Most people have heard of postnatal depression. It gets talked about more than it used to, which is genuinely a good thing. But here is the problem with PND being the condition everyone knows about. It means everything else gets missed. Women are sitting in GP surgeries, midwife appointments and health visitor check-ins describing symptoms that do not fit the PND box, and walking away without answers. Without a name for what they are experiencing. Without the support they need. And that is not okay. Because postnatal depression is just one condition in a much wider landscape of perinatal mental health. Perinatal mental health conditions include depression, anxiety, postpartum psychosis, birth trauma, PTSD, eating disorders, OCD and tokophobia. ¹ Each one is different. Each one deserves to be understood. And each one is far more common than most people realise. So this blog is for anyone who has ever felt like something was not right but could not quite put their finger on what. Anyone who has googled their symptoms at 2am and come up with nothing helpful. Anyone who has been told they are fine when they really, really are not. Let us talk about the conditions that do not get nearly enough airtime.
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Perinatal Anxiety
Anxiety during pregnancy and after birth is actually more common than depression, and yet it is consistently under-recognised. Anxiety affects around 13% of pregnancies and 15 to 20% of women in the first year after birth. ² That is a huge number of women. And yet anxiety in the perinatal period is so easy to dismiss. We tell ourselves that of course we are worried. We are growing a human being, or keeping one alive. A certain amount of worry is normal, right?
Yes. But there is a significant difference between normal new parent worry and anxiety that is taking over your daily life. Anxiety that stops you sleeping even when the baby sleeps. Anxiety that makes you convinced something terrible is about to happen. Anxiety that is physically exhausting, relentless and impossible to switch off.
If that sounds familiar, please know that it has a name. And it is treatable.
Perinatal OCD
This is one I feel particularly strongly about because it is so frequently misunderstood, and the consequences of that misunderstanding can be devastating.
OCD is highly prevalent during the perinatal period, particularly postnatally, with an average prevalence of around 7%. ³ That means roughly 1 in 14 new mothers is experiencing it. It is not rare. It is just rarely talked about.
Perinatal OCD may be a new and sudden onset in those with no previous history, or an exacerbation of existing OCD. Symptoms commonly centre around the baby and caregiving. ⁴
And here is the bit that stops women from speaking up. The thoughts that come with perinatal OCD are often deeply distressing. Intrusive, unwanted thoughts about something terrible happening to the baby. Sometimes thoughts about accidentally or deliberately causing harm. These thoughts feel completely out of character. They feel shameful. And because of that shame, most women suffer in silence rather than telling anyone.
The shame of disclosing these difficulties is often made worse by fears of being misunderstood by professionals and being judged a potentially harmful parent. ⁴ But here is what is so important to understand. These thoughts are not a reflection of who you are or what you want. They are a symptom. The very fact that they cause so much distress is evidence that they go against everything you feel. Women with perinatal OCD love their babies fiercely. That is precisely why the thoughts feel so unbearable.
If you are experiencing intrusive thoughts that you cannot shake, please speak to your GP or midwife. There is effective treatment available. You do not have to keep this to yourself.
Tokophobia
Tokophobia is a genuine, clinical phobia of childbirth. Not nerves. Not normal anxiety. A phobia.
More severe fear of childbirth may affect up to 14% of women. ⁵ That is not a small number. And yet so many women are told they are being dramatic. That every woman is scared. That they just need to relax.
Tokophobia is not something you can just relax out of. It can manifest as nightmares, panic attacks, difficulty concentrating and an overwhelming urge to avoid anything related to birth entirely. It may be associated with depression and post-traumatic stress disorder, and recognition alongside close liaison with appropriate professionals can help to reduce its severity and ensure efficient treatment. ⁶
There are two forms worth knowing about. Primary tokophobia affects women who have never given birth before. Secondary tokophobia develops after a previous traumatic birth experience and is considered a form of PTSD. ⁵
This is one of the reasons I am so passionate about what I do. Hypnobirthing cannot cure tokophobia on its own and I want to be honest about that. But working with a trained practitioner to understand birth, to build genuine knowledge and to develop tools for managing fear can make a real difference for many women. And for those with more severe tokophobia, specialist support is available and absolutely worth pursuing.
Birth Trauma and Perinatal PTSD
Around 1 in 20 women develops PTSD following childbirth. ⁷ But the number of women who experience their birth as traumatic, even if they do not go on to develop a full PTSD diagnosis, is thought to be much higher.
Birth trauma is not always about dramatic emergencies. Sometimes it is about feeling unheard. Feeling out of control. Having decisions made without your input. Experiencing pain that was not managed well. Being separated from your baby. The medical outcome can be perfectly fine and the emotional experience can still be deeply traumatic.
A frightening or distressing birth experience can lead to postnatal PTSD. ⁸ Symptoms can include flashbacks, nightmares, hypervigilance, emotional numbness and a strong avoidance of anything that reminds you of the experience. For some women this means avoiding hospitals, television programmes about birth or even conversations with pregnant friends.
If your birth experience is still affecting you, whether it was six weeks ago or six years ago, you deserve support. It is never too late to process what happened.
Perinatal Eating Disorders
This one does not get talked about nearly enough. Eating disorders do not disappear when someone becomes pregnant. For some women, pregnancy is a trigger for an eating disorder to resurface or worsen, particularly because of the significant and unavoidable changes to body shape and size that come with growing a baby.
Eating disorders occur in around 1 to 3% of the perinatal population. ³ But the real number is likely higher because shame keeps so many women from disclosing what they are going through.
If you are struggling with your relationship with food or your body during pregnancy or in the postnatal period, please reach out to your GP or midwife. You deserve support with this too.
Why Does Any of This Matter?
Because untreated perinatal mental health conditions do not just affect mothers. Perinatal mental health disorders are linked to pregnancy complications including low birthweight and preterm birth, and carry risks for long-term effects on a child's cognitive, social and emotional development. ³
Getting support is not just for you. It is for your baby too. And it is never a sign of weakness to ask for help. It is one of the bravest things a mother can do.
If you do not recognise yourself in postnatal depression but you know something is not right, please do not let that stop you from reaching out. You do not have to tick a specific box. You just have to tell someone how you are feeling.
Your GP, midwife or health visitor is always a good place to start. And tomorrow on the blog I will be talking about something that very few people discuss openly. The thoughts that make mums feel like monsters, and what they actually mean.
Bex x
References
- Maternal Mental Health Alliance. About maternal mental health. maternalmentalhealthalliance.org
- ScienceDirect (2024). Maternal medicine: perinatal mental health. sciencedirect.com
- National Institute for Health and Care Research (2025). Overview of perinatal mental health. ncbi.nlm.nih.gov/books/NBK618809
- PMC / British Journal of General Practice (2013). A hidden problem: consequences of the misdiagnosis of perinatal OCD. pmc.ncbi.nlm.nih.gov
- NHS Lincolnshire (2024). Fear of childbirth. ulh.nhs.uk
- Wikipedia / British Journal of Psychiatry. Tokophobia. en.wikipedia.org
- Wellbeing of Women. What is a perinatal mental health problem? wellbeingofwomen.org.uk
- Mind. Postnatal depression and perinatal mental health. mind.org.uk