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Addressing Anxiety in Pregnancy

Learn about anxiety during pregnancy, how it manifests in our bodies and the best ways to cope.

Pregnancy is a very exciting time, but it also comes with a ton of changes. In addition to these changes, pregnancy, labor and delivery can bring up feelings of uncertainty, loss of control or past trauma—all of these factors make anxiety during pregnancy a common occurrence. During a Live Lesson with our Virtual Birth Village, licensed clinical psychologist Dr. Afiya Mbilishaka dives deep into how to calm anxiety while pregnant. By understanding what anxiety is, how it feels in our bodies and applying coping strategies, we can find peace in the storm from anxiety and stress.


What is Anxiety?

Dr. Mbilishaka describes anxiety as a future-oriented mood state. It can cause feelings of worry and stress, recurring thoughts, panic attacks, muscle tension and trouble sleeping. Anxiety and fear are normal emotional states but become disorders if persistent and pervasive, cause excessive avoidance and escape and affects your daily life, work and relationships.


Anxiety during pregnancy is called antenatal anxiety and can present itself in different ways, such as generalized anxiety disorder, panic disorder, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD) and phobias.


Anxiety about childbirth is connected to fundamental human feelings, says Dr. Mbilishaka. Research shows that expecting mothers often feel anxiety about their lack of trust in their doctor, fear of their own abilities, fear of pain, loss or worst case scenarios during childbirth. And if you’ve had a previous complicated delivery, chances are you are predisposed to anxiety.


Some women may experience panic attacks. These are abrupt episodes of intense fear or discomfort. During a panic attack, you may feel breathlessness, chest pain, heart palpitations, sweating or chills, a feeling of “going crazy” and fear of dying. If you identify with these symptoms, please know an important part of managing a panic attack is recognizing it and labeling it.


How Anxiety Feels

During pregnancy, a woman’s body undergoes incredible hormone shifts, contributing to the mood changes you’ve been experiencing. Dr. Mbilishaka encourages mothers to listen to their thoughts, feelings and physiological reactions. They are our reactions to our life’s stories and stressors.


Our bodies hold onto our experiences—even those we don’t remember in our conscious mind—and our culture shapes our brains. Our body stores these self-defining moments, reactions, emotions and memories. Experiences of abuse, neglect, household experiences and dysfunction can come up, especially as we grow life and give birth. Because of this connection, our bodies give us clues about how we feel, and at times, we may need to process the past.


Please know that your body experiences anxiety for a purpose: to help you survive. When you’re anxious, it is a sign that your survival instincts are kicking in. Fight, flight or freeze are our biological reactions to stress. These three physiological responses activate different parts of our bodies so we can survive and have energy for the situation.


When our “fight, flight or freeze'' response happens, it can manifest itself in three components of anxiety. Our physiological response can cause cardiovascular and respiratory activation, gastrointestinal distress and muscle tension. Our cognitive response can show up as negative thoughts, images and emotions. And our behavioral response happens when we try to escape or avoid what is stressing us out.


Anxiety can appear in many different ways. It can look like difficulty making decisions, anger, changes in appetite, sleep problems, headaches, back pain, stomachaches, trouble concentrating, loss of interest in normal activities, increased use of alcohol and drugs, sadness and depression.


How to Cope with Anxiety

Once you start recognizing anxiety and your body’s responses, you can take action to soothe yourself. Every person will have a unique way of soothing their stress and anxiety.


Dr. Mbilishaka classifies activities to reduce anxiety under the “six R’s”:

● Relational activities foster feelings of safety with people around you.

● Relevant activities engage you in something that affirms your identity.

● Repetitive activities provide patterns and routines that give you and your brain a soothing structure.

● Rewarding activities are pleasurable and fulfilling.

● Rhythmic activities, such as those involving movement or music, help calm your neural patterns.

● Respectful activities demonstrate honor and respect toward your child, family and culture.


For some people, talking or writing about their stress can help relieve it. Others find a release through movement, such as yoga or walking, while some want to unplug through meditation, deep breathing and rest. Stimulating your mind and empowering yourself through learning something new can also channel anxiety into a positive outlet.


To figure out which types of activities might be most helpful, Dr. Mbilishaka recommends rating your anxiety on a scale of 1-100. If your number is below 50, you can often find relief by doing something that engages your senses and calms your body, such as listening to music or diffusing a soothing scent. If your number is over 50, it may be more effective to do something active, like move or exercise, change activities or talk to someone.


Your doctor, holistic health practitioner or doula is also a valuable resource for mental health questions and concerns. They may recommend specific herbs, medications or therapy to help manage anxiety. Dr. Mbilishaka suggests seeking out a maternal mental health specialist for cognitive behavioral therapy (CBT). CBT focuses on your current feelings and behaviors rather than past events. In collaboration with your therapist, you’ll work to find ways to change your thought process, so in turn, you can change those feelings and behaviors. Engaging in CBT doesn’t have to be an ongoing commitment—it can be effective in as few as 16 sessions on average.



The goal of therapy—and managing anxiety in general—is a recovery of your sense of mastery and control in life and a restored sense of safety, security and trust in yourself. Letting go of misunderstanding, self-blame and trauma allows you to find a new way forward.


You can't change the world during your pregnancy, but you can take care of yourself. By listening to your body and mind, you can take steps to be at peace and remain connected with your baby.


Join the Chicago Birthworks Virtual Village to learn about topics like this and more from the pros and experts in our village, and sign up for doula services so you can feel safe and supported during your pregnancy and beyond.

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