How To Manage Pregnancy and Postpartum Anxiety With Cognitive Behavior Therapy (CBT)


Manage Pregnancy & Postpartum Anxiety With Therapy

Pregnancy is a life-changing and transformative journey that brings a mix of emotions, ranging from joy and excitement to sadness and anxiety. As a woman takes the monumental step towards motherhood, it’s not uncommon to experience an overwhelming range of emotions, which may develop into pregnancy anxiety or depression. Fortunately, there are effective treatments available, like Cognitive Behavior Therapy (CBT), that can help expectant and new mothers navigate these emotional challenges and provide essential support during their transition. Today, I am specifically focusing on a type of therapy that after 25 years of working with pregnant and new moms, I have found to be the most effective.

Affecting approximately 1 in 5 women, pregnancy anxiety is often characterized by excessive worrying, racing thoughts, and a constant fear of harm befalling oneself or the baby. Left untreated, these persistent feelings of anxiety can escalate and give way to depression, which could have adverse effects on both the mother and the baby. Postpartum anxiety, on the other hand, plagues new mothers with similar emotional difficulties and can take a toll on their mental, emotional, and physical well-being – ultimately affecting their ability to bond with and care for their newborn.

Cognitive Behavior Therapy (CBT) is a short-term, goal-oriented form of psychotherapy that has gained prominence and recognition as an effective treatment for a wide range of mental health issues, including pregnancy and postpartum anxiety. CBT is based on the understanding that our thoughts, feelings, and behaviors are interconnected, and by changing maladaptive thought patterns, one can alter negative emotions and unhelpful behaviors.

For expectant and new mothers, CBT offers a structured framework of techniques that can help identify and challenge unhelpful thoughts and beliefs rooted in fear and worry. By replacing these negative thought patterns with healthier, more adaptive perspectives, women can gain better control over their emotions and reduce overall anxiety levels. Additionally, CBT equips mothers with essential coping skills to manage stress, boost self-esteem, and nurture their overall emotional well-being during this critical life phase.

In the following sections of this blog, I shall discuss various aspects of Cognitive Behavior Therapy for pregnancy and postpartum anxiety, delving deeper into its techniques, available support options, and evidence of its effectiveness in helping women reclaim a sense of calm and joy during their journey to motherhood.

Understanding Pregnancy and Postpartum Anxiety

As women move through the different stages of their pregnancies, it is normal to feel a tinge of worry and concern for the well-being of the growing baby inside them. However, for some women, these feelings of anxiety can become all-consuming, interfering with daily functioning and affecting quality of life. Pregnancy anxiety may manifest as excessive worry about childbirth, the baby’s health, or the ability to care for the newborn.

Similar to pregnancy anxiety, postpartum anxiety affects women after giving birth. It often involves intrusive, repetitive thoughts and fears about the baby’s well-being, accompanied by physical symptoms like a racing heart, feeling on edge, and difficulty concentrating. It is important to differentiate postpartum anxiety from the more commonly known “baby blues,” which is a temporary emotional state characterized by mood swings, weepiness, and mild anxiety, typically lasting no more than two weeks after childbirth.

Understanding the role of Cognitive Behavior Therapy (CBT) in addressing pregnancy and postpartum anxiety is key to helping women overcome these emotional challenges and embrace the joys of motherhood.

CBT Techniques to Manage Anxiety during Pregnancy and Postpartum

>Cognitive Behavior Therapy has a broad range of techniques that can be tailored to meet the individual needs of expectant and new mothers experiencing anxiety. Some of the most effective CBT techniques include:

  1. Cognitive Restructuring: This technique focuses on identifying unhelpful thoughts and beliefs that contribute to anxiety and replacing them with more balanced, rational perspectives. For instance, a pregnant woman worried about her baby’s health might learn to reframe unhelpful thoughts like “Something is wrong with my baby” to more adaptive thoughts like “I am taking good care of my baby by following my doctor’s advice.”
  2. Exposure Therapy: Pregnant or postpartum women with anxiety may experience fear or avoidance of certain situations that trigger their anxious thoughts. Exposure therapy involves gradually facing these fears in a safe, controlled environment, allowing the woman to gain confidence and reduce anxiety over time.
  3. Mindfulness and Relaxation Techniques: Deep breathing, progressive muscle relaxation, and mindfulness meditation can help lower anxiety levels and promote a sense of calm. By becoming more aware of the present moment and their physical sensations, women can learn to manage stress and tension more effectively
  4. Behavioral Activation: This technique involves identifying and scheduling pleasant, engaging activities that align with personal values and goals. This can improve mood and provide a sense of accomplishment that can combat feelings of anxiety and low self-worth.

