Therapy for perinatal anxiety
You're supposed to be glowing, excited, preparing joyfully for your baby. Instead, you lie awake catastrophizing about everything that could go wrong. During pregnancy, every kick (or lack of kick) sends you into a spiral of worry. Is the baby moving enough? Too much? After birth, you watch your baby breathe obsessively, convinced they'll stop. You google every tiny symptom. You can't enjoy this time because anxiety has stolen it from you.
What perinatal anxiety looks like
During pregnancy
You may feel convinced something is wrong with the baby even when every test looks normal. You check symptoms constantly, research every sensation, and worry that you have eaten or done something harmful. Each appointment brings dread rather than comfort. Thoughts about labour or complications can take over your day. Some people avoid pregnancy content because it triggers fear, while others keep searching for reassurance that never lasts.
Physical symptoms often blend with pregnancy changes. A racing heart, tight chest, or dizziness can be hard to interpret, which makes the anxiety stronger. Panic attacks may occur and sleep becomes difficult because your mind keeps imagining worst case scenarios.
After birth
Once the baby arrives, the anxiety can intensify. You may watch them sleep to make sure they are breathing, react to every sound, and worry about SIDS or illness. Intrusive thoughts about accidents or harm can appear, which can feel frightening even though you do not want them.
Leaving the house may feel impossible, or being alone with the baby may feel overwhelming. You might seek constant reassurance from loved ones and healthcare providers or avoid appointments out of fear of bad news. Worries about being a good enough parent can feel relentless.
Understanding the numbers
Data from Canadian research studies on perinatal anxiety and mood disorders. For example, a Canadian sample found about 15.8 percent prevalence during pregnancy and about 17.1 percent in the early postpartum period.
Different types of perinatal anxiety
Generalized anxiety means worrying about everything related to pregnancy, birth, and baby care. Panic attacks during pregnancy or postpartum, with sudden intense fear and physical symptoms. Health anxiety focused on your baby or your own health. Obsessive compulsive symptoms, particularly intrusive thoughts about harm coming to the baby and compulsive checking behaviours. Social anxiety about being judged as a parent. Sometimes it's a mix of several types. They all share the common thread of anxiety stealing your ability to enjoy this time in your life.
What perinatal anxiety takes from you
Bonding and attachment
Anxiety makes it difficult to be present with your baby. You may stay on high alert, watching for danger, or feel so overwhelmed that you pull away emotionally. During pregnancy, it can be hard to feel connected. After birth, the pressure to get everything right can create distance. You miss the small moments because your mind is focused on fear rather than connection. None of this is your fault. With treatment, bonding can grow naturally once the anxiety eases.
Your relationship
Partners often want to help but do not know how. Reassurance may not work, and frustration can build on both sides. Intimacy often fades under the weight of constant worry. If you are parenting alone, the anxiety can feel even more isolating. You may withdraw or depend heavily on others, and the joy of pregnancy or new parenthood gets overshadowed by fear and tension.
Missing the experience
The hardest part is realizing you cannot get this time back. Each pregnancy is unique, and the newborn stage is brief. When anxiety takes over, you lose moments you hoped you would cherish. You may look back and remember very little because you were coping rather than living. Many parents feel grief about this even once the anxiety improves. Getting support early matters because you deserve to be present for your own life.
How therapy helps with perinatal anxiety
Why specialized perinatal care matters
Not every therapist understands the unique aspects of perinatal anxiety. You need someone who knows that intrusive thoughts about harm coming to your baby are a symptom, not a sign you're dangerous. Someone who understands the physical overlap between pregnancy symptoms and anxiety symptoms. Who knows how to work around the exhaustion and time constraints of new parenthood. Who can distinguish between realistic concerns (yes, you need to watch a newborn carefully) and anxiety-driven hypervigilance (no, you don't need to check if they're breathing every two minutes all night). The right therapist makes space for both the anxiety and the legitimate challenges of this life stage.
What therapy actually involves
Therapy during pregnancy or the postpartum period needs to be flexible. Virtual sessions are common because getting out of the house is hard. Sessions might be shorter. You might need to feed or soothe your baby during therapy. A good therapist expects all of this and works with it rather than against it.
