Postpartum Anxiety
Postpartum anxiety involves excessive, hard-to-control worry occurring during pregnancy or within a year after birth, affecting roughly 12% of birthing parents, per ACOG Clinical Practice Guideline No. 4.
Symptoms
Persistent, excessive worry (often focused on the baby's health or safety), restlessness, difficulty sleeping even when the baby is asleep, racing thoughts, and physical tension; intrusive worried thoughts about the baby are common and do not by themselves indicate any risk of harm to the baby.
Causes and risk
Hormonal shifts, sleep deprivation, and the major life adjustment of new parenthood all contribute; a personal history of anxiety, a difficult birth experience, and lack of support raise risk.
How it is evaluated
Screening uses tools like the EPDS and GAD-7 alongside clinical assessment, per ACOG guidance and USPSTF anxiety screening recommendations.
Treatment
CBT is the best-supported psychotherapy, per network meta-analysis data; sertraline or escitalopram are first-line medications when needed, per ACOG Guideline No. 5, though the evidence for medication specifically in the postpartum period is more limited than for the general population.
When to seek care
Postpartum psychosis -- confusion, hallucinations, or bizarre behavior appearing rapidly after birth -- is a psychiatric emergency requiring immediate care (call 911 or go to the emergency room). Any thoughts of self-harm require immediate crisis support via the 988 Suicide and Crisis Lifeline.