Articles (EN)

Anxiety and fears during pregnancy

2026-05-27 12:00 Pregnancy
In short: Anxiety during pregnancy is a very common phenomenon: 15-25% of pregnant women suffer from it. Some fears are natural and normal. An anxiety disorder that interferes with normal life requires help from a psychologist or doctor. Without treatment, anxiety increases the risk of pregnancy complications and postpartum depression.

Anxiety during pregnancy - how normal is it

Pregnancy is one of the largest transitions in life. The body changes, responsibility increases, the future becomes less predictable. It's no wonder that most pregnant women experience anxiety, worry, or fear at some point.
According to research, anxiety disorders during pregnancy occur in 15-25% of women - about as common as depression, and possibly even more often. At the same time, anxiety during pregnancy often remains unrecognized and untreated - both the woman and others tend to explain it as "just hormones" or "normal excitement".
It is important to distinguish between "normal" anxiety and anxiety disorder: the first is an adaptive response that helps to prepare for change. The second is a condition that interferes with normal life, work, eating and sleeping, and requires help.

The most common fears during pregnancy

Fear of miscarriage. One of the most common fears, especially in the first trimester. The real risk of miscarriage after the heartbeat is confirmed on ultrasound is reduced to about 5%. Nevertheless, this fear is quite understandable – especially after experiencing losses or long fertility treatment.
Fear for the child's health. Anxiety about malformations, genetic abnormalities, and the correct development of the fetus is a very common occurrence. Routine ultrasound and screenings help to obtain objective data and reduce uncertainty.
Fear of childbirth. Fear of pain, complications, loss of control – tokophobia (pathological fear of childbirth) occurs in 6-10% of pregnant women. Childbirth preparation courses significantly reduce this fear.
Fear of becoming a bad mother. Lack of confidence in their own abilities, fear of not being able to cope with the child are almost universal for primiparous women. It is important to know: almost everyone has this fear, and it does not mean that you really cannot cope.
Fear of losing oneself. Career, freedom, relationships, individuality. These fears are real and deserve an honest conversation with your partner and loved ones.
Financial fears. Concerns about the family's financial support are well founded, especially in the context of maternity benefits and budget changes.

When anxiety becomes a disorder

Anxiety turns into a disorder when it:
Constant – not associated with specific reasons and does not disappear after their disappearance.
Intense – feels uncontrollable, "overwhelming".
It interferes with normal life – disrupts sleep, appetite, work, relationships.
It is accompanied by physical symptoms - palpitations, shortness of breath, sweating, a feeling of a "lump" in the throat, muscle tension.
Includes obsessive thoughts —repetitive frightening thoughts that are difficult to "turn off."
Anxiety disorders during pregnancy increase the risk of premature birth, low fetal weight, and postpartum depression. This is a medical problem, not a weakness of character.

The relationship between anxiety and physical symptoms

Anxiety and the physical symptoms of pregnancy can reinforce each other. Toxicosis, back pain, swelling - all this in itself causes concern. And anxiety increases muscle tension, disrupts sleep, lowers the pain threshold, making physical symptoms more pronounced. It is important to break this vicious circle.

How to cope with anxiety on your own

Information and an honest conversation with the doctor. Anxiety is often fueled by uncertainty. Specific questions — concrete answers. Ask the doctor everything that bothers you, do not hesitate to clarify and ask again.
Limitation of "horror stories". Forums with tragic stories, disturbing content on social networks, searching for symptoms on the Internet - all this feeds anxiety. Choose your sources of information consciously.
Relaxation techniques. Diaphragmatic breathing (slow deep inhalation and exhalation), progressive muscle relaxation, mindfulness meditation are effective for anxiety even with a short period of regular practice.
Physical activity. Moderate walking, swimming, yoga for pregnant women reduce cortisol (stress hormone) levels and increase serotonin levels. For more information, see the article Sports and physical activity during pregnancy.
Sleep and regimen. Chronic sleep deprivation increases anxiety. The right sleeping position, rituals for falling asleep, and a regular routine are your allies.
Social support. Talking to loved ones, a partner, friends who have already been mothers normalizes your experience and reduces the feeling of loneliness. Pregnancy support groups (face-to-face or online) are also a good option.
Childbirth preparation courses. They reduce the fear of childbirth, give specific tools and create a community - other pregnant women are nearby.

Professional Help for Anxiety

Psychologist and psychotherapist. Cognitive behavioral therapy (CBT) is indicated for anxiety disorders in pregnancy - this is a method with proven effectiveness, safe and does not require medication. Mindfulness approaches (MBSR, MBCT) are also used.
Drug therapy. In case of severe anxiety, the doctor may consider safe drugs. A number of antidepressants (SSRIs) are used during pregnancy if there are indications - the decision is made individually, taking into account the risk-benefit ratio. It is categorically impossible to take psychotropic drugs on your own.

When to see a doctor

See a doctor or psychologist if:
Anxiety is strong, constant and does not lend itself to independent methods.
You can't sleep normally because of anxious thoughts for several nights in a row.
Panic attacks appeared.
Anxiety is accompanied by a depressed mood, tears, loss of interest in life - depression of pregnant women is possible.
If you are thinking about harming yourself or your child, seek help immediately.

Frequently Asked Questions

Does mother's anxiety affect the child?

Chronic high stress during pregnancy can affect the development of the child - this is shown by many studies. Short-term episodes of anxiety are not dangerous. That is why it is important not to ignore the expressed anxiety - both for yourself and for the sake of the baby.

Is anxiety during pregnancy a weakness?

No. Anxiety is a medical condition with biological mechanisms, not a character trait. Seeking help for an anxiety disorder is reasonable and courageous, not weak.

Will the anxiety go away on its own after childbirth?

Some of the fears associated with pregnancy disappear after childbirth. However, untreated anxiety during pregnancy is one of the main risk factors for postpartum depression and anxiety disorder. It is better not to wait, but to ask for help.

Conclusion

Anxiety during pregnancy is a very common, but not inevitable condition. Moderate fear and anxiety are normal companions of such an important transition. When anxiety becomes constant, intense and interferes with life, this is a signal to seek help. The good news is that pregnancy anxiety is highly treatable, and by taking care of your mental health, you're also taking care of your unborn child.

Bibliography

  1. Fawcett EJ, et al. The Prevalence of Anxiety Disorders During Pregnancy and the Postpartum Period: A Multivariate Bayesian Meta-Analysis. J Clin Psychiatry. 2019. https://pubmed.ncbi.nlm.nih.gov/30371009/
  2. NICE Guideline CG192. Antenatal and postnatal mental health. NICE, 2014 (updated 2020). https://www.who.int/teams/mental-health-and-substance-use/promotion-prevention/perinatal-mental-health
  3. Nes RB, et al. Anxiety and depression during pregnancy and the first year postpartum. BMC Pregnancy Childbirth. 2021. https://pubmed.ncbi.nlm.nih.gov/33413188/
  4. Wenzel A. Anxiety in Childbearing Women: Diagnosis and Treatment. APA, 2011.
  5. Ministry of Health of the Russian Federation. Clinical recommendations: Normal pregnancy. Ministry of Health of the Russian Federation, 2023. https://cr.minzdrav.gov.ru/
  6. WHO Roadmap for Maternal Mental Health. WHO, 2022. https://www.who.int/publications/i/item/9789240058033
This material is for informational purposes only and does not constitute medical advice and is not a substitute for medical advice. If a child's sleep is accompanied by alarming symptoms, a pronounced deterioration in health, problems with breathing, feeding or weight gain, it is necessary to consult a qualified medical specialist as soon as possible, and not rely only on information from the Internet.