Are you pregnant or a new mom? Have you been feeling worried or anxious? If so, this website can help. We (the writers) are four mothers with a total of eight children between us. Like most mothers, each of us struggled with worries during our pregnancies, and certainly during that roller-coaster first year with a newborn (and for one of us, newborn twins!).
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As mental health professionals, we knew about many web-based resources that help women with postpartum depression, but wondered why there weren’t more resources on how to effectively manage anxiety during pregnancy and the postpartum period. After all, anxiety and worries are so common during this time.
Your life is really busy—so we wanted to create a resource that is easy to navigate. If you are not sure where to start, take a look at the Feeling Anxious? section to get a sense of the different ways anxiety can show up for new moms (and see if you can relate). Then you may want to read through the Taking Care section and see how you are doing with self-care. Are there one or two small changes you can regularly incorporate into your day? Next you may want to look at the Flexible Thinking section - there may be some ideas you want to try out. You can then move onto the Facing Fears section, which introduces you to strategies that many have found to be very effective. Take your time through this section, and it can be helpful to find someone to support and encourage you through the steps. Finally, if you are a family member or friend of a new mom who is dealing with anxiety, you may be interested in the For Family section and see what family and friends can do to help.
We recommend taking it slow and trying one thing at a time for at least a few weeks. Some strategies take repeated practice, and don’t really “kick in” for a little while. You need to find what works for YOU.
Personal stories: Salima, Jennifer, and Ellen
Salima
Salima is a single mom with a three-month-old son, Arman. Salima experienced a healthy, uncomplicated pregnancy and was relieved when she gave birth to a healthy baby boy. The first month was a big adjustment for Salima, but overall things were going as well as she could hope. She was finally getting into a routine with feeding but Arman wasn’t sleeping for long stretches and Salima was exhausted.
About four weeks after Arman was born, Salima unexpectedly started to experience unexplained periods of dizziness. It felt like the room was spinning and things were unreal or dreamlike. She would have to sit or lie down until the sensation passed. Also, out of the blue, her heart would suddenly feel like it was racing. She would feel jittery and nervous, like she had too much caffeine. These sensations were especially likely to happen if she had been worrying about something for a long time. Salima completely lost her appetite and only felt like eating a few items like green apples and toast. Salima’s doctor asked if she was feeling depressed but she thought the symptoms didn’t quite fit. She wondered if her physical and mental changes were due to hormonal changes and lack of sleep.
During this period, Salima began to read and re-read parenting books on newborn health and sleep habits, hoping to find answers to Arman’s sleeping problem. She started to realize that parenting books are a double-edged sword for her. Instead of being helpful, the books made her feel as if she was doing everything wrong because Arman wasn’t responding. Their glowing anecdotes made it sound as if he would if she just followed their instructions on sleeping, feeding, and schedules. Salima started to distrust her own instincts. She began to constantly and repeatedly ask others for advice.
Usually a very outgoing and social person, Salima began to isolate herself at home with the baby. Timing errands between naps became more and more stressful, so she started to avoid going out unless it was absolutely necessary. Salima was able to get groceries and other necessities delivered to her apartment. This, however, has started to make her feel like a prisoner in her own home. She also worried about taking Arman out in public in case he started crying and she couldn’t calm him down. She wondering if her life would always be like this, never feeling like she could take a leisurely trip to the bookstore or coffee shop. She wondered if she would always be a slave to this new life. She found herself missing her old life and then felt guilty about thinking this way.
On the rare occasion she pushes herself to go outside for a short walk, worries pop up about Arman’s safety, like whether he is too cold, or whether a car might drive off the road and onto the sidewalk, or whether someone would grab him and run. She has stopped watching the news on television because it would create more new worries.
Most of the time Salima is too wound up to relax and enjoy her son. She feels extremely guilty and is worried that she won’t be the happy, secure mother that Arman deserves. Salima feels crazy with worry most of the time and is increasingly overwhelmed about her new role as a single mother. She says to herself, "How am I going to do this for the next week, much less the next 18 years?"
Jennifer
Jennifer is a young mother with an 8-month-old daughter, Maya. During her pregnancy she felt very protective of her unborn baby and was terrified of having a miscarriage like her sister. For the whole nine months, Jennifer would frequently go to the bathroom to make sure she was not bleeding. She would hold her breath around any chemicals and move on a bus if someone wearing perfume sat beside her. She switched to only natural products and cleansers at home, and brought her own bedsheets and cleaning products when staying at her parents’ house.
For the first few months Jennifer would check at least 10 times a night that Maya was breathing, despite having two monitors on in the baby’s room. Seeing how anxious Jennifer was, her husband offered to check on the baby instead, but Jennifer did not trust him to do it right and would refuse.
