Summary
Pregnancy can bring joy—but it can also bring anxiety, intrusive thoughts, perfectionism, and self-doubt. This guide explains how anxiety and OCD may show up during pregnancy and offers tools for coping with distress, reducing over-responsibility, challenging unhelpful thought patterns, and staying grounded in what matters most. Whether you’re dealing with everyday worry or feeling overwhelmed by obsessive thoughts or uncertainty, you’ll find tools backed by evidence—and a reminder that you’re not alone.
Tools to Calm Your Mind and Reconnect with What Matters Most During Pregnancy
Pregnancy is often thought of and portrayed on social media as a time of pure joy and excitement. However, for many women, it also comes with a range of emotional experiences, including anxiety, distressing thoughts, mood swings, heightened sensitivity, self-doubt, and a deep sense of responsibility or perfectionism. These feelings can vary—some may experience occasional worry or discomfort, while others may feel significantly overwhelmed. Sometimes, these emotions can escalate into obsessive-compulsive disorder (OCD), characterized by intrusive thoughts—often involving fears of unintentionally harming the baby or concerns about parenting abilities—and repetitive behaviors like excessive checking, seeking reassurance, or rigid routines. Worrying during pregnancy is common but can lead to a cycle of negative thoughts and behaviors, like over-researching or seeking constant reassurance. While these behaviors might seem like ways to cope with uncertainty, they usually intensify anxiety and distress without leaving you more prepared.
At The Center for Anxiety, OCD, and Cognitive Behavioral Therapy, we regularly support women and their partners managing anxiety and OCD during pregnancy. Our team of psychologists helps individuals effectively cope with distressing thoughts and regulate challenging emotions. In this blog, we’ll explain how anxiety and OCD may manifest during pregnancy and share some practical skills to help navigate these challenges.
How Media and Social Media Fuel Anxiety and OCD
Social media can offer valuable information and connection, yet for many of our patients, these platforms can also heighten anxiety during pregnancy. When was the last time you saw someone post about lying in bed, feeling sick, or exhausted during pregnancy? Probably not recently. But when was the last time you saw a happy, glowing post of someone working out in their second trimester? Probably quite recently. Platforms like Instagram, Facebook, and TikTok often portray pregnancy unrealistically, highlighting idealized moments rather than everyday realities. If your experience differs from these portrayals, you might feel you’re doing something wrong.
Moreover, while social media can spread scientific information related to pregnancy, they often propagate fear-based messaging and misinformation. For example, seeing posts claiming “drinking any coffee during pregnancy will harm your baby,” or “ultrasounds are dangerous and should be avoided,”can cause unnecessary worry, prompting you to obsessively question your actions, seek reassurance, or research these topics online.
Similarly, other media sources can also contribute to anxiety by presenting information in problematic ways. Articles or news releases frequently highlight only snippets of scientific studies about pregnancy without providing important context. They may neglect to review the strength or limitations of the evidence, omit relevant debates or controversies, overlook contradictory findings, or fail to discuss what the broader body of research indicates. This incomplete picture can leave readers confused and unnecessarily worried.
Given these challenges, we encourage clients to approach all media—including social media and news sources—with a ‘detective mindset,’ critically evaluating sources for credibility, accuracy, balance, and emotional impact. Remind yourself regularly that what you’re seeing may not reflect the full truth or your personal reality. Being deliberate about what information you consume and taking regular breaks from social media and other media can help reduce anxiety and reconnect you with your own experience.
How Your Values and Self-Doubts Can Intensify Anxiety
Beyond external factors like social media, anxiety during pregnancy is often intensified by internal factors, including your deeply held values and personal self-doubts.When you’re pregnant, it’s natural for your anxieties to feel especially intense because they often relate directly to your most deeply held values—like keeping your baby safe, making good parenting decisions, and being the kind of parent you want to be. If you didn’t care so much about these important values, you probably wouldn’t worry so deeply.
Your fears may reflect uncertainties or self-doubts about how well you’re meeting these values, such as effectively protecting your baby or managing your pregnancy. These doubts can leave you feeling unsettled, overwhelmed, or emotionally drained. Even small questions—like whether you’re getting enough nutrients, staying hydrated, or managing stress appropriately—can quickly become significant worries because they connect directly to your meaningful values.
In our work with patients, we frequently draw upon Acceptance and Commitment Therapy (ACT), an evidence-based cognitive-behavioral approach. From ACT, we encourage patients to acknowledge and allow difficult thoughts and feelings about what could go wrong, without becoming consumed by them. One practical strategy we often recommend involves balancing these anxious thoughts with intentional focus on the kind of pregnancy experience and life you truly want. Instead of becoming stuck in a purely preventive mindset—obsessively worrying about potential problems—we encourage patients to gently accept the presence of these worries while actively pursuing meaningful moments, enjoyment, and connection during pregnancy. This balanced approach helps anxiety become less overwhelming and allows you to stay connected to the positive experiences you value most.
