anxiety is on the rise, and anxiety in pregnancy is no exception.

a few practical tips for identifying and calming anxiety in pregnancy.

Perinatal anxiety is unfortunately an issue often overlooked and under-recognised. A study early this year, by King's College, London found that one in four pregnant women experience mental health problems. The study identified conditions ranging from anxiety (15%), depression (11%), eating disorders and obsessive-compulsive disorder (both at 2%) and PTSD and bipolar in less than one per cent.

The symptoms of pregnancy anxiety.

Pregnancy anxiety symptoms can include an overactive mind, catastrophising and worrying about the future (including health of baby or the birth), social paranoia, insomnia, feeling tense and irritable, and other physical symptoms like sickness, shakiness, blurred sight, racing heart and breathlessness.

You may or may not have experienced some of those symptoms, but if you have, I hope you know you’re not alone. The stats testify to this, and in fact I’ve experienced some perinatal anxiety myself, which I’d like to be honest about.

Whilst I spent most of my pregnancy with Iris feeling positive and happy, I had periods of stress and worry. These were triggered by a couple of things:

First, the worry of losing Iris in early pregnancy, having experienced two miscarriages before. I found myself unable to sleep, worrying, and then convinced that I’d had a miscarriage when I lost some blood at 9 weeks. I went immediately to worst case scenario setting. It wasn’t until I went for an scan at Kings to confirm the miscarriage, that I discovered I had an 11 week old active little baby inside me. ‘Phew’ is an understatement.
But my anxiety was triggered once more when I discovered my cervix was opening at just 20 weeks of pregnancy. Meaning there was a pretty big chance I could give birth to Iris way too early. I had a cervical stitch put in, and thank goodness it worked. But that was an incredibly stressful month or so. To pretend otherwise would have been inauthentic and downright ridiculous really.

So here I want to share some top tips for dealing with anxiety in pregnancy, many of which I and my clients have used and found helpful.

NB. I want to flag that sometimes its important to access specialist maternal mental health services, particularly if you are finding life stifled by anxiety on a day to day basis. CBT and other forms of Talking Therapy can be particularly helpful.

But there are things that you can do to help yourself too.

Be honest about how you feel. You’re not alone.

If you experience anxiety in pregnancy, please don’t feel bad about feeling bad. It’s normal, especially when you consider the terms like ‘high risk’ that some of us are labelled with in pregnancy, or the birth horror stories you hear, or the terrible news stories we’re fed every day.

Tell people how you feel. Your partner, friends, a therapist, just whoever you trust will listen to you and understand. Finding a non judgemental space to be listened to is key.

Although admitting you feel low, stressed, anxious (or whatever it is) can be daunting, it’s often the case that as soon as you share how you feel, others may confide that they feel the same, or their sympathetic ear will be enough to start to ease the load.

Look after yourself. Listen to your body. slow down.

Please take care of yourself. If you feel energetic, go for it. If you are feeling tired, rest. Stopping doesn’t make you weak.

When I was pregnant with Joseph (my first), I continued rushing around, going out in the evenings a lot, doing a pregnancy yoga evening class every week , religiously, even when I was feeling exhausted and really wanted to stay at home on the sofa. I wish I’d slowed it down a notch or three.

Second time around, I made sure my energy levels matched my plans. When they didn’t, I apologised, cancelled and gave myself a break. I also applied this rule: go because I want to, not because I should do.

So, shake off the ‘should’s’ and be OK with not doing stuff sometimes. If you’re someone who finds that hard, try practicing it anyway - it gets easier with time. Be honest with those who you’ve made plans with and if they’re a good friend, they’ll understand and won’t make you feel guilty.

The same goes with work. Indeed, you might find that when you set firmer boundaries, your performance actually improves as you focus on doing fewer things better.

Have a break before your baby is born, and get inspired

I know women who worked up to the wire, and then regretted not taking more time to relax before their baby was born. On the other hand, I have never heard anyone say they regretted taking too much maternity leave before their baby was born.

Unless you love your job so much the thought of stopping makes you weep, or it’s incredibly relaxing (I’m struggling to think of an example of a relaxing job but I’m sure there are some!?) take some time off for yourself. The weeks before your baby comes along are precious alone time. It’s a luxury to take the leave, but if you can do it, seize this time. It won’t come around again.

I don’t advocate taking lots of time off and spending it ruminating on all the things that could go wrong in pregnancy, birth, motherhood, life generally. Keep busy enough to be happily distracted, not totally shattered.

For example, when I was pregnant with Iris, I had a month off before I was due (I took annual leave, instead of saving it for the end of my maternity leave). When I wasn’t running around after Joe, I spent this time doing things I wouldn’t do so much with a baby in tow. Like going to galleries, to Peckhamplex to see a film in the middle of the day (joy) and sitting in cafes with friends. Or I just pottered around at home, did some drawing and watched Netflix. Lots of Netflix.

Depending on what inspires you, do more of it! Drawing, cooking, galleries, exercise. As the mental health charity Mind says, physical activity can help distract you from any thoughts making you anxious, and also use up some of the anxious energy you might be feeling. When you get into your flow with a task like sewing, writing or drawing, you can give your mind a rest.

Try out Hypnobirthing

Particularly useful for combatting anxiety in pregnancy in the third trimester.

