Anxiety

Anxiety in the postnatal period can take a variety of forms.

This section describes some of the common themes which may arise when a woman experiences difficulties with anxiety postnatally.

Anxiety difficulties arising postnatally can present in a number of ways. Some of the more common themes include:

• Anxiety – about the baby’s health and development, which may be accompanied by frequent checking of the baby for signs of illness or that they are still alive, and reassurance-seeking from health professionals.
• Intrusive thoughts – that the woman, her baby or other family members may come to some harm. This form of anxiety, sometimes known as Perinatal OCD, can involve thoughts that the mother might harm her baby. Fleeting intrusive thoughts are considered relatively common among new parents, and while many parents may dismiss or forget about such a thought, others can find them deeply distressing, particularly when they become more persistent. Intrusive thoughts may be differentiated from any genuine wish to harm the baby when the thoughts produce feelings of fear or shame. Professionals can help by listening carefully and with empathy when a woman describes such intrusive thoughts, making a referral to specialist services where required.
• Social anxiety – which might involve concerns about being negatively evaluated by others, particularly regarding parenting abilities or what others might think about the baby. Some women experience a heightened sense of self-consciousness about being in public during pregnancy or when with the baby. This can include concern about strangers approaching the woman to discuss her pregnancy and talk to the baby and may also include anxiety about social contact with extended family members. The context of early parenthood can often include a degree of social isolation when mother and baby are at home for lengthy periods. For some women, this can bring the experience of having long periods without ‘adult talk’, producing reduced confidence in the ability to engage in social conversation. Social anxiety can sometimes be difficult to identify because the anxiety symptoms may not be apparent until the prospect of leaving home arises. It can therefore be useful for professionals to directly ask about the mother’s feelings about being in social situations with the baby.
• Generalised anxiety and worry – which can be associated with a range of concerns. Examples include a fear of being judged as a ‘bad mother’, which can result in a wish to do things perfectly or to avoid getting things wrong; some women may attempt to manage the challenges of caring for a baby by trying to keep things controlled and predictable, refusing help from others or avoiding changes to routine; or a more pervasive sense of dread that something will go wrong, which sometimes is a reflection of the sense of responsibility associated with caring for a baby.