When Maya was two months old, Jennifer had a terrible dream that she was cutting up carrots in the kitchen and then turned towards Maya with the knife. Jennifer woke up covered in sweat and ran to hold sleeping Maya. Shaking and crying from the intensity of the dream, she wondered why she would have such terrible thoughts and if they meant that she could actually hurt Maya in real life.
From that moment on, things got a lot worse for Jennifer and her family. Jennifer became petrified that she would sleepwalk and stab Maya in her sleep. Every night before she went to bed, she put a gate across the kitchen door. She also put all the knives under a pile of plates so the noise would wake her up if she went looking for a knife in her sleep.
Jennifer has become afraid of being left alone with her daughter. On bad days, she begs her husband not to leave the house. She is terrified of giving her daughter a bath, afraid that she might snap and drown Maya. When she is really upset, she finds that if she sits in a certain chair in the living room and says a prayer perfectly 10 times she feels better. However, this ritual is taking up more and more time, and now she is doing this about a dozen times a day. She also feels constant nausea and a tightness around her throat and chest.
Jennifer’s husband is trying to be understanding but he’s getting tired of her obsessing and strange rituals. Sometimes she just wants to run away and leave her family forever. At least then she knows her thoughts would never come true.
Ellen
Ellen, a 37-year-old mother with a 5-year-old daughter, lives with her boyfriend. Two months ago she gave birth to their son, Kieran.
For the first 12 hours of labour, Ellen progressed well. Then her doctor discovered that the baby’s heart rate had excessively dropped and was not recovering. The medical team was concerned that the umbilical chord might be wrapped around her baby’s neck. Ellen was quickly wheeled into the operating room for an emergency C-section. The staff moved quickly around her, but did not look at her or tell her what was happening. During this whole ordeal, she was panicking and trembling uncontrollably. She felt out of control and frantic with worry about her baby. Everything was happening so fast. Ellen had always been terrified of having a C-section. She thought that she or the baby was going to die.
Ellen and Kieran stayed in the hospital for five days, recovering. Eventually they were both allowed to return home. For the first few weeks Ellen felt strangely numb and calm. Then, out of the blue, she started to have flashbacks of being wheeled into the operating room. Several times a day she relived her experience of labour, going over every detail in her head again and again. What went wrong? What did she do wrong? How could it have been different?
She would also have nightmares about her birth experience and wake up drenched in sweat with a racing heart. One minute Ellen would feel panicked and frightened, and the next minute she felt such intense rage that she would verbally snap at whoever was close by. Her relationships with her boyfriend and daughter were suffering.
Now, certain words and images trigger her. Whenever she hears an ambulance her heart races, she has difficulty breathing, and she becomes teary. Once she tried driving past the hospital, but she started shaking so much that she had to pull over. She also avoids watching any TV shows about birth and new moms. She stopped reading, which she used to enjoy doing a lot, because she can’t seem to focus on anything anymore. The hardest part for Ellen, however, is that instead of feeling positive and loving toward Kieran, she feels numb. She just wants to feel like herself again.
Recognizing postpartum anxiety
"It’s like I have all this nervous energy; I can’t slow down or turn my brain off. Like my adrenaline is pumping all the time. When I look at my baby, instead of feeling lovey-dovey, I feel my throat and chest clench. What is wrong with me?" –Jennifer
"I am so nervous all the time, I feel so out of control with worries. I don’t even want to leave the house and bump into anyone I know. If I go out I worry about Arman starting to cry—what if I can’t console him, and everyone stares at me and thinks I am a terrible mother?" –Salima
Having a newborn at home is a time of emotional upheaval, even under the best circumstances. Whether it’s a woman’s first venture into motherhood or her fourth, anxiety is a common feeling during this time. However, for some women, anxiety can start to build gradually and interfere with her ability to enjoy and take care of her new baby – and herself. Unfortunately, even medical care providers can miss the signs of prolonged postpartum anxiety, sometimes mislabeling it as postpartum depression or attributing it to all the sudden life changes. Many people don’t know that it’s possible to have an anxiety disorder and depression at the same time.
A moderate amount of new fears and worries is normal and expected during this time of change. If you are experiencing quite a bit of anxiety, it can be helpful to first learn more about what anxiety is, and how it can show up for new moms.
What is anxiety?
Anxiety is a natural, adaptive response we experience when we feel unsafe or threatened. We perceive many kinds of "threats;" some can be specific and real (e.g., being followed down a dark alley). Some feel more vague, like a general sense that something "bad" will happen. We may also have an anxious response to a threat we are imagining in our heads, like picturing a loved one getting into an accident.
We can experience anxiety in these areas:
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In our bodies (increased heart rate, sore stomach, tight chest and throat, shallow breathing, loss of appetite, difficulty falling or staying asleep, etc.)
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In our mind (racing thoughts about the future; imagining the worst-case scenario; ruminating; worrying and obsessing, etc.)