How Does Over-Responsibility Affect Mental Health During Pregnancy?
Even as you practice acknowledging your anxieties and working toward the pregnancy experience you want, the strength of these deeply held values can sometimes push you toward taking on too much responsibility. Responsibility is generally viewed as a positive trait, especially when preparing for parenthood. We often want others to perceive us as responsible—capable and conscientious. However, when this sense of responsibility becomes excessive, it can contribute significantly to anxiety and OCD symptoms (Pozza & Dèttore, 2014; Avard & Garratt-Reed, 2021).
Over-responsibility involves feeling solely accountable for preventing any possible harm to your baby or ensuring your pregnancy unfolds perfectly. This heightened sense of responsibility can lead you to believe you must control every outcome and prevent anything bad from happening, increasing worry and distressing thoughts. You might find yourself thinking things like, “Wait, did I drink a second cup of coffee today? Am I putting my baby in danger? I’m already failing as a parent,” or “I shouldn’t be stressed, this is supposed to be a good time in life, I have to enjoy being pregnant” or “I am the only one protecting this baby, and I have to do it perfectly.” These thoughts may lead you to worry excessively and research topics like “how much coffee is safe during pregnancy?” or “does stress harm my baby?” You may set unrealistic rules for yourself such as “I can’t let work stress me out” then feel like a failure when work inevitably does become stressful.
During pregnancy, it’s helpful to adopt a more realistic view of responsibility. Recognize and acknowledge what you can and cannot control, focusing your energy primarily on what is reasonably within your influence. While this mindset might sometimes feel aspirational, simply reminding yourself that you can’t control every aspect of pregnancy, labor, or delivery can help reduce pressure. Gradually becoming more comfortable with uncertainty as a natural part of pregnancy can also bring greater peace of mind and help ease anxiety.
Recognizing Unhelpful Thought Patterns During Pregnancy
In addition to struggling with feelings of over-responsibility and strivings to be perfect, you might find yourself caught in other unhelpful patterns of thinking, often known as ‘thinking traps’ or cognitive distortions. Cognitive distortions are exaggerated or biased thought patterns that can amplify your anxiety and distress during pregnancy.
Here are some common cognitive distortions you might notice in yourself during pregnancy:
Intolerance of uncertainty: Pregnancy naturally involves many unknowns, and feeling uncomfortable with uncertainty is understandable and common. Intolerance of uncertainty occurs when this discomfort becomes overwhelming, leading you to mistakenly interpret uncertainty as a sign that something is definitely wrong or unsafe. Instead of tolerating the unknown, you may assume things are unsafe or problematic unless uncertainty is eliminated. For example, uncertainty about exactly how labor will unfold could trigger you to believe something will inevitably go wrong, causing significant anxiety or prompting constant reassurance-seeking—even though uncertainty itself doesn’t indicate real danger.
Catastrophizing: Quickly assuming the worst-case scenario will happen. For example, you might become deeply anxious over the possibility of needing a c-section because you fear it will negatively affect your ability to bond with your baby, despite evidence that many parents bond well regardless of delivery method. Another example might be believing that if you don’t follow every pregnancy recommendation exactly, your baby will inevitably suffer serious health consequences, even though these guidelines usually offer flexibility rather than rigid rules.
Filtering out positives: Focusing primarily on negative details while disregarding neutral or positive information. For example, you might fixate on a doctor’s comment that your baby is slightly underweight at 32 weeks, overlooking the reassuring context that your doctor caught this early, is not concerned and has a clear plan to address this. Or you might obsess over a slight increase in your blood pressure, while overlooking the fact that your overall health is being closely monitored and that you’re already taking appropriate steps to stay healthy.
All-or-nothing thinking: Viewing situations strictly in terms of absolutes—such as entirely good or entirely bad—without recognizing that there can be something reasonable or balanced in the middle. For instance, after learning you should limit caffeine during pregnancy, you might interpret this to mean you must have absolutely no caffeine, and then rigidly eliminate it altogether. Another example could be believing that a minor slip-up from your idea of a “perfect” pregnancy diet means you’ve completely failed as a parent.
Learning to Catch, Check, and Respond to Your Thought Patterns
By now, you may have started to notice some of the unhelpful patterns that show up during pregnancy—whether it’s feeling solely responsible for preventing harm, assuming you’ve failed after a small misstep, or reacting to uncertainty as if it signals danger. These patterns often come from a meaningful place: your values. You care deeply about being a good parent and doing the right thing for your baby. But when those values combine with self-doubt or uncertainty, they can fuel perfectionism, anxiety, and rigid thinking.
