Pregnancy Anxiety: Why Trying to ‘Stay Positive’ Can Make It Worse

The moment you see those two lines on the test, the advice starts pouring in. “Just relax,” people say. “Stress is bad for the baby.” “Think happy thoughts!” “Enjoy every moment—it goes so fast.”

From the outside, these comments seem supportive. They are meant to be encouraging, a way to usher you into the joyful season of expecting a child. But for many pregnant individuals, these well-meaning platitudes feel less like a warm hug and more like a heavy blanket, suffocating the very real, very complicated emotions bubbling underneath the surface.

This is the paradox of pregnancy anxiety: you are worried, and then you become worried about being worried. You feel pressure to “stay positive” for the sake of your baby’s health, yet the harder you try to force positivity, the more isolated and anxious you feel. It is a vicious cycle that leaves many parents-to-be feeling broken, guilty, and unseen.

If you are currently pregnant and finding it impossible to “just stay positive,” this article is for you. We are going to dismantle the myth that you need to be glowing with happiness 24/7 to have a healthy pregnancy. We will explore why toxic positivity is harmful to your nervous system and offer a trauma-informed perspective on how to navigate the messy, beautiful, terrifying journey of growing a human.

The Reality of Pregnancy Anxiety

Pregnancy is often painted in pastel hues of nurseries and baby showers, but the biological and psychological reality is much more intense. It is a massive physiological event. Your body is building a new organ (the placenta), increasing its blood volume by 50%, and shifting every internal system to support life. It makes sense that your emotional landscape would undergo a similar upheaval.

Pregnancy anxiety is incredibly common. Studies suggest that nearly 15-20% of pregnant people experience significant anxiety, though many experts believe this number is underreported. Why? Because we have been taught that admitting to fear means we aren’t grateful or ready for parenthood.

What Does Pregnancy Anxiety Look Like?

Unlike general anxiety, pregnancy anxiety specifically latches onto themes related to the pregnancy, birth, and parenting. You might experience:

• Intrusive thoughts about the baby’s health: “Is the baby moving enough?” “Did I eat something that could hurt them?”
• Fear of childbirth: Obsessing over labor complications, pain, or medical interventions.
• Identity crisis: worrying about how your life, career, or relationship will change.
• Body dysmorphia or discomfort: Feeling out of control as your body changes rapidly.
• Hyper-vigilance: Scanning your body for every cramp, twinge, or symptom and assuming the worst.

These feelings are not a sign of weakness. In many ways, they are an evolutionary adaptation. Your brain is becoming hyper-aware to protect your offspring. However, in our modern world, this protective mechanism often goes into overdrive, leaving you stuck in a state of chronic stress.

The Problem with “Just Stay Positive”

When you share these fears with friends, family, or even sometimes medical providers, the response is often a variation of “Stay positive!” or “Don’t manifest bad things.” This phenomenon is known as toxic positivity.

Toxic positivity is the belief that no matter how dire or difficult a situation is, people should maintain a positive mindset. It rejects, invalidates, and displaces negative emotions in favor of a cheerful, often false facade.

Here is why this approach is not just unhelpful, but actively harmful during pregnancy.

1. It Invalidates Your Reality

When someone tells you to “look on the bright side” while you are terrified of a miscarriage or struggling with prenatal depression, they are essentially telling you that your feelings are wrong. This leads to shame. You start to think, “Why can’t I just be happy like everyone else? What is wrong with me?”

Shame is a powerful stressor. It disconnects you from others and from yourself. Instead of processing your fear, you bury it, where it tends to fester and grow stronger.

2. It Creates a “Meta-Emotion” Struggle

Meta-emotions are how we feel about our feelings. If you feel anxious, and then you judge yourself for being anxious (because you “should” be positive), you now have two problems: the original anxiety and the secondary guilt.

This adds a layer of psychological burden. You are now expanding energy trying to suppress your emotions rather than understanding them. From a trauma-informed therapy perspective, suppression takes a massive toll on the nervous system. The energy required to hold down a beach ball underwater is exhausting; eventually, it pops up with force.

3. It Implies You Have Ultimate Control

The phrase “stress hurts the baby” is perhaps the most damaging weapon of toxic positivity. It implies that if something goes wrong, it is your fault for not being zen enough.

While chronic, severe stress can impact health, the human body is incredibly resilient. Women have birthed healthy babies in war zones, during famines, and amidst personal tragedies for millennia. The idea that your fleeting anxious thoughts have the power to harm your baby is not scientifically accurate, but it places a crushing weight of responsibility on your shoulders.

4. It Prevents Connection

True connection happens in the messy middle, not in the polished exterior. If you feel you must perform happiness to be accepted, you cannot be vulnerable. You might withdraw from your partner or friends because you don’t have the energy to put on the mask. This isolation is a far greater risk factor for perinatal mood disorders than “negative thinking” ever could be.

A Trauma-Informed Lens on Pregnancy

To move away from toxic positivity, we need to adopt a trauma-informed lens. This approach asks, “What has happened to you?” rather than “What is wrong with you?” It recognizes that pregnancy is a vulnerable time that can reawaken past wounds.

The Body Remembers

Pregnancy is an inherently somatic (body-based) experience. If you have a history of trauma—whether it is sexual trauma, medical trauma, or childhood neglect—the physical sensations of pregnancy can be triggering.

• Loss of bodily autonomy: Frequent medical exams, the sensation of the baby moving inside you, and the impending loss of control during birth can mirror past experiences where you felt unsafe or overpowered.
• Medical environments: For those with medical trauma, hospitals and doctor’s offices can trigger a fight-or-flight response.
• Attachment wounds: If your own childhood was unstable, the prospect of becoming a parent can bring up deep-seated fears about your ability to bond or protect a child.

When we view anxiety through this lens, we see that “staying positive” is impossible because the body is screaming that it is not safe. You cannot think your way out of a nervous system response. You have to feel your way through it.

The Role of the Nervous System

Dr. Esther Chon’s work emphasizes the importance of the nervous system. When you are anxious, you are likely in a sympathetic state (fight or flight) or a dorsal vagal state (shutdown/freeze). Telling a nervous system in survival mode to “be happy” is like telling a person in a burning building to enjoy the warmth.

Healing comes from regulation, not suppression. Regulation means helping your nervous system move from a state of alarm back to a state of safety and connection.

Why Acknowledging “Bad” Feelings Actually Helps

It sounds counterintuitive, but the path to relief lies in leaning into the discomfort, not running away from it. This is the core of emotional acceptance.

The paradox of acceptance