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In our actions or behaviours (avoiding certain situations, activities, places, or people; over-controlling; asking others for constant reassurance; checking things repeatedly; being extra careful and vigilant of danger, etc.)
Other possible signs of anxiety during the postpartum period:
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loss of appetite
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difficulty sleeping
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irritability
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muscle tension (grinding teeth, neck and shoulder pain, back pain, muscle twitching)
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difficulty concentrating and focusing
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forgetfulness
For more information on anxiety, see What is Anxiety?.
Everyone experiences anxiety differently
Salima experiences anxiety in her body as dizziness, feeling jittery, and suddenly feeling her heart racing. Some of her anxiety-producing thoughts include "What if I go out and Arman starts crying hysterically and I can’t calm him down" and "What if someone grabs him?" As a result, her behaviours include constantly asking for repeated and excessive reassurance from friends and care providers, obsessively reading and re-reading parenting books and blogs for hours, and avoiding going outside.
Jennifer experiences her anxious thoughts as repeated and intrusive obsessions about harm coming to her baby. Her anxious and compulsive behaviours include checking in on her baby over and over through the night, and repeating prayers to "prevent" something bad from happening. In her body, she experiences anxiety as a constant tightness in her throat and chest. She also feels nauseous. Jennifer's obsessions and compulsions slowly started to consume more and more of her energy and time and caused her significant distress.
After a traumatic birth experience, Ellen's anxious thoughts involve extremely frightening flashbacks of the birth, and nightmares. She repeatedly replays her experience of the birth over and over, tormented by what could have been. She also experiences panic attacks, especially when triggered by something that reminds her of her experience (such as hearing an ambulance). She experiences this in her body as a wave of anxiety coming over her, teariness, a racing heart, and difficulty catching her breath. Her behaviours include avoiding going near the hospital and avoiding watching certain TV shows.
Postpartum anxiety and depression
Many new moms develop sufficient ways to cope with fluctuating levels of anxiety over this time. However, some continue to struggle and become debilitated by chronic anxiety, which can contribute to the development of postpartum depression.
For more information on depression during pregnancy and after the birth of a child, see the BC Mental Health and Substance Use Services guide, Coping with Depression During Pregnancy and Following the Birth.
How much anxiety is too much?
Ask yourself the following questions to help gauge whether your anxiety is reasonable or too much:
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How long have I been experiencing this high level of anxiety?
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How much is it upsetting to me or causing me distress?
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Is it starting to interfere with my daily life?
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Do others in my life think I am too anxious?
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Is my anxiety negatively affecting my relationships?
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Is my anxiety negatively affecting my enjoyment of my baby?
Remember that some anxiety is normal and to be expected
It is also normal for anxiety levels to wax and wane over your life. This is true during the postpartum period as well. Some days or even weeks you may feel more anxious than others. Then something shifts and you feel better again. For example, your baby slowly loses weight for a week and you worry. You worry about ever getting a good night's sleep again. You worry whether your relationship with your husband or partner will ever get back on track. Then things slowly get better (of you get a good night's sleep!) and you feel more energetic and calm. Hey, maybe I can handle this, you think to yourself. Then your baby gets the flu and you worry again. This is the roller-coaster ride of early motherhood.
For some, normal levels of anxiety can escalate and turn into an anxiety disorder.
An anxiety disorder is when the anxiety is severe enough to interfere with your daily life at home and/or at work over a longer period of time. It feels like incapacitating fear.
For example, some women (like Salima) begin to feel terrified of even leaving the house. Some may begin to experience frequent panic attacks and avoid certain places. Others (like Jennifer) may spend hours obsessively washing or checking things, or feel completely exhausted by constant worries. Or some (like Ellen) have a very frightening experience during their baby’s birth and experience nightmares and frequent flashbacks, and just don’t feel like themselves.
Is your anxiety reaching the red zone?
This chart can help you decide whether you have high levels of anxiety (the "Red Zone"). If you find that you are mostly in the green zone, you can still benefit from learning about the tools to manage anxiety on this website, as they are also great for general stress management.
Everyone can benefit from these tools at some time, now or in the future.
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Yellow zone |
Red zone |
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Extra help for specific types of anxiety
Some types of anxiety need additional, more specific tools to help manage them effectively. We have linked to sections of the Adult Self-Help section of AnxietyBC’s website for these extra tools.
Panic attacks
Some new moms fear having panic attacks. They may begin to avoid doing things or going places that may bring on a panic attack or panic attack-like symptoms, such as:
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certain places that remind her of a past panic attack
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places that would be difficult to escape from should she start to feel panicky (such as the mall or public transit)
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activities that bring on similar physical sensations of panic, like increased breathing or heart rate
Sometimes this anxiety is so intense that she barely wants to leave the house. See the Panic Disorder page to find out more and learn how to manage it.
