Anxiety in Pregnancy

You will probably remember from my last post that evidence has shown that one in four women experience some form of mental illness during the perinatal period (this relates to the period of time before and after the birth) (Howard et al, 2018).
Most common mental health disorders are depression (11%) and anxiety (15%), but eating disorders, obsessive-compulsive disorder and post-traumatic stress are also seen.

These figures, though, do not always accurately reflect the true number of women who suffer, because a great number of mental ill health cases still do not get reported by the women themselves due to the stigma attached to them and the fear that women will be judged as being poor mothers who are unable to cope.

So, what exactly is anxiety?

Anxiety is a normal reaction to an unknown situation and many psychologists believe it is to be expected to be anxious about the unknown. However, it is the persons reaction to the stress response that needs to be addressed in order that it does not become all-consuming and colours an experience which otherwise should be an exciting and joyful time.
In other words, it is a feeling most people experience at various points in their lives but when it is constant and overwhelming and out of proportion to the situation then something needs to be done to address the anxiety.

Anxiety is a feeling of unease…

…like a worry or fear, that can be mild or severe. Everyone feels anxious from time to time and it usually passes once the situation is over. Anxiety can also cause a myriad of physical and mental symptoms although not everyone will experience all of the symptoms all of the time. I do not intend to list all the symptoms here or how to manage your anxiety. There are plenty of web sites where you can do this, for example…

Useful websites for symptoms of anxiety and how to help your self are: and

Talking therapies such as counselling are beneficial.  Talking through your concerns with a counsellor and therapist will help you cope with whatever is causing you to have anxious thoughts.

Pregnancy and childbirth is a time of great anxiety for some women and some of the anxiety can be expected. Your body is in an altered state physiologically so its common sense to expect your emotions and psychological health to be altered. Every woman is different and will have a different anxiety relating to herself, the baby, the labour, how they will cope and so on.

I remember one of my pregnancies feeling terrified that every time the post person delivered a letter or a parcel that it was a bomb! (This being in the 1970’s when the IRA were setting off bombs in England). Why they would want to blow me up I don’t know, but all that I do know is that I had the fear. Fortunately, I was able to tell myself that it was because I was pregnant and feeling protective of my unborn baby.

I have counselled a number of pregnant women in the past who have presented to me, saying that they are just frightened, and they could not articulate the reason why.

One woman in particular, was however able to explain that there was no way that she could give birth to her baby – the very thought of it made her physically vomit. She displayed all the signs and symptoms of sheer panic at the thought of going through labour and childbirth.

After further discussion and talking to her we decided, together, that she had a mental health condition called Tokophobia .  A rare specific phobia with an overwhelming, debilitating fear of childbirth. So much so that in some instances (not in this case) women have been known to request a termination, avoid getting pregnant or as in this case opt for a caesarean section for the birth. This mental health condition can be managed if identified and as in this case a lot of work was done with myself, the clinical psychology team and the obstetrician who supported her request for a caesarean section. Other plans were put into place to support the woman, who was able to have a positive birth experience with a good outcome.

Rosemary A Harris.

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