Perinatal anxiety: one in five women experience it – but many still suffer alone before or after childbirth
Our research found that stigma often prevents women from getting help for this hidden illness.
March 23, 2020 • 7 min • Source
Becoming a parent is usually celebrated as a happy time. But it can often be stressful and overwhelming, too. While some anxiety at this time is normal, around one in five women may experience something called perinatal anxiety during their pregnancy through the first year after giving birth.
This condition is characterised by high levels of anxiety. Some women may find their symptoms difficult to control, distressing or intense, or symptoms may significantly interfere with their day-to-day lives. When this happens, it’s important to seek help.
- constantly worrying about the pregnancy or baby
- feeling tense, nervous or on-edge
- having a general sense of dread
- difficulty concentrating or racing thoughts
- behaviour or rituals to reduce negative thoughts (such as repeatedly checking the baby’s breathing throughout the night)
More physical symptoms can include heart palpitations, rapid breathing, churning stomach or nausea, light-headedness, muscle tension, headaches, and pins and needles.
The good news is that perinatal anxiety is treatable once recognised. However, it’s largely a hidden illness. Less than 50% of women experiencing symptoms of perinatal anxiety will seek help. Even fewer will go on to receive effective treatment. This is problematic, as untreated perinatal anxiety has been associated with a number of long and short-term consequences for both mother and baby. These include premature delivery, excessive infant crying, bonding issues, and adverse developmental and mental health problems in children, such as cognitive delays, poorer social competence and maturity, and increased delinquency and schizoid features.
One reason women don’t get the help they need is because perinatal anxiety is a relatively new concept. This means it’s still poorly understood by the public and healthcare professionals alike. As such, symptoms may simply go unrecognised – particularly as most perinatal mental health information, screening and interventions, focuses on depression alone.
A recent review of perinatal anxiety support websites found that information provided was often inaccurate, confusing, and frequently confused perinatal anxiety for depression. This meant women experiencing anxiety (without depressive symptoms) many not relate to the information given, leaving their anxiety symptoms unrecognised and unchecked.
My colleagues and I recently interviewed perinatal women to explore their experiences of anxiety and support. We found that women consistently said stigma was a significant barrier to asking for help. Many felt ashamed of their symptoms, and were worried that they might be seen as a “bad mother” or that their child or children might be taken away from them if they disclosed their feelings. So, many chose to suffer in silence.
Our study found that that feelings of stigma and anxiety frequently came from a mismatch between the reality of women’s experience, and their preconceived notions of what pregnancy, childbirth, and motherhood should look like. Social and mainstream media portrayals of motherhood may be partly to blame for this, setting unrealistic standards with frequent displays of well-presented mothers who appear to take naturally to motherhood – effortlessly balancing the needs of their baby with other life demands.
But many women also felt this mismatch was a result of receiving inadequate and unrealistic information before childbirth. Many felt the information given during some antenatal classes and pregnancy or parenting books was biased and “sanitised”. Much information focuses on natural childbirth and breastfeeding, giving little information about alternatives.
Only 52% of births happen without medical intervention, and 49% of women struggle with breastfeeding. Having little information about these common experiences may leave many women feeling uncertain, anxious and stigmatised.
Breaking the silence
One way of breaking down stigma around perinatal anxiety is to talk about it. A study found that being heard and understood by trusted peers can be therapeutic for perinatal wellbeing. Talking about one’s experiences may positively impact listeners, too.
Our study also found that hearing about other people’s experiences with perinatal anxiety (and parenting in general) broke down unrealistic notions of motherhood. It also helped many realise their experiences weren’t abnormal, they weren’t inadequate, and they weren’t alone in their feelings.
Unfortunately, research has yet to show specific things we can do to prevent perinatal anxiety. However, there are some risk factors that may make developing it more likely, including:
- living with extended family members
- having multiple babies
- disordered sleep
- having no partner or social support
- history of mental illness
- past or present pregnancy complications
- previous loss of a baby
Maintaining a healthy lifestyle, and trying to reduce stress will likely help prevent – or lessen – perinatal anxiety. Learning about the symptoms of perinatal anxiety might also help you recognise if you have it – and know when to get help. Our website also provides evidence-based information about perinatal anxiety, and screening tools that may help to identify symptoms and find support.
Research on treatments for perinatal anxiety is relatively limited at the moment. However, a recent review found that therapy is likely to be the most effective and safe treatment for pregnant and postpartum women. Initial research also suggests mindfulness techniques (such as breathing exercises, yoga, and meditation) may help relieve symptoms.
Gini Harrison does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.