Most people have heard of postpartum depression. Far fewer have heard of perinatal anxiety, even though it is at least as common — possibly more. Research suggests that anxiety disorders during and after pregnancy affect up to 20 percent of mothers, making them among the most common complications of the perinatal period. The American College of Obstetricians and Gynecologists’ 2023 clinical practice guideline now recommends universal screening for perinatal mood and anxiety disorders, and Postpartum Support International maintains the leading clinician directory and a 24/7 helpline. Unlike the “baby blues,” perinatal anxiety doesn’t resolve on its own in a couple of weeks.
What Perinatal Anxiety Looks Like
Some degree of worry during pregnancy and early parenthood is normal and even adaptive. You’re responsible for a new life, and your brain is appropriately vigilant. Perinatal anxiety goes beyond normal concern. It is persistent, disproportionate, and interfering.
During pregnancy, it may look like this: constant worry that something is wrong with the baby, despite reassuring test results. Difficulty sleeping because of racing thoughts, even when physically exhausted. Avoidance of normal activities due to fear of harming the pregnancy. Excessive Googling of symptoms and worst-case scenarios. Physical symptoms — heart racing, shortness of breath, nausea unrelated to morning sickness, chest tightness — that have no medical explanation. A sense of dread that you can’t shake.
After delivery, perinatal anxiety often manifests as hypervigilance about the baby’s health and safety. Intrusive, unwanted thoughts about terrible things happening to the baby — dropping them, SIDS, accidents. These are not desires or intentions; they are OCD-like intrusions that cause enormous distress. Difficulty letting anyone else care for the baby. Inability to sleep even when the baby is sleeping. Irritability that feels out of proportion. And a pervasive sense that something catastrophic is about to happen.
Why It Gets Missed
Perinatal anxiety is dramatically underdiagnosed for several reasons. Standard screening tools at OB and pediatric appointments often focus on depression, not anxiety. Many of the symptoms — sleeplessness, worry, hypervigilance — overlap with what our culture considers “normal” for new mothers. The mother herself may not recognize it, because she believes her worry is just good parenting. And in Catholic communities, where openness to life and joyful motherhood are emphasized, admitting to pervasive anxiety can feel like a failure of gratitude.
It is not. Perinatal anxiety is a medical condition driven by hormonal changes, sleep deprivation, and neurological vulnerability. It has nothing to do with how much you love your baby or how grateful you are for the gift of life.
The Catholic Mother’s Burden
Catholic mothers often bear a particular version of this burden. If you are open to life and have multiple children, each pregnancy brings another round of hormonal upheaval. The cumulative effect on a woman’s mental health can be significant, and there is often an unspoken expectation in Catholic circles that large families should be managed with grace and joy at all times.
This expectation is unrealistic and unfair. Large families are beautiful, and they are also demanding. Acknowledging that you are struggling is not a rejection of your vocation. It is an honest reckoning with the toll that your vocation takes on your body and mind. Saints are not people who never struggle. They are people who seek help when they need it.
Treatment
Perinatal anxiety responds well to treatment. Cognitive-behavioral therapy is the first-line intervention, focusing on identifying and restructuring the catastrophic thoughts that fuel the anxiety, developing coping strategies for intrusive thoughts, and gradually reducing avoidance behaviors. For moderate to severe cases, medication may be appropriate — SSRIs are generally considered safe during pregnancy and breastfeeding, though this is always a conversation with your prescriber.
Support from partners, family, and community is also crucial. If your spouse, mother, or friend is a new mother showing signs of perinatal anxiety, the most helpful thing you can do is normalize her experience, validate her distress, and encourage her to seek professional help without judgment.
Finding Help in Colorado
At Denver Catholic Counseling, we specialize in perinatal mental health and understand the specific pressures that Catholic mothers face. Our Greenwood Village office is easily accessible from the Denver Tech Center, and we offer telehealth throughout Colorado — which means you can access support without arranging childcare or leaving home.
If you’re pregnant or postpartum and the worry won’t stop, if the intrusive thoughts are frightening you, if you can’t sleep even when the baby sleeps — you deserve help. And it is available.
“Do not fear, for I am with you; do not be dismayed, for I am your God.” — Isaiah 41:10