Support Options for CBT during Pregnancy and Postpartum

There are a variety of ways women can access CBT for pregnancy and postpartum anxiety, ensuring that they receive the support best suited to their unique circumstances:

  1. Individual Therapy: One-on-one sessions with a therapist or counselor specialized in CBT can offer personalized guidance and support in managing anxiety during pregnancy or after childbirth.
  2. Group Therapy: Pregnant or postpartum women may benefit from group therapy sessions led by a mental health professional, where they can learn CBT techniques and share experiences with others going through similar challenges.
  3. Online Resources and Teletherapy: Remote CBT sessions through video calls or telephone can be a convenient option for women who are unable to access in-person therapy or prefer receiving support from the comfort of their homes.
  4. Self-help materials: Books, mobile apps, and websites offering self-guided CBT techniques can provide supplementary support for women working through their anxiety independently.

The Evidence: CBT’s Effectiveness in Treating Pregnancy and Postpartum Anxiety

Numerous research studies have demonstrated the efficacy of CBT in treating anxiety disorders, including those specific to pregnancy and postpartum. Numerous research studies have demonstrated the efficacy of CBT in treating anxiety disorders, including those specific to pregnancy and postpartum. A retrospective cohort study found that CBT effectively reduced anxiety symptoms in pregnant women, with effects persisting postpartum.

By addressing the core cognitive and behavioral components contributing to anxiety, CBT can offer lasting relief for expectant and new mothers facing emotional challenges during this transitional period in their lives.

Cognitive Behavior Therapy (CBT) is a proven, effective short-term approach for treating pregnancy and postpartum anxiety. By identifying and challenging unhelpful thought patterns and providing practical coping skills, CBT can help women successfully navigate the emotional ups and downs of pregnancy and early motherhood. It is important to note that it is just one technique that we will use in our therapy together. I don’t use a cookie-cutter approach as everyone is different and therapy is tailored to you and what you are personally going through.


Dr. Sarah Allen

Dr. Sarah Allen has 25+ years of experience helping women to transition to being the mom they want to be. She is also the Director of the Postpartum Depression Alliance of IL, a non-profit she started 20 years ago that offers information & support to pregnant & postpartum women and their families. She has also published research on postpartum depression and traumatic childbirth and presented at conferences.

If you would like to work with Sarah, please phone her at 847 791-7722 or on the form below.

If you would like to read more about me and my areas of specialty,  please visit Dr. Sarah Allen Bio. Dr. Allen’s professional license only allows her to work with clients who live in IL & FL & the UK and unfortunately does not allow her to give personalized advice via email to people who are not her clients. 

Dr. Allen sees clients in person in her Northbrook, IL office or remotely via video or phone.

    What Can I Read That Helps Me While I Am Waiting For My First Appointment With Sarah?

    If you feel that you may be experiencing pregnancy or postpartum mood disorder, or worry that you may be at risk of developing it, please download my free booklets below.

    See each specific webpage to download one or many.

    As featured in

    Warm & Knowledgeable.

    I highly recommend Dr. Allen! She is warm and so easy to talk to. She has lots of knowledge about women’s health.

    Kathryn Gardner, LCSW

    Excellent Therapist!

    Dr. Allen is a colleague of mine and she is an excellent therapist. She is warm, caring, and exceptional at her work. I refer clients to Dr. Allen and I highly recommend her if you are looking for a top notch therapist.

    Jodi Petchenik, LCSW

    Sarah Transformed Our Family’s Sleep and Sanity

    My baby didn’t sleep. She wouldn’t sleep more than a couple of hours at night and no more than 30 minutes during the day. I was completely overwhelmed and my husband and I were at each other’s throats. I was supposed to be going back to work but was barely functioning. Sarah helped us to learn how to get our baby sleeping and then she supported me in my transition back to work. She also helped my husband and I navigate how to share childcare and running the house fairly. She is a very knowledgeable therapist and has really helped us.