The focus is practical and immediate. You'll work on managing intrusive thoughts, reducing compulsive behaviours like constant checking, challenging catastrophic thinking, developing realistic expectations about parenthood, improving sleep in whatever ways are possible, and building confidence in your ability to care for your baby. If trauma from previous pregnancy loss, difficult births, or other experiences is contributing to anxiety, that gets addressed too.
Effective treatment approaches
Cognitive behavioural therapy adapted for perinatal anxiety
CBT helps you identify anxious thought patterns specific to pregnancy and parenting. "Something is wrong with my baby" becomes "I'm having an anxious thought. My baby is fine based on all available evidence." You learn to tolerate uncertainty, which is crucial because parenthood is inherently uncertain. The therapy acknowledges real risks while helping you calibrate your response to actual rather than imagined danger levels.
Exposure therapy for perinatal OCD
If you have intrusive thoughts and compulsive behaviours, exposure and response prevention works incredibly well. You gradually reduce checking behaviours while learning to tolerate the anxiety that arises. For instance, if you check your baby's breathing every five minutes, you might work up to checking every 15 minutes, then every hour, then just when naturally noticing. You face feared situations (being alone with baby, going for a walk) while resisting safety behaviours. This teaches your brain that your baby is safe even when you're not hypervigilant.
Mindfulness approaches
Mindfulness for perinatal anxiety isn't about relaxation. It's about learning to be present with your baby rather than lost in anxious thoughts. You practice observing anxiety without reacting to it. Notice the thought "What if something's wrong?" without immediately checking or googling. Ground yourself in the actual moment: your baby is here, breathing, fine. This takes practice but becomes a powerful tool for breaking anxiety spirals.
Psychoeducation and normalization
Sometimes just learning that what you're experiencing is common makes a huge difference. Understanding why intrusive thoughts happen, why anxiety often worsens postpartum, what's within the range of normal new parent worry versus what's excessive. Your therapist helps you develop realistic expectations about pregnancy, birth, and infant care. This isn't minimizing your experience but rather providing context that reduces the "am I going crazy?" fear.
The therapy process
Initial assessment
Your therapist begins by understanding how your anxiety shows up. They ask what you fear most, when it started, how much time you spend on anxious thoughts, and how you are coping with sleep, eating, self care, and caring for your baby. They will ask about past anxiety, OCD, trauma, pregnancy losses, complications, support systems, and your birth experience if you are postpartum.
This is the time to be fully honest about intrusive thoughts. Thoughts like imagining dropping the baby or fearing you might harm them are symptoms of perinatal anxiety or OCD. They do not mean you will act on them. Your therapist needs to know so they can help you safely and effectively.
Active treatment
Weekly sessions are common, and you begin learning practical skills right away. You learn how to respond to intrusive thoughts differently, reduce safety behaviours, and challenge catastrophic thinking in real time. You practise these skills between sessions.
If you are pregnant, therapy includes preparing for birth and postpartum while managing current anxiety. If you are postpartum, the focus is on support for the immediate demands of caring for a baby. Many people notice improvement within four to eight weeks.
Building confidence
As anxiety lifts, you begin trusting yourself again. You can put the baby down for a nap without hovering. You can take them out without imagining the worst. Moments start to feel enjoyable instead of overwhelming. The anxious thoughts still appear sometimes, but you know how to handle them. They no longer dictate your day. This stage often takes twelve to sixteen sessions, though timelines vary, especially if birth trauma or complex feelings about parenthood are part of the work.
Find a therapist who specializes in perinatal anxiety
Choosing the right therapist matters. Each province in Canada has its own regulations, which is why working with a recognized professional can make a real difference in your care. Stellocare takes the uncertainty out of the process by listing only verified therapists you can trust.
The right therapist for you
No therapists found with these specialties in Ontario.
Try selecting a different province.Resources and strategies
Canadian support services
Pacific Postpartum Support Society
PPSS serves people across Canada with free counselling, support groups, and resources for perinatal mood and anxiety disorders. They understand the full spectrum of perinatal mental health challenges including anxiety, OCD, and panic during pregnancy and postpartum.