When these thought patterns become automatic, they can feel like they’re running the show. That’s why one helpful skill we often teach as part of the cognitive and behavioral therapies we use at our Center is learning how to catch, check, and respond to these thoughts in a more balanced and supportive way.
- Catch: Begin by noticing when you’re getting hooked by an anxious or rigid thought. For example, Annie, who was 16 weeks pregnant, found herself thinking, “If I don’t sleep exactly 8 hours, my baby won’t grow properly and might be born prematurely.” These kinds of thoughts often reflect over-responsibility and catastrophizing.
- Check: Pause and ask yourself if the thought might be distorted. Is it exaggerated or extreme? Is it one-sided or absolute? Is your discomfort with uncertainty making this feel more threatening than it actually is?
- Respond: You might try to reframe or soften the thought in a way that’s both realistic and self-compassionate. Annie learned to say to herself, “While sleep is important, one night of less sleep won’t determine my baby’s growth. I’m doing my best, and that’s enough.” Another approach is to create a bit of distance from the thought itself. Annie might instead say, “That’s the part of my mind that worries about doing everything perfectly—of course it shows up when I’m tired. I don’t need to believe everything it says.” This kind of gentle acknowledgment can help the thought feel less overwhelming, even if it doesn’t go away completely.
This process can be especially helpful for perfectionistic thinking or repetitive behaviors that show up as attempts to feel certain or in control. Take Sofia, for example. She was 20 weeks pregnant and struggling with obsessive thoughts about food. She found herself constantly checking ingredients to make sure everything she ate was safe. Over time, and with support, she was able to shift her thinking to: “I can’t eat perfectly and still have the pregnancy I want to have. I’m going to make informed choices, but I’m also going to stop checking every label when I eat a snack.”
These strategies are ones we frequently help patients develop in therapy—approaches that allow you to stay grounded in your values while responding to anxiety with flexibility and care.
If you’re finding it difficult to step back from these patterns—whether it’s overthinking, repeated checking, constant researching, or trying to follow rigid rules—we encourage you to explore more in our related blogs, such as You Are Not Your OCD Thoughts: Gaining Perspective on Intrusive Thoughts of Harming Yourself or Others and Uncovering the Truth: A Closer Look at the Misunderstood Realities of OCD Beyond the Stereotype, and reach out to us. And if you’re seeking support, we’re here to help. Our team specializes in evidence-based therapy for anxiety and OCD during pregnancy and can work with you to reduce the emotional intensity of these thoughts and build a more grounded, fulfilling experience of this important time.
Finding Stability in Moments of Uncertainty and Stress
Even with practice catching and responding to your thoughts, pregnancy can still bring moments when anxiety feels overwhelming—especially in the face of uncertainty. From questions about labor and delivery to worries about how your baby is developing, the unknowns can feel intense. If you’ve heard difficult birth stories or had challenging experiences yourself, these fears can grow stronger, leaving you feeling out of control or stuck in spirals of worry.
In therapy, we often help patients build a personalized set of coping strategies to draw on in these moments. These may include mindfulness practices like breath awareness and present-moment focus, emotion regulation skills to manage intense feelings, and cognitive and values-based techniques—including the ones described above. One helpful type of skill that’s especially easy to describe and try on your own is a grounding exercise—something you can use to reconnect with the present moment when anxiety pulls you into imagined fears about the future.
One example is the 5-4-3-2-1 grounding technique:
- 5 things you can see – Look around and name five objects in your environment.
- 4 things you can touch – Focus on textures: your clothing, a blanket, or your chair.
- 3 things you can hear – Notice background sounds like traffic, birds, or your own breath.
- 2 things you can smell – Inhale a calming scent or simply notice the air around you.
- 1 thing you can taste – Sip water, chew gum, or notice the aftertaste of a meal.
This exercise helps anchor your attention in the here-and-now, offering a moment of calm and clarity when anxiety feels all-encompassing. It’s not about getting rid of anxious thoughts altogether, but about creating just enough space to breathe, reset, and re-engage with what matters most.
Everyone’s mind and body respond differently, which is why we tailor coping strategies to each individual in therapy. You might find that grounding techniques help during anxious moments, while others benefit more from mindfulness exercises, values-based action, or behavioral strategies. The goal is to build a set of tools that help you stay present, reduce distress, and feel more supported—even when uncertainty is unavoidable. And while these tools can help you feel more grounded in the moment, it’s also important to reconnect with what matters most—your hopes, your values, and your capacity for compassion through this time of change.