Quick facts about panic attacks
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Panic attacks are not harmful or dangerous, although they can feel very scary.
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You might feel like you are dying or going crazy, but you are not.
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Panic attacks are brief, although they sometimes feel like they go on forever.
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Panic attacks are private experiences. Others (except those very close to you) usually cannot tell that you are having a panic attack.
Obsessive compulsive behaviours
Other moms are more focused on very distressing or anxiety-provoking thoughts that seem to keep intruding into their minds, over and over. For example, she may have disturbing images of cutting up her baby, drowning her baby, her baby getting some rare contagious disease, or even some stranger kidnapping her baby. She may also imagine that everything is covered in toxic and dangerous germs.
Certain compulsions or rituals may develop as a way to deal with these distressing thoughts, such as:
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avoiding certain objects or situations
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repeating prayers or phrases in the head to keep thoughts away or “protect the baby”
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obsessively cleaning or arranging things until it "feels right"
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repeatedly checking things over and over "just in case"
Many new moms (like Jennifer) suffer in silence and feel embarrassed or guilty for having such thoughts and urges. Having these obsessions does not mean that we are crazy, dangerous, or evil deep down inside! Our safety (and the safety of our loved ones) is determined by our actions, NOT our thoughts. Intrusive, unwanted, or even disturbing thoughts are common; everyone experiences them from time to time.
To find out more about obsessions and compulsions (and OCD), see the Obsessive Compulsive Disorder page.
The difference between postpartum OCD and postpartum psychosis
Postpartum OCD (obsessive-compulsive disorder) is distinctly different from postpartum psychosis. In postpartum psychosis, the new mom has lost touch with reality and may be experiencing delusions and faulty beliefs, and may be in danger of harming the baby. For example, she may think her baby is possessed by a demon. She may hear voices and/or see things that others don't see. Postpartum psychosis is a very serious problem. If you have any concerns about yourself or someone you know, please seek professional help.
On the other hand, women who are experiencing postpartum OCD have not lost contact with reality. OCD is an anxiety disorder. Women who are suffering from postpartum OCD are often highly distressed and disturbed by their intrusive thoughts, and they behave in ways to diminish or "neutralize" their thoughts. They are so afraid that their thoughts will come true. This is not the case for women suffering from postpartum psychosis, who can't separate what they are thinking from reality and may take steps towards acting on their thoughts.
For more information, read the article “Beyond the Blues” from the International OCD Foundation.
Generalized anxiety
Other moms (like Salima) may start to experience excessive and uncontrollable worries. As a result, they may feel constantly keyed up and on edge, have excessive doubts, and have difficulty “shutting off” the mind, particularly before sleep. She may worry about things like the health and safety of her baby and her abilities as a mom.
Find out more ways to manage worries.
If you think your anxiety is excessive and uncontrollable worries are really affecting your happiness and peace of mind, see Generalized Anxiety Disorder to find out more and learn how to manage it.
Post-traumatic stress
For some women, childbirth can actually be a traumatic experience, as it was for Ellen. Women who have had a history of past traumas (like childhood sexual abuse) can be triggered by the delivery process. As a result, these moms can experience:
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upsetting and vivid memories, nightmares, and flashbacks of the childbirth
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feelings of being numb and detached
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extreme emotional and/or physical reactions when reminded of childbirth (such as starting to cry uncontrollably or becoming suddenly enraged)
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a desire to avoid things that remind her of birth experience
It's important to note that not everyone who experienced a traumatic childbirth will develop these symptoms. Some moms experience some of these symptoms for a few weeks but then recover and are able to generally move on. It’s also important to note that sometimes these symptoms do not show up right away and can develop months or even years later. However, if you feel that you may be suffering from the signs of this anxiety problem, see the Post Traumatic Stress Disorder page to find out more and learn how to manage it.
Social anxiety
Some new moms feel extremely self-conscious around others. They may have difficulty speaking in public and avoid certain places out of fear of perceived judgments and criticism. For example, a new mom may avoid going to a drop-in playgroup because she fears the others with think negative things about her. She may be highly anxious about saying or doing the wrong thing, somehow looking wrong or unacceptable, or worry about other things like blushing or freezing. Because social interactions create so much anxiety and discomfort, she may just decide to stay home and avoid other people when possible.
If you feel like you may be experiencing increased social anxiety and it is significantly interfering with your life, see the Social Anxiety Disorder page to find out more and learn how to manage it.
An untreated anxiety disorder can often put a person at increased risk for future problems with anxiety and depression. If you think your anxiety is significantly interfering with your overall well-being and/or your parenting abilities, discuss it with your maternity care provider or family doctor.
About the author
Anxiety Canada promotes awareness of anxiety disorders and increases access to proven resources. Visit www.anxietycanada.com.