Pregnancy and postpartum anxiety support
Postpartum Support International has a helpline (1-800-944-4773) specifically for perinatal mental health. They can connect you with local resources and provide immediate support. Text "HELP" to 800-944-4773 for text support.
Public health nursing
Every province offers public health nurse visits during pregnancy and after birth. These nurses can screen for perinatal anxiety, provide referrals, and offer support. Don't minimize your symptoms when they ask how you're doing. Be honest so they can help.
Online support communities
PSI offers online support groups specifically for perinatal anxiety and OCD. Connecting with others who understand exactly what you're experiencing reduces the isolation and shame that often accompany these conditions.
Your healthcare provider
Talk to your midwife, OB, or family doctor. They should take perinatal anxiety seriously and be able to refer you to appropriate mental health care. If they dismiss your concerns, find another provider. Your mental health during this time matters enormously.
What you can do now
Managing intrusive thoughts
- Understand they're symptoms: Intrusive thoughts about harm are incredibly common in perinatal anxiety and OCD. Having them doesn't mean you're dangerous or a bad parent. They're distressing precisely because they're opposite to your values.
- Label them: "That's an intrusive thought, not reality." Don't engage with or try to figure out why you're having them.
- Don't seek reassurance about them: Constantly asking "Am I a bad person for thinking this?" maintains the problem.
- Let them pass: Thoughts are just thoughts. They lose power when you stop fighting them.
Reducing compulsive checking
- Set limits: If you check your baby's breathing constantly, start by setting specific check times. Every 20 minutes instead of every 2 minutes. Gradually extend intervals.
- Use a baby monitor: If you don't have one with breathing monitoring capabilities, consider it. This can reduce checking compulsions for some people, though for others it creates more anxiety. Know yourself.
- Delay the check: When you get the urge, wait 5 minutes. Often the urge passes.
- Stay out of the nursery: If your baby is sleeping and the monitor shows they're fine, resist going in to check. This is hard but necessary for recovery.
Managing general anxiety
- Limit googling: Set rules. No symptom searching after 8 PM. Maximum two searches per concern, then stop. Use blocking apps if needed.
- Schedule worry time: Give yourself 15 minutes daily to worry about everything. Outside that time, postpone anxious thoughts. "I'll think about this during worry time."
- Get outside: Fresh air and light help regulate mood and anxiety. Even sitting outside with your baby for 10 minutes matters.
- Accept uncertainty: You cannot control everything about pregnancy or your baby's health. Learning to tolerate "I don't know for certain" is crucial.
Building support
- Tell someone: Let your partner, a friend, or family member know you're struggling with anxiety. They can't fix it, but having support helps.
- Join a parent group: Not therapy, just normal parent connection. Being around other new parents normalizes the experience and reduces isolation.
- Ask for practical help: Let people bring food, hold the baby while you shower, do laundry. This reduces overall stress.
- Connect with others who get it: Online or in-person perinatal anxiety support groups provide validation and strategies from people who truly understand.
What actually helps sleep
- Sleep when baby sleeps: Yes, everyone says it and it's annoying, but try. Even 20-minute naps help.
- Have a partner take one feeding: If possible, have someone else handle one night feeding so you can get a longer stretch of sleep.
- Reduce phone use before bed: No googling symptoms or reading news before sleep. Read something light or listen to calming music instead.
- Accept "good enough" sleep: You won't sleep well during the newborn phase. That's reality. But even fragmented sleep is better than no sleep.
MindShift CBT has anxiety management tools. Expectful and Magnesium offer pregnancy and postpartum-specific meditations. Tide or any white noise app can help both you and baby sleep. Baby tracking apps (like Huckleberry) can reduce anxiety about whether baby is eating/sleeping enough, though for some people they increase anxiety, so use judgment.
Questions about perinatal anxiety
Are intrusive thoughts about harming my baby normal?
Yes. Intrusive thoughts about harm are extremely common in perinatal anxiety and OCD, affecting up to 50% of new parents to some degree. These thoughts are ego-dystonic, meaning they're opposite to your values, which is exactly why they're so distressing. Having them doesn't mean you're dangerous or will act on them. If you're frightened by the thoughts and have no desire to act on them, that's perinatal anxiety or OCD, not a risk issue. However, if you have urges to harm your baby or plans to do so, that's different and requires immediate psychiatric care.