Reconnecting with Compassion During a Time of Change
You are going through a profound transition. Pregnancy doesn’t just change your body—it changes your mind, your identity, your routines, your relationships, and your sense of what the future will look like. In the midst of all this change, it makes sense that anxiety and OCD might try to take over. These parts of your mind often respond to uncertainty by pushing you to tighten your grip: to control everything, to get it all exactly right, to anticipate every possible risk. But pregnancy and parenting don’t reward perfection—they require flexibility.
That’s why self-compassion matters. It offers an alternative to anxiety’s rigid demands. Compassion doesn’t ask you to stop caring or to let go of what matters—it invites you to stay grounded in your values, while meeting yourself with more kindness and openness along the way.
We often invite patients to reflect on the kind of pregnancy experience they want to have—not just what they’re trying to prevent, but what they’re hoping to feel and connect with. What would it be like to have a little more openness, even alongside anxiety? Can you allow yourself to feel your baby move, and notice what that stirs in you? Are there moments when calm, joy, humor, or love can still show up—without needing the fear to disappear first?
These questions aren’t easy, and you don’t have to answer them all at once. But they can gently shift your focus from only avoiding what could go wrong, to noticing what you want to make space for. Reconnecting with compassion helps loosen the grip of anxiety and OCD. It allows you to move through pregnancy not from fear alone, but with more flexibility, meaning, and care.
If you’d like to explore more on this topic, we recommend our related blog posts:
- Self-Validation: Overcoming Anxiety and OCD with Compassion
- How Self-Compassion Can Transform Your Approach to Anxiety, OCD, PTSD, and More
We also work with many patients during pregnancy to strengthen this compassionate mindset in therapy—alongside tools for managing distress, uncertainty, and self-critical thoughts. If you’re struggling to find room for compassion or calm in the midst of all the change, we’re here to help.
Ways to Find Support
Pregnancy can be meaningful and rewarding—but it can also bring real emotional challenges. If your anxiety or OCD symptoms feel difficult to manage, or if you’re struggling to stay connected to the experience you want to have, you’re not alone—and support is available.
Effective, evidence-based treatments like cognitive behavioral therapy (CBT), exposure-based strategies, mindfulness, and compassion-focused approaches can help. At our Center, we specialize in guiding people through this stage of life with clarity, flexibility, and care.
If you’re looking to learn more, we invite you to explore these related blog posts:
- Overcoming Your Anxiety: Enhancing Exposure Therapy Using DBT Skills
- Think You Might Be Worried Over Your Health? Here’s What You Need to Know
- Managing Anxiety Through DBT and CBT.
You might also benefit from external resources like Postpartum Support International or local support groups for pregnant individuals navigating anxiety or OCD. And don’t underestimate the power of informal support—talking with someone who understands can make a real difference.
You may also find the following trusted external resources helpful:
- Postpartum Support International’s Information on OCD around Pregnancy
- International OCD Foundation – Perinatal OCD
- MGH Center for Women’s Mental Health – respected, research-based site on psychological issues during pregnancy and postpartum
- MotherToBaby – information on considerations like medications, food, and caffeine during pregnancy
- Evidence Based Birth – can help use your detective mindset as it explains pregnancy-related risks, interventions, and options using accessible summaries of scientific research
At The Center for Anxiety, OCD, and Cognitive Behavioral Therapy, we’re here to help. Whether you’re working to reduce worry, loosen the grip of obsessive thoughts, or reconnect with what matters most, our team offers personalized support rooted in evidence-based care.
Engage with Us for Insight and Collaboration
As you navigate your path to managing anxiety and OCD during pregnancy, remember that you don’t have to do it alone. Our Center offers resources and care designed to meet you where you are, including comprehensive guides, detailed resources, and evidence-based cognitive and behavioral treatment.
Explore more of what we offer:
- Learn more about our structured and supportive approach to therapy on our CBT and Exposure-Based Therapy page.
- Read more about how we help with specific challenges like OCD, panic, generalized anxiety and worry, health anxiety, trichotillomania, and skin excoriation disorder and more.
- Browse our anxiety, OCD, and CBT resources page for valuable tools and self-help materials.
Dive into related blog posts:
- Overcoming Your Anxiety: Enhancing Exposure Therapy Using DBT Skills
- You Are Not Your OCD Thoughts: Gaining Perspective on Intrusive Thoughts of Harming Yourself or Others
- How Self-Compassion Can Transform Your Approach to Anxiety, OCD, PTSD, and More
- Think You Might Be Worried Over Your Health? Here’s What You Need to Know
- Managing Anxiety Through DBT and CBT.
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This blog was co-written by Allie Bond, M.A., and Daniel Chazin, Ph.D., ABPP, A-CBT
