’s also an enormous amount of pre-living the future: worrying about things that haven’t happened yet, such as how long to breastfeed for immunity, what happens if the baby gets sick, etc.”

Dr. Witkin reiterates that anxiety is common during pregnancy but if you’re having difficulty performing your daily home and work tasks or functioning in relationships, it would be helpful to seek further mental health care.

Depending on the level of anxiety you experience, therapy techniques and dietary and lifestyle changes may be able to provide some relief.

Explore Cognitive Behavioral Therapy

Cognitive behavioral therapy, or CBT, is a therapy technique that involves evaluating your anxious or negative thought patterns and applying healthier coping mechanisms. Dr. Lasseter refers to CBT as “the most effective non-medication treatment for anxiety during pregnancy.”

Working with a licensed therapist or counselor on CBT can help you identify certain thoughts or behaviors that trigger your anxiety. From there, you can either avoid some of those triggers if possible, says Dr. Gleaton, or you can learn ways to work through them when they arise.

Employ Relaxation Techniques

Making a point to physically relax your body has been proven to reduce maternal stress, according to a small, 2021 study that analyzed stress levels in pregnant people after relaxation techniques involving music, guided imagery and rest^[2]Bauer I, Derntl B, Hartkopf J, Preissl H, Schaal NK, Schleger F, Wikström A-K. Acute relaxation during pregnancy leads to a reduction in maternal electrodermal activity and self-reported stress levels. BMC Pregnancy and Childbirth. 2021;21(1):1-12. . Other helpful practices for reducing anxiety symptoms during pregnancy include meditation, acupuncture and prenatal yoga, according to Dr. Lasseter.

Modify Your Diet

Aim for a balanced diet that’s nutrient-rich, which is proven to help with the symptoms of anxiety, says Dr. Gleaton. She recommends adding omega-3-packed foods like salmon (a type of seafood that’s low in mercury) into your meals to help support healthy brain function.

Additionally, a 2020 systematic review found a link between vitamin D deficiency and anxiety in pregnant people^[3]Asemi Z, Askari G, Fallah M. Is Vitamin D Status Associated with Depression, Anxiety and Sleep Quality in Pregnancy: A Systematic Review. Advanced Biomedical Research. 2020;9:32. . Dr. Gleaton suggests adding vitamin D sources—such as eggs and sardines—to your plate, as it can help protect against drops in mood-boosting hormones such as dopamine and serotonin.

And when it comes to caffeine and sugar, practice moderation. “These can trigger or worsen feelings of stress and anxiety,” says Dr. Gleaton.

FEATURED PARTNER OFFER

Partner Offers feature brands who paid Forbes Health to appear at the top of our list. While this may influence where their products or services appear on our site, it in no way affects our ratings, which are based on thorough research, solid methodologies and expert advice. Our partners cannot pay us to guarantee favorable reviews of their products or services

Enjoy 20% Off With Code FORBES20

Ritual Essential for Women Prenatal Multivitamin

• Vegan, bioavailable, and clinically-studied key nutrients
• Choline and Folate to support neural tube development
• Omega-3 DHA to support baby's brain development during pregnancy
• Nested, delayed release capsule designed for optimal absorption
• 100% ingredients Made Traceable

Shop Now

On Ritual's Website

Find a Daily Release

If your OB-GYN gives you the greenlight for exercise, go for it, says Dr. Lasseter, as the hormones you release while sweating are great for stress and anxiety relief. You can also try low-impact activities to help slow down your thoughts and feel grounded in your body, like a daily walk, yoga or meditation session, adds Dr. Gleaton.

Prioritize Rest

You need additional sleep when you’re anxious or stressed to help your body and brain recharge, says Dr. Gleaton, who recommends a solid eight to 10 hours during pregnancy. This can be easier said than done, though—a study in Obstetric Medicine found that 73% of pregnant people experience some form of insomnia by their third trimester^[4]Reichner C. Insomnia and sleep deficiency in pregnancy. Obstetric Medicine. 2015;8(4):168-171. .

Sleeping well can be difficult for pregnant people due to increased urine frequency, discomfort, acid reflux and restless leg syndrome, so you might need to allocate some time for a nap during the day. Dr. Gleaton also recommends sleeping with a pregnancy pillow to relieve some of the tension in your back, and a screen-free bedtime wind-down routine including habits like yoga, reading or journaling.

Find Things You Can Control

“Any activity that increases your sense of control will give you a rest from the adrenaline surges,” says Dr. Witkin. Try cleaning your desk or closet, organizing your wallet or paying some bills, she suggests, to balance out what you can’t control with things that you have control over.

Try a Rhythmic Activity

These types of activities can similarly help you ground yourself and calm your mind because you know what to expect next, says Dr. Witkin. She suggests listening to some slow jams, specifically music that is slower than your heartbeat (which is around 72 beats per minute), going for a jog or rewatching a favorite movie or series.

One treatment for managing more severe anxiety during pregnancy is medication. Most anxiety disorders are treated with selective serotonin reuptake inhibitors (SSRIs), which are often considered the safest type of anxiety medication to use during pregnancy, according to Dr. Lasseter.

“The most common risk associated with exposure to SSRIs in pregnancy is neonatal adaptation syndrome, which is typically a mild condition that resolves within several days without long-term effects,” says Dr. Lasseter. Neonatal adaptation syndrome may involve symptoms such as jitteriness, restlessness and rapid breathing, mostly in babies whose birthing parents took SSRIs up until delivery. In most cases, these symptoms dissipate within the first five days after birth, according to research in Nature^[5]Galabally M, Johnson A, Kohan R, Lappas M, Lewis A, Spigset O. Neonatal adaptation following intrauterine antidepressant exposure: assessment, drug assay levels, and infant development outcomes. Nature. 2017;82:806-813. .

Benzodiazepines, on the other hand, which include certain sedative drugs known by the brand names Xanax, Valium and Klonopin, can cause neonatal health issues and should ideally be tapered off during the third trimester or avoided altogether during pregnancy, per research in the Journal of Mental Health and Clinical Psychology.

It’s worth noting, though, the maternal and fetal health risks of severe untreated anxiety when weighing the potential safety risks of anxiety medications during pregnancy, which can include a greater likelihood of complications including preeclampsia, preterm labor, low birth weight and developmental delays in the baby, according to Dr. Lasseter.

If you are pregnant and experiencing feelings of prolonged sadness, fear or anxiety for two weeks or more, reach out to your doctor for guidance. Some keys to look for include anxiety impacting your sleep, appetite, work and relationships, according to Dr. Witkin.

In some cases, these concerns can be addressed in sessions with a mental health professional, whether with a partner or individually. “Most couples who are going through a pregnancy and reach out for help find that between three and eight sessions is enough, but everyone is different,” says Dr. Witkin.

Start by bringing up your anxiety to your OB-GYN, doula or midwife during your next checkup, advises Dr. Witkin. They can then provide a referral to a mental health professional who may specialize in pregnancy or fertility-related mental wellness.

Remember, pregnancy is not just about keeping your baby healthy—it’s about keeping you healthy, both physically and mentally, too.