The worry has a second floor to it. First there's the baby. Then there's the fear that worrying about the baby is itself doing the baby harm. That second floor is the one that keeps the light on at three in the morning. Anxiety during pregnancy has a worse reputation than it deserves. Here is what it does and does not mean for your baby, how to tell ordinary worry from the kind worth treating, and what helps.
Is anxiety during pregnancy harmful to my baby?
Not in the way you're picturing. Everyday worry is very common and is not a sign your baby is in danger. Severe anxiety is worth treating, for your sake and your baby's.
What's worth acting on is what severe anxiety does around the edges:
Nights with almost no sleep.
Meals skipped.
An appointment cancelled because you couldn't face what might get said in it.
A long stretch of untreated worry also makes the first months after the birth harder, and that part is worth heading off now.
A note on medication
Medication is a separate question that belongs with whoever prescribes for you. Our counsellors don't prescribe. Where talking therapy can carry the load, it is worth trying first. If medication does come up, the risks and benefits belong in a conversation with your prescriber, not in a search at midnight.
Not sure whether this is the ordinary kind of worry? A free 15-minute consultation with our team asks nothing else of you.
Why am I so anxious now, when I wanted this?
Because wanting it raises the stakes rather than lowering them. The more a thing matters, the more there is to lose, and your nervous system has noticed.
On top of that, pregnancy brings a lot at once:
a body doing something unfamiliar
broken sleep
appointments where you're measured and told numbers
a great deal you can't control
other people's opinions, arriving unasked
If you've had a loss before, or a long route here through fertility treatment, your body has evidence that things go wrong. It won't unlearn that on request.
None of it means you'll be an anxious parent.
Common signs of anxiety during pregnancy
Anxiety can show up in your thoughts, your body and your habits. You might notice:
thoughts that race, or keep circling back to the same fear
trouble falling asleep, even when you're exhausted
feeling on edge, restless or quick to snap
a tight chest, a pounding heart or an upset stomach
checking, searching or asking for reassurance again and again
Some of these overlap with ordinary pregnancy changes. That's one more reason to mention them to your midwife or doctor, who can help you sort out what's what.
How much worry is normal, and when is it more?
Worrying about the baby constantly is common in pregnancy, and it's not a warning sign on its own. Four things separate the ordinary kind from the kind worth treating. They matter more than any checklist of pregnancy anxiety symptoms, including the one above.
Duration. It's most days over several weeks, rather than one bad Tuesday.
Reach. It's got into your sleep, your eating, your work or your ability to be with people.
Stickiness. Reassurance from a midwife lasts an hour instead of a week, so you go looking for more.
Avoidance. You've started skipping scans or conversations because not knowing feels safer.
Unwanted, frightening thoughts
Unwanted images of something terrible happening are frightening, and also very common in pregnancy. They are not a sign of what you would do. If they are frequent, or you have started avoiding the baby's things because of them, tell someone. That pattern has a name and a treatment.
If it feels urgent
If the worry has tipped into feeling that everyone would be better off without you, please treat that as urgent.
In Waterloo Region, Here 24/7 is reachable on 1-844-437-3247 whenever you need it.
Wherever you are in Canada, 9-8-8 takes calls and texts.
Around Ottawa, 613-722-6914 gets you the Mental Health Crisis Line, or 1-866-996-0991 toll free. 613-238-3311 gets you the Distress Centre of Ottawa and Region.
If you're in danger tonight, go straight to your nearest emergency department, or call 911.
Will getting help affect my pregnancy?
Talking to a counsellor carries none of the questions medication carries, because there's nothing to cross a placenta. It's confidential like any health record. And being anxious while pregnant is not held against you as a parent. That fear is the one that keeps people quiet.
Your midwife, family doctor or obstetrician has had this conversation many times. "I'm worrying more than I think is normal" is enough to start with.
What helps right now, tonight?
A few small steps can take the edge off an anxious evening:
Name the specific fear, not the fog. "Something will go wrong" can't be answered. "I won't know if something is wrong between appointments" can be. Ask your midwife exactly what to watch for and when to call.
Put a fence around the searching. One window a day, and write your questions down for the next appointment. Nine tabs open at midnight is a machine for making worry worse.
Make the exhale longer than the inhale for two minutes. For example, breathe in for a count of four and out for a count of six. It won't fix the thought. It brings your body down far enough to handle it.
Say the sentence out loud to one person. Not the tidy version.
Move, if your body allows it and your care provider agrees. A walk in daylight does more for an anxious evening than another article.
Park the worry until morning. If a worry wakes you at night, jot it down on paper by the bed. Then let the morning version of you deal with it.
What perinatal counselling looks like in Ontario
Perinatal anxiety gets worked with the way other anxiety does, adjusted for the fact you're tired, on a deadline and uncomfortable. Courses tend to be short and aimed at the worry loop, the reassurance-seeking and the sleep. We also see partners, who are often frightened and saying nothing.
What a first session can look like
A first session is mostly a conversation. Your counsellor will ask what's been happening, what worries you most and what you'd like to feel different. Together you'll decide what to work on first, and you set the pace.
Free and private options
Ontario Structured Psychotherapy is the free, publicly funded route for anxiety disorders, and adults can refer themselves. Waits vary by region, so apply even while you look privately. If low mood is the bigger part of this, or you want support that carries on after the birth, see our page on prenatal and postpartum therapy.
Privately, there are five offices to choose between, and video sessions work from anywhere in the province, which matters in a third trimester. In many cases we can bill your insurance directly, depending on your plan and your therapist. You don't need a doctor's referral to book. And a first appointment is not months out.
Frequently asked questions
Is it normal to feel anxious during pregnancy?
Yes. Some worry is a normal part of pregnancy. It becomes worth treating when it lasts for weeks, spreads into your sleep, eating or work, or starts to shape what you avoid.
Can I see a counsellor online while pregnant?
Yes. Video sessions work from anywhere in Ontario. That can make things easier late in pregnancy, or in the early weeks after the birth.
Should I tell my midwife or doctor?
It helps. They have heard it many times before, and they can check whether anything physical needs attention.
Getting support
Pregnancy is a lot to carry alongside this. Fifteen free minutes of somebody else's attention can be booked whenever it suits you.
If you are in crisis, call or text 9-8-8, or call Here 24/7 at 1-844-437-3247. In an emergency, call 911.