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Hi, I'm Kate.
Your therapist friend who refuses to sugarcoat motherhood, and isn’t afraid to spill the tea on my own messy journey.

Pregnancy can take a toll on your mental health. You feel unbelievably anxious about what lies ahead. Birth? Might seem terrifying. You have no idea how you’ll do when that moment comes. Becoming a mom? You *know* you can do it, but being in charge of a vulnerable new baby makes you nervous. Plus there’s all the unknowns: the health of the baby, the ways your life will change, if your birth plan will go as desired, how your relationship will change, and how the remaining stages of your pregnancy will go. 

For a time that’s often portrayed as “exciting,” this has been feeling intensely stressful, right? You thought pregnancy was shrieking in excitement once receiving a positive test, a healthy glow, cute maternity clothes and decorating the baby’s room. Instead it’s anxiety, “what if” thinking, intrusive thoughts, and physical discomfort. Those are all really hard to deal with. 

Whether you’re not excited about being pregnant, you’re dreading some of what lies ahead, or you’re dealing with strong waves of anxiety that you never saw coming, your mental health might need a bit more care during this time. In this post, my goal is to help you understand why anxious thoughts are so common during these months. 

What causes anxiety during pregnancy?

If you’re someone who struggles with (or is prone to) anxiety, pregnancy can be the perfect storm to trigger that. You’re not the only one! Here are some of the main reasons why things might be feeling less than calm right now. 

Anxiety lives in the future. Pregnancy is a temporary state that largely focuses on what’s ahead.

If you’re reading the resources, following the mental health accounts online, and/or going to therapy, this might sound familiar. Anxiety lives in the future. So what does that mean exactly? 

Speaking specifically about anxiety, it means that the things that are taking away from your mental wellbeing are thoughts focused on what’s to come. This can look like what if scenarios (“What if the baby isn’t healthy?” “What if I have a traumatic birth?”), worrying about things that haven’t happened yet (“Am I going to be a good enough mom?”) or feeling anxious about the future in general (“I can’t rest until I’m sure this child will have a happy, healthy life!). 

Pregnancy can really trigger this because it’s a very temporary, short-term state that largely focuses on the future. Think about it. You’re not going to be pregnant forever, it’s literally a transition time. When you find out that you’re pregnant, you have nine months to prepare. Suddenly, the focus shifts from the present moment to what lies in the near future: giving birth, learning how to become a parent, raising a child. In many ways, that nine months is a kind of limbo or waiting period. That’s anxiety inducing! Your mindset becomes largely focused on before or after the due date. That’s a very different feeling from just living your days as they come where the shifts and life changes occur more gradually.   

Perinatal anxiety starts during this phase.

When we talk about “perinatal” anything (i.e. perinatal mental health, the perinatal period, perinatal anxiety), we are talking about the time from pregnancy up until one year postpartum. This is such a critical time for women—particularly for mental health—as so much changes. The perinatal stage is just difficult for so many women. If you find that you’re anxious, unsettled, on-edge and just not feeling like yourself these days, but you’re unable to really articulate what’s bothering you, this is something to keep in mind. 

Perinatal anxiety is the uptick of anxiety symptoms (like panic attacks, an uneasy stomach, feeling like you can’t calm down or self-regulate, feeling reactive, or obsessing over minor things) that happens during this time period in someone’s life. It’s exactly like general anxiety with the only difference being its onset and that it’s triggered by this specific stage. 

Past experiences of loss or miscarriage can come up. 

If you’re pregnant after having experienced miscarriage or infant loss, your emotions might be running high right now. And they may include many feelings that are not positive. For a lot of women, excitement or happiness get majorly overshadowed by anxiety, fear, anger, resentment, sadness as you relive or continue processing what happened, or sometimes jealousy of those who haven’t experienced what you have. 

A lot of women who have loss or miscarriage in their history just feel like they can’t be happy or excited yet because they’re scared about what could go wrong. Things like check-ups, medical care appointments, planning for the baby, sharing the pregnancy news, creating a birth plan, or choosing a baby name can bring on a lot of anxiety for this group. 

So much about the baby remains unknown. 

