Mental Health

Feeling stressed during pregnancy is very normal.
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How To Manage Stress & Anxiety During Pregnancy

Up at 3 a.m. staring bug-eyed at the ceiling? You aren’t alone.

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Yes, being pregnant can be amazing. Yes, being pregnant can be beautiful. And yes, being pregnant can be extremely stressful. Which is why its vital moms-to-be find healthy, effective ways to manage their stress.

Feelings of anxiety and worry during pregnancy are all too common, particularly during the past year and half, when women have had the surreal experience of carrying a child during a global pandemic. The line between normal anxiety and abnormal worry may feel a bit blurry. But fortunately, the methods for managing stress remain much the same.

I reached out to Dr. Alice Domar, the executive director of the Domar Center for Mind/Body Health, and the director of Mind/Body Services at Boston IVF. She is also the author of Finding Calm for the Expectant Mom: Tools for Reducing Stress, Anxiety, and Mood Swings During Your Pregnancy. Domar says that stress during pregnancy is very common and natural, particularly in the wee hours.

Stress During Pregnancy Is Normal

“It’s normal to wake up in the night and worry. I don’t think I’ve ever had a patient report not doing it at least some of the time. I like to call it the ‘the midnight imp.’ Dreams seem to be more vivid during pregnancy, and a lot of women who have never before woken up in the middle of the night to worry, do so during pregnancy,” Domar says. “They’re worrying about their health, about the baby’s health, about what it’s going to be like to have a new baby, about financial strain, about what the impact might be on siblings or a partner... it’s a lot to think about!”

It certainly is! And it would be a little weird if moms-to-be weren’t thinking about some of these things, as we know a certain amount of worry can be a good thing, and function as a means of preparation. But if anxiety starts to affect a women’s ability to function, or her overall quality of life — say mom isn’t sleeping at all, or isn’t getting enough nutrients, or is maybe even relying on alcohol — well obviously all of these things impact both the mother and fetal development.

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When The Stress Becomes Too Much

And while there are some studies that indicate that prolonged stress during pregnancy could lead to an anxious child, Domar says that the science there is a bit hazy. “An anxious woman during pregnancy doesn’t necessarily make an anxious baby. We don’t really know. You can’t really parse out nature versus nurture. If a woman is already genetically predisposed to having anxiety, well then there’s a possibility her child may as well, regardless of whether or not she was anxious during the pregnancy.”

So what should a stressed out mama do? Domar is a big fan of talk therapy, and points out that right now, most insurance mandates cover teletherapy, making it incredibly convenient. (Sure, you might have to do the session in your car for privacy, as I often do, but hey, therapy is therapy, regardless of whether you do your crying in a Subaru or on a doctor’s couch.)

Often, a lot of the things you’re stressed or anxious about during pregnancy — like making sure you have enough diapers, getting the nursery finished before the baby comes, figuring out how long to take of a maternity leave — are easier to solve and figure out when you talk them out with someone. Just the act of getting it off your chest and out of your brain can break it down into easier-to-manage ideas.

Domar also suggests talking to your OB-GYN or midwife about stress concerns, or even just reaching out to friends and family to talk over fears. “Peer support is crucial,” she says. “It can be particularly helpful to talk to someone who is at the same stage of pregnancy that you are.” Domar shares that during her own pregnancy, a friend of hers was also pregnant with a due date close to hers, and she found it comforting to talk as they were both feeling and experiencing a lot of the same things. You can join a Facebook group with people due the same month as you, as well as find friends on apps like Peanut that you can commiserate with.

Managing Anxiety

Another super effective way to manage stress? Exercise. “Exercise is probably the best antidote we know for depression or anxiety,” Domar says. If your OB-GYN says it’s OK, Domar recommends walking or doing whatever exercise you were doing before pregnancy as a way to manage stress.

And if exercise or talk therapy aren’t possibilities, there are still many other methods, all of which Domar outlines in her book. Things like prenatal yoga, meditation, or cognitive behavior therapy. Domar says there’s also research showing that back rubs from a woman’s partner can greatly reduce anxiety and depression during pregnancy. So tell your partner to grab the lotion and flex those fingers!

If you’re pregnant and feel like you’re struggling, take some deep breaths, know you’re not alone, and remember that there are lots of strategies that may help. Most importantly, don’t ever be afraid to ask for help.

If you or someone you know is experiencing depression or anxiety during pregnancy, or in the postpartum period, contact the Postpartum Health Alliance warmline at (888) 724-7240, or Postpartum Support International at (800) 944-4773. If you are thinking of harming yourself or your baby, get help right away by calling the National Suicide Prevention Lifeline at 1-800-273-8255, or dialing 911. For more resources, you can visit Postpartum Support International.


Dr. Alice Domar, Executive Director of the Domar Center for Mind/Body Health, Director of Mind/Body Services at Boston IVF, and author of Finding Calm for the Expectant Mom: Tools for Reducing Stress, Anxiety, and Mood Swings During Your Pregnancy

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