What Perinatal Anxiety Actually Feels Like

We talk a lot about postpartum depression. We talk far less about perinatal anxiety — anxiety during pregnancy itself — even though it is actually more common than perinatal depression and can be just as disabling. ## What It Looks Like Perinatal anxiety is not just "being a worried mom." It is: - Persistent, intrusive thoughts about something being wrong with the baby - Inability to sleep even when exhausted, because your mind will not stop - Excessive researching of symptoms, test results, birth outcomes - Avoidance of anything that might "jinx" the pregnancy - Hypervigilance about fetal movements — counting kicks obsessively, convinced each pause means something terrible - Feeling like the worst possible outcome is not just possible but likely ## Why It Goes Untreated Several reasons. First, some anxiety during pregnancy is normalized and expected — "of course you're nervous, you're having a baby." Second, the physical symptoms of anxiety (nausea, fatigue, racing heart) overlap with pregnancy symptoms, so they get attributed to the pregnancy rather than recognized as anxiety. Third, women are often reluctant to take medication during pregnancy even when it is indicated and safe. ## What Treatment Looks Like Therapy — particularly CBT — is effective for perinatal anxiety and carries no risk to the baby. For moderate to severe anxiety, medication is sometimes the right call, and the risk calculation often favors treating the anxiety over leaving it untreated. I work closely with OBs and midwives on these decisions. If you are pregnant and this sounds familiar, please tell your provider. You do not have to white-knuckle nine months.