When you’re pregnant, suddenly so many unknowns are introduced to your life. The unknowns about your baby can be particularly upsetting. That makes so much sense when you think about it. There are the immediate concerns like how your pregnancy will go and how your baby is doing as she develops. Then there are the fears around birth and the early days for both of you. It can also feel pretty strange to not yet know anything about this person who you’re about to be tied to for the rest of your life. Their personality, needs, strengths, interests, and difficulties are all going to take a significant amount of your thoughts and energy and yet all of these things remain question marks as you just wait for them to arrive. That can feel… unsettling and pretty weird. You’re not alone there!  

Physical changes and thinking about birth can impact your mental state. 

Mind and body are connected. We hear that all the time, right? But usually, we hear that in the context of why working out and eating a balanced diet improves mood. Being pregnant and experiencing physical changes (rapidly!) is another physical element that can have an impact on your mental health. Our bodies are our homes so if you’re feeling tired, lethargic, uncomfortable in your usual sleeping positions, or disconnected from your appetite which is now raging allll the time, that has an effect on you! Plus, let’s just acknowledge that body image issues are not just for teenagers or young adults. Past body image issues may be triggered as you continue to change… or new ones might emerge. So much is changing so fast and it can be hard to not recognize your own body.

As your baby continues to develop (and you both grow), birth might start to be on your mind a lot more too. Thinking about labour and how giving birth is going to go can feel… really scary. This is one of those things where the anticipation and thinking about it can make everything feel so much harder. No wonder anxiety seems to be at a high!  

Various appointments can trigger medical anxiety.

If you’re someone who suffers from medical or health anxiety, being pregnant can bring on so many triggers. There are way more appointments, check-ins with healthcare providers, tests, and changes to your body to pay attention to. Plus, you may find yourself being hyper aware of things like food safety, not being around those who are sick, and protecting yourself. Many women find this all to be so stressful. And when you go in for your scheduled checks, if certain appointments don’t go as planned, you might find yourself constantly searching for more information or waiting until the next appointment to get reassurance and peace of mind. 

There are also so many medical checks that you won’t be familiar with if this is your first pregnancy (like ultrasounds, and blood tests). It can be a steep learning curve and if physical checks and trusting others with your body makes you queasy, that can be so hard to adjust to. 

Starting a whole new life can feel really scary. 

Hey, it’s human nature to worry a little bit when things feel new and unfamiliar. Remember all of those first days of school? Remember starting a new job and wondering how you’d perform? What about moving to a new place? Starting a new chapter is HARD! I mean, that’s why most of us have established comfort zones that we like to stay in, right?

This chapter is now different. It’s perfectly acceptable for pregnancy to bring on crazy anxiety as you brace yourself for what’s right around the corner. This can sound like, “Omg! I didn’t think I’d get pregnant right away. This is happening too fast!” Or, “How am I actually going to raise a child?! I have no idea what I’m doing!” Or even, “There’s no way I’m going to be a mom in a mere three months. I need more time to prepare!” 

So much is out of your control as you wait in limbo. 

There’s that saying, “You think you have control, but all you really have is anxiety.” That might make you laugh because really, it’s true. So much anxiety stems from wanting to gain control over the uncontrollable. Perfectionists, type A people, over workers, those who plan everything to a tee, and people with high standards might relate to this. If you’re always trying to gain control over every single situation and make things go just your way and exactly as planned, pregnancy can be a huge challenge. 

In other scenarios, you might gain “control” over your anxiety by overworking yourself to get ahead or being overly organized to prevent a mishap. During pregnancy though, you’re kind of stuck in limbo. You can’t start practicing breastfeeding now, you can’t do a trial run of your first weeks postpartum, and your five-year plan (if you’re that person) is probably in danger because life’s about to get really unpredictable. This together can all feel like a serious trial. 

If you’re pregnant and your anxiety is getting the best of you, it’s helpful to know that that’s a surprisingly common experience. Hopefully this post has helped you understand why anxiety can really pick up during this phase of your life. If there’s one thing I want you to take with you though is that just because anxiety is present right now doesn’t mean that you automatically have to tolerate it as it’s showing up. You don’t have to spend nine months worrying or feeling uneasy. This is temporary and it will pass. 

Are you currently pregnant and feeling overwhelmed with anxiety? I’ve created a free workshop and workbook for moms about anxiety, what it looks like, how it feels, and how to best manage it so it stops robbing you of your joy during this phase of your life. It’s totally free! Check it out here

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Your therapist friend who refuses to sugarcoat motherhood, isn’t afraid to spill the tea on my own messy journey, and promises not to dole out cliche therapy advice.



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