What is prenatal anxiety?

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If a doctor recommends medication for prenatal anxiety, there are several options they may prescribe. While all medications have risks, doctors will aim to prescribe the safest medications at the lowest effective dose.

There are medications that doctors use to treat anxiety that they also recommend for treating depression. Antidepressants that healthcare professionals may prescribe during pregnancy include:

• Some selective serotonin reuptake inhibitors (SSRIs): A large study found no link between sertraline (Zoloft), one of the most commonly prescribed SSRIs, and congenital disabilities. Although they did find that paroxetine (Paxil) and fluoxetine (Prozac) had some associations with some congenital disabilities, it is important to note that the risk of these conditions is still incredibly low.
• Serotonin and norepinephrine reuptake inhibitors (SNRIs): SNRIs also offer a relatively low-risk option for pregnant individuals with anxiety. Examples of these types of medications include duloxetine (Cymbalta) and venlafaxine (Effexor XR).
• Other medications: Doctors may prescribe other medications if SSRIs or SNRIs are not effective. Individuals can discuss the risks of each with a doctor before taking these.

Learn more about the difference between SSRIs and SNRIs.

Doctors sometimes prescribe benzodiazepines to treat severe anxiety. One 2019 meta-analysis found that these medications may have links with an increased risk of certain congenital disabilities. However, more research is necessary to investigate these findings. It is also important to note that exposure to benzodiazepines during pregnancy is rare, and individuals taking them should speak to a healthcare professional if they have concerns.

Potential risks of medication

While some studies show a link between anxiety medication use and premature birth, low birth weight, and congenital disability, there is also a risk of untreated mental health conditions. Untreated prenatal anxiety may contribute to miscarriage, preterm birth, and delivery complications.

There are also risks associated with coming off SSRI and SNRI medications, especially in a short period of time. Because these medications can cause unpleasant discontinuation symptoms, a person needs to taper them off gradually under the supervision of a doctor.

Stopping medication “cold turkey” or deciding to stop a medication before a person is ready can cause their mental health to worsen.

Learn more about coming off antidepressants.

Despite the increased risks of medications, the Centers for Disease Control and Prevention (CDC) advise that the actual risk for a congenital disability in the babies of people on some of these medications is still very low. With this in mind, individuals may need to discuss the advantages and drawbacks of medications with a doctor.

There are many ways a person can manage their anxiety symptoms. They can involve the help of a healthcare professional, such as a therapist or psychologist, or individuals can carry out other methods or lifestyle changes on their own.

Therapy

Therapy is one of the main treatments for anxiety. Some forms of therapy may be more effective than others for managing anxiety symptoms, while individuals respond differently to different types.

Cognitive behavioral therapy, for example, is an effective treatment for anxiety disorders.

Read about types of therapy.

Learn more about free or affordable therapy options.

Self-care

The following self-care tips may also be helpful:

• Reduce sources of stress: For example, a person could try scheduling their daily activities on an hourly basis. This makes an overwhelming day feel more manageable, while studies show it may help treat anxiety and depression symptoms.
• Follow a nutritious diet: Try to eat a balanced diet. A person may also wish to limit their intake of caffeine and sugar, which can make anxiety worse.
• Exercise regularly: Research indicates that physical activity can reduce anxiety.
• Get enough sleep: Try going to bed and waking up at consistent times. Use relaxation techniques, such as guided breathing, to help ease anxiety before bedtime.
• Perform relaxation techniques: Perform deep breathing, progressive muscle relaxation, and grounding techniques.
• Take part in activities: Try adding enjoyable activities into your day, such as calling a friend or reading a book.
• Take up journaling: Writing can help reduce anxiety and uncover people’s fears and anxiety triggers. It can also be helpful to bring the journal to therapy.
• Self-empowerment: This can help ease a person’s anxiety — often, learning more about a situation is empowering, and it may reduce symptoms.

Although these tips may help some people, they are general suggestions. Individuals who believe they have anxiety should speak with a doctor and seek guidance on self-care strategies before starting anything new.

Yes, pregnancy can trigger or worsen anxiety. Some research suggests that anxiety disorders are among the most common types of psychiatric disorders during and after pregnancy, affecting 11–17% of pregnant women.

It is important to note that this study, along with much of the research in this area, examines cisgender women. There is limited research on the mental health implications of pregnancy for trans and nonbinary people. One 2020 review indicates these groups may be more vulnerable to mental health difficulties during and after pregnancy. The authors of the review called for more research in the field. Additionally, it is important to note that this review looked at studies involving primarily white individuals.

Pregnancy and childbirth cause many changes, including hormonal effects, some of which involve worry and fear. A 2016 review of studies suggest the following factors may increase a person’s risk of developing prenatal anxiety:

• lack of partner support
• lack of social support
• history of abuse or domestic violence
• prior mental illness
• unplanned or unwanted pregnancy
• adverse events in life and high perceived stress
• present or past pregnancy complications
• pregnancy loss

Anxiety during pregnancy may range from mild or severe, and its symptoms may improve or worsen as the pregnancy progresses. Depression and anxiety also often occur together, with 30–58% of pregnant individuals experiencing both.

Learn more about depression and pregnancy.

Individuals may wish to speak with a doctor if they experience any or more of the following symptoms:

• anxiety that affects their everyday life, functioning, or well-being
• feeling irritable or on edge and having difficulty concentrating
• specific fears or phobias, such as the fear of giving birth
• uncontrollable feelings of worry
• persistent headaches, stomach aches, or both
• trouble sleeping

Experts recommend that pregnant individuals contact a healthcare provider if they have a history of anxiety, depression, or other mental health issues, even if they are not experiencing symptoms right now.

While anxiety during and after pregnancy is common, treatment can benefit pregnant individuals. Many medications can help, and therapy is another effective option, particularly for mild-to-moderate anxiety. Other coping strategies, such as mindfulness and self-care, can also help people manage their anxiety symptoms.

Those experiencing prenatal anxiety may need to speak with a doctor or mental health professional who can provide appropriate support and treatment.