Can anxiety during pregnancy hurt my baby?
Severe, chronic, untreated stress and anxiety can affect pregnancy outcomes, which is exactly why treatment matters. However, having anxiety doesn't mean you've harmed your baby. Many people with perinatal anxiety have perfectly healthy pregnancies and babies. The key is getting support rather than suffering in silence. Treating your anxiety is protecting both you and your baby.
I'm terrified of childbirth. Is that perinatal anxiety?
Some fear about birth is normal. Tokophobia is intense fear of childbirth that can be a manifestation of perinatal anxiety. If the fear is severe enough to make you consider avoiding pregnancy or requesting an unnecessary cesarean, or if it's consuming your pregnancy with dread, that warrants treatment. Therapy can address birth fears specifically while treating the underlying anxiety.
My partner has anxiety about the baby. Is that common?
Yes. Non-birthing partners experience perinatal anxiety too, though it's discussed less often. They worry about their partner's health, the baby's health, being a good parent, financial stress, all of it. Partners should also seek help if anxiety is interfering with functioning. Some therapists work with couples together, which can be particularly helpful.
I had a previous loss. Is my anxiety understandable or do I need help?
Both can be true. Your anxiety is completely understandable given your history, AND you deserve help managing it. Previous loss, traumatic births, infant health scares, or fertility struggles all increase risk for perinatal anxiety. Your fears make sense, but living in constant terror isn't sustainable. Therapy helps you honor your history while developing tools to manage anxiety in your current pregnancy or with your current baby.
When should I seek help versus just coping on my own?
If anxiety is interfering with sleep, eating, functioning, bonding with your baby, or enjoyment of pregnancy or parenthood, seek help. If you're having panic attacks, constant intrusive thoughts, or compulsive checking that takes significant time, seek help. If loved ones are expressing concern about your anxiety level, listen to them. Don't wait until you're in crisis. Early intervention prevents things from worsening.
Related concerns
References
- CANMAT. (2024). Clinician Pocket Guide: Management of Perinatal Mood, Anxiety and Related Disorders from the 2024 CANMAT Clinical Practice Guideline. Retrieved from https://www.canmat.org/2025/03/31/clinician-pocket-guide-management-of-perinatal-mood-anxiety-and-related-disorders-from-the-2024-canmat-clinical-practice-guideline/
- Dennis, C. L., Falah-Hassani, K., & Shiri, R. (2017). Prevalence of antenatal and postnatal anxiety: systematic review and meta-analysis. British Journal of Psychiatry, 210(5), 315-323. Retrieved from https://pubmed.ncbi.nlm.nih.gov/28302701/
- Pacific Postpartum Support Society. (2024). Services and Resources. Retrieved from https://postpartum.org/
- Postpartum Support International. (2024). Online Support Groups. Retrieved from https://www.postpartum.net/get-help/psi-online-support-meetings/
- Fairbrother, N., Janssen, P., Antony, M. M., Tucker, E., & Young, A. H. (2016). Perinatal anxiety disorder prevalence and incidence. Journal of Affective Disorders, 200, 148-155.
- Goodman, J. H., Watson, G. R., & Stubbs, B. (2016). Anxiety disorders in postpartum women: a systematic review and meta-analysis. Journal of Affective Disorders, 203, 292-331.
- Arch, J. J., Dimidjian, S., & Chessick, C. (2012). Are exposure-based cognitive behavioral therapies safe during pregnancy? Archives of Women's Mental Health, 15(6), 445-457.
- Abramowitz, J. S., Schwartz, S. A., Moore, K. M., & Luenzmann, K. R. (2003). Obsessive-compulsive symptoms in pregnancy and the puerperium: a review of the literature. Journal of Anxiety Disorders, 17(4), 461-478.
- Wenzel, A., Haugen, E. N., Jackson, L. C., & Brendle, J. R. (2005). Anxiety symptoms and disorders at eight weeks postpartum. Journal of Anxiety Disorders, 19(3), 295-311.