The birth preparation you opt for is definitely down to personal preference. Anything that helps you feel confident, knowing what to expect and what you can do to influence labour positively is a GOOD THING and can take away much of the anxiety around giving birth in particular.

For me, Hypnobirthing is the ultimate preparation. I would say this given I teach it, but I chose to teach hypnobirthing because it makes a difference for everybody who does a course and I’ve seen first hand how transformative it can be for perinatal anxiety.

The techniques are designed to help you relax on command, to build up your belief in your ability to give birth and to release fears and anxiety. This often leaves women feeling more confident and capable, and can be particularly helpful for anyone with anxiety and fear about childbirth.

My approach is particularly focused on helping women shake off pressure and self criticism and be kinder to themselves instead. This is about upping the self care, and letting go of the disregard for ones-self.

The strategies to help you focus on the positive make it easier to enjoy the pregnancy. Avoiding negative birth stories and seeking out positive birth stories is one way of doing this. The breathing techniques and relaxation exercises can quickly help to reduce tension in the muscles and the mind.

I focus a lot on the active role a partner can play in supporting women through pregnancy and birth, and this takes away the feeling that all responsibility rests on a pregnant woman’s shoulders.

It’s not unusual to find your sleep is disturbed in pregnancy, either because you’re uncomfortable or have an overactive, anxious mind. The self hypnosis practice each evening helps you to completely relax and let go of any stress built up during the day, so you can sink into a deep and restorative sleep.

Moreover, a study reported by the Royal College of Midwives revealed that self-hypnosis reduces postnatal anxiety about birth. All those studied found the hypnosis helpful, both in labour and in other areas of their lives

Be ok with ‘making a fuss’

Commuting in pregnancy can be a source of anxiety. If you are tired, asking someone if you can sit down on the train is ALWAYS better than standing and suffering because they haven’t noticed you. In two pregnancies I always asked with a smile and I never met someone who didn’t jump to give me their seat.

Physical symptoms can also make you anxious. There may be times when the baby doesn’t move, or at least you don’t feel it move, and that makes you panic. There is a reason we have maternity helplines. Use them. I rang ours to say I was worried I’d injured my baby by dancing too much at a wedding(!). The woman on the phone was so funny, she could have been a stand up comedian. She made me laugh and reassured me no end. Amongst other things, she explained that acrobats get pregnant and that in fact my baby probably had a whale of a time in there. That made me feel 100% better.

We’re lucky to have hospitals with equipment for you to hear the baby’s heart beat or see it on a screen. But many of my clients are worried about making a fuss with medical professionals. They feel guilty about wasting people’s time. They don’t want to miss work in case their boss thinks they’re slacking or being overly “paranoid and hormonal” as one mum-to-be told me. They especially don’t want anyone thinking they’re a hypochondriac.

Well here’s the thing. If you’re worried about your baby not moving, or about a pain in your tummy, it’s always better to get rid of that worry. Let it linger and it will make you tense, which will inevitably exacerbate the symptoms. Yes there may be times when you have to be rigged up to monitors for a few hours or even over night, but better that than wondering what if.

Ideally you won’t spend your pregnancy in hospital, but give yourself permission to make a fuss when you need to. If it helps, reframe ‘making a fuss’ as ‘knowing and asking for what you need’

Do a quick life audit

Pregnancy can be a source of anxiety, but there’s also a bigger picture here. There are some fundamental aspects of life that need to be OK for us not to be stressed. These include your health and wellbeing, finances, relationships, sense of meaning / purpose and your home. It’s worth thinking about how each one is for you.

You can draw a wheel of life (here’s an example) with all the categories you feel are important for you. Mark them out of 10 and take a look at whether any are lower than 5. If they are, you might want to think about what is in your power to make it better. If your finances are out of control, can you take a step to consolidate them before your baby is born? If your home is cluttered, be ruthless and fill some bags for the charity shop – it will only get more cluttered when your baby comes along, I guarantee!

Your health is your top priority. Identify some small things that’ll make a difference. Make sure you’re eating a balanced diet; as long as some greens find their way to your belly, the beige food is fine too. Do some exercise, however small. Yoga or pilates in a class or at home are great and a perfect fit with hypnobirthing.

Get out in nature

Research tells us nature is wonderful for mental health. We don’t need research to tell us that though. It feels GOOD to get outside!

Fill your lungs with fresh air.

Fill your eyes and heart with trees, sky, clouds, rivers and best of all, the sea.

London is full of wonderful parks and woodland. Here’s a nice list of 10 quiet green spaces in South East London.

Get out, drink it all up, breathe deeply and feel your anxiety flow away.

from me, to you…

During my cervical stitch time, I used many of the methods above. I tried to keep as calm as I could with my hypnobirthing relaxation practice, using self hypnosis and positive affirmations to steer my mind in a positive direction. Here are a couple of examples; you can download these and more for FREE from my website here.

I used conscious breathing techniques, which were so helpful during the appointments and the operation too. I sought as much medical advice as I could from the experts at St Thomas’s.

Perhaps most importantly, I was honest with myself and others about how I was coping day by day and I treated myself with as much care and kindness as I could, knowing it would benefit my baby too.

I hope you find some ways that work for you too.

Please feel free to share any of your own thoughts or tips in the comments below.

7 ways to calm and reduce pregnancy anxiety