Anxiety in the perinatal period

Click to the right above to watch a video from Best Beginnings on anxiety.

 


Contact information for your local maternity service

East and North Hertfordshire (The Lister Hospital): 01438 284 124

West Essex (The Princess Alexandra Hospital): 01279 827 286 

South and West Hertfordshire (Watford General Hospital): 01923 217 343

Contact information for your local health visiting service

Hertfordshire health visiting service:  0300 1237572

West Essex health visiting service:   0300 247 0122

Anxiety in the perinatal period

Anxiety is something we all experience from time to time. It includes both physical sensations and emotional reactions. Anxiety is a response to a situation we might see as a threat to us or a situation we feel we have no control over, for example moving house, being in a difficult relationship or giving birth. In these situations it's understandable to be worried and you may even find it hard to sleep, concentrate or eat for a brief period. These feelings of worry usually stop when the situation has resolved.

We know that manageable levels of anxiety can be helpful in certain situations such as in emergencies or when we need to meet a deadline; we all have different tolerance to stress/anxiety. However, if your feelings of anxiety are very strong or last a long time you need to access help to learn how to deal with it.

Perinatal anxiety is anxiety experienced during pregnancy or in the year after childbirth. You might hear it called:

  • prenatal or antenatal anxiety if you experience anxiety during pregnancy
  • postnatal anxiety if you experience it after giving birth
  • some women may have severe anxiety around childbirth also known as tokophobia - your local maternity service will offer support to help you manage this.  
  • you may experience panic attacks
  • if your anxiety leads you to experience unwelcome thoughts, images, urges or doubts, or there are repetitive activities that you feel you have to do, you may have Obsessive Compulsive Disorder.

Many women experience anxiety during the perinatal period. The National Institute for Health and Care Excellence (NICE) suggests that 13% of women experience anxiety during pregnancy, this is higher than figures for depression. Perinatal anxiety is less well known about, but far more prevalent than we had first thought.

How you may think:

  • racing thoughts
  • unable to concentrate
  • constant worrying
  • thinking the worst case scenario
  • doubting yourself
  • going over the same worries/thoughts
  • that other people know your are anxious and are watching you

How you may feel:

  • anxious
  • frightened
  • worried
  • stressed/on edge
  • unsettled
  • detached
  • strange (not feeling yourself)
  • feel numb

 

 

 

 

Physical signs might include: 

  • Headaches
  • Unexplained aches and pains
  • Decrease in appetite
  • Difficulty sleeping
  • Sweating
  • Stomach churning
  • Tight chest

 

 

 

Things you might start doing:

Unable to sit and relax

  • Constantly on the go/pacing
  • Find it difficult to finish off one thing
  • Eat less (or more)
  • Being snappy/increased irritability

 

 

 

We know that talking about how you are feeling can often be very difficult, however there is help out there, you do not have to feel like this. We hear that women often worry that they will be judged or seen to be 'not coping', this is a common misconception. Health professionals are aware of how common anxiety is during the perinatal period, and are able to support you and your family.

There will be a range of treatment options available to you:

Self help - offers you the option of exploring how you might be feeling through workbooks which you can download or print off. Reading well books are available from most libraries, they promote the benefits of reading for health and wellbeing.

Talking therapy is a NICE recognised therapy delivered by a therapist either face to face, over the telephone or in groups. The therapy is available wherever you live via the NHS and is completely free. Women in the perinatal period (antenatal and up to 1 year post-birth) will be prioritised for talking therapy treatment. There are many different types of therapy available including Cognitive Behavioural Therapy (CBT), which has proved very effective. You should receive your treatment within 6 weeks of the initial referral (NICE 2014).

Medication - You will need to seek the advice of your GP. For mild to moderate depression, talking therapy is the first choice of treatment and medication won't usually be considered until you have undertaken some therapy. The medications for treating depression are called antidepressants and there are lots of different ones to choose from. If you are pregnant or breastfeeding there are still antidepressants that you can take, but you need to discuss this with your GP. Please see further advice. It is not generally recommended that you take holistic medication without speaking to your GP in the first instance.

Here are some of the different ways you can access support locally:

  • Your local Health Visitor 
  • Your GP
  • Click here to find your local talking therapy service in Hertfordshire or West Essex

Birth reflections/after thoughts/debrief service:

If you have unanswered questions about your birth experience, you can contact your maternity service to discuss and understand what happened. The confidential service is run by midwives, and can help resolve any unanswered questions, discuss implications for future pregnancies and births, and give an opportunity to provide feedback both positive and negative of your experience.

Princess Alexandra Hospital - self-referral by emailing tpa-tr.antenatalclinicpah@nhs.net. Please include your name, date of birth and NHS number.

Lister Hospital: self-referral by emailing maternitybat.enh-tr@nhs.net. Please include your contact details.   

Watford General Hospital - self-refer by emailing westherts.birthdebriefservice@nhs.net. Please include your contact details.   

Self help:


For more information help and support see below:

Local Hertfordshire: Specialist Perinatal Mental Health Team  call 0300 124 0939 (out of hours mental health helpline 0800 6444 101)

Local west Essex: Perinatal Mental Health Service | Essex Partnership University NHS Trust (eput.nhs.uk) call 01245 315637 / 01702 538170

Local talking therapy service in Hertfordshire or West Essex

NHS: Mental health issues - Every Mind Matters - NHS (www.nhs.uk)

MIND Hertfordshire: NHS Talking Therapies – Counselling | Hertfordshire Mind Network (hertsmindnetwork.org

MIND Essex: Understanding Depression - Mid & North East Essex Mind (mnessexmind.org)

RCOG: RCOG welcomes RCM perinatal mental health roadmap | RCOG

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