- Ross, L. E., & McLean, L. M. (2006). Anxiety disorders during pregnancy and the postpartum period: a systematic review. Journal of Clinical Psychiatry, 67(8), 1285-1298.
- Miller, E. S., Hoxha, D., Wisner, K. L., & Gossett, D. R. (2015). The impact of perinatal depression on the evolution of anxiety and obsessive-compulsive symptoms. Archives of Women's Mental Health, 18(3), 457-461.
- Matthey, S., Barnett, B., Howie, P., & Kavanagh, D. J. (2003). Diagnosing postpartum depression in mothers and fathers: whatever happened to anxiety? Journal of Affective Disorders, 74(2), 139-147.
- Field, T. (2017). Prenatal anxiety effects: a review. Infant Behavior and Development, 49, 120-128.
- Stein, A., Pearson, R. M., Goodman, S. H., Rapa, E., Rahman, A., McCallum, M., ... & Pariante, C. M. (2014). Effects of perinatal mental disorders on the fetus and child. The Lancet, 384(9956), 1800-1819.
- Sheen, K., & Slade, P. (2015). The efficacy of psychological treatment for postnatal anxiety: a systematic review. Journal of Reproductive and Infant Psychology, 33(4), 379-395.
About Stellocare
Stellocare is a Canadian platform where you can find the best fit therapist for you. Search the right thperaists now by asking our AI, browsing our list, or finding our social workers for personal referral.
Mackenzie Fournier
Registered Psychotherapist (ON)
Liv Noël Dakkak
Registered Social Worker (ON)
Ekta Sehgal
Registered Psychotherapist (ON)
Morgan Fancy
Registered Psychotherapist (ON)
Natasha Milloy
Registered Psychotherapist (Qualifying) (ON)
Amelia Henriquez
Registered Psychotherapist (Qualifying) (ON)
Chelsea Almeida
Counselling Therapist (PE)
Shani Ellis-Alman
Registered Social Worker (ON)
Daniella Sanchez
Registered Social Worker (ON)
Marla Soubhie
Registered Psychotherapist (Qualifying) (ON)
Jessica Marshall
Registered Counselling Therapist (NS)
Justin Appler
Registered Psychotherapist (Qualifying) (ON)
Florence Wong
Registered Social Worker (BC)
Manishapreet Grewal
Registered Psychotherapist (Qualifying) (ON)
Tiphanie Routier
Thérapeute en relation d'aide (QC)
Lindsey Cepek
Registered Psychotherapist (Qualifying) (ON)
Anna Evans
Registered Social Worker (ON)
Kat Sevsek
Registered Psychotherapist (Qualifying) (ON)
Karen Liivoja
Registered Psychotherapist (Qualifying) (ON)
Kemelle Deeble
Registered Psychotherapist (Qualifying) (ON)
Mackenzie Fournier
Registered Psychotherapist (ON)
Liv Noël Dakkak
Registered Social Worker (ON)
Ekta Sehgal
Registered Psychotherapist (ON)
Morgan Fancy
Registered Psychotherapist (ON)
Natasha Milloy
Registered Psychotherapist (Qualifying) (ON)
Amelia Henriquez
Registered Psychotherapist (Qualifying) (ON)
Chelsea Almeida
Counselling Therapist (PE)
Shani Ellis-Alman
Registered Social Worker (ON)
Daniella Sanchez
Registered Social Worker (ON)
Marla Soubhie
Registered Psychotherapist (Qualifying) (ON)
Jessica Marshall
Registered Counselling Therapist (NS)
Justin Appler
Registered Psychotherapist (Qualifying) (ON)
Florence Wong
Registered Social Worker (BC)
Manishapreet Grewal
Registered Psychotherapist (Qualifying) (ON)
Tiphanie Routier
Thérapeute en relation d'aide (QC)
Lindsey Cepek
Registered Psychotherapist (Qualifying) (ON)
Anna Evans
Registered Social Worker (ON)
Kat Sevsek
Registered Psychotherapist (Qualifying) (ON)
Karen Liivoja
Registered Psychotherapist (Qualifying) (ON)
Kemelle Deeble
Registered Psychotherapist (Qualifying) (ON)