    Pam. L.

    Dr. Allen Helped Me to Feel More Empowered

    Dr. Allen has really helped me find my own voice. When I began therapy I would swing between being passive and doing whatever other people wanted me to do to being angry and frustrated. I have been on antidepressants for quite a few years but it wasn’t really working. Through therapy I have learned to listen to my own needs and to speak up. I used to worry that people wouldn’t like me if I didn’t agree with them but when Dr. Allen gave me the support I needed I challenged my fears. I spend a lot less time feeling angry and depressed now and I have really widened my social network. This is how I have always wanted to be but didn’t know how to get there. Dr. Allen has a very reassuring manner and makes you challenge yourself but by using small steps so you feel ready to do it. I have really come out of my shell and would recommend anyone who is feeling depressed to come and talk with her.

    Rebecca F.

    Trusted & Knowledgeable Therapist.

    When I need to refer any of my patients for talk therapy I immediately think of Dr. Allen as she is wonderful at helping people with severe and complex issues really get to the root of their problems. She is very caring and knowledgeable and I have found her extensive experience really helps people to change their lives for the better.

    Dr. Teresa Poprawski

    Dr. Allen is an expert in treating perinatal mood disorders.

    I refer as many patients as I can to Dr. Allen. She is an expert in treating perinatal mood disorders, and a well-trained and experienced therapist who is committed to working with her clients to develop a treatment plan designed for each individual. She exhibits genuine warmth, kindness and compassion for each of her clients. Dr. Allen has been a colleague of mine for more than 20 years, and I have great confidence when I refer patients to her.

    Leslie Lowell Stoutenburg

    I become empowered and a happier person.

    I began seeing Dr. Allen when my first child was around a year old. I had experienced a very traumatic birth, after a difficult pregnancy where I was on bed rest for a good portion of the time. The first year of my son’s life was spent worrying constantly. I also experienced flashbacks to the birth, which was an emergency C-section under general anesthesia. My son was in the NICU for several days following his birth, and I was not given very much information as to why. I remember thinking that he would die, or that something awful was going to happen.

    I experienced a great deal of anxiety that first year, and I thought that it was due to being a new mom. I wasn’t sleeping, I wasn’t eating as normal, and I remember being worried about leaving the house or taking my baby with me anywhere. I worried constantly about illness, germs, etc.

    The first day that I saw Dr. Allen, she gave me some questionnaires to fill out before we started talking. Then we sat down and talked about my experiences with my son’s birth and the early days of his life, and the year or so since then. I remember to this day the relief that I felt when she looked at me and said that I had PPD and PTSD, which was a result of the trauma I experienced during and immediately after the birth of my son. She explained how my brain had reacted to the stress of these events, and related it to why I was feeling the way that I felt. It made so much sense. Then, she described ways that I could get over the trauma, work through the feelings, and recover from PTSD and PPD. I felt so empowered, and so happy that the way I felt had a name, and that it was treatable. It also made me feel so validated in the ways that I had felt and reacted following my son’s birth. I wasn’t going crazy. My reaction was normal and natural. And with the help of Dr. Allen, and the type of therapy that she uses, I knew I could recover.

    It is over five years since that first visit with Dr. Allen, and I still use the tools that she taught me today to deal with stress. I credit her with helping me to become a more empowered, happier person.


    Overcoming PPD with Dr. Sarah’s Support

    When I had my first baby I had what I now know was postpartum depression but I didn’t get any help. It did go away after about 18mths but it was a miserable way to begin motherhood.  When I was pregnant with my second child I started to become depressed again and this time told my OB/GYN how I was feeling and she referred me to Sarah. By starting to deal with how I felt and change the way I was handling the stresses in my life, I was in a much better place when my baby was born. The second time round my PPD was much less severe and didn’t last as long. 

    Sarah was also really helpful in teaching me ways to make the transition of becoming a big sister easier for my oldest one too.   My husband came with me for some sessions and that really helped our relationship and we started working on parenting issues together.  Sarah’s counsel and support really helped our family transition to the good place we are all in today.

    Sarah C.


    If you are thinking about getting counseling and you’d like to talk to someone about the things that are troubling you, I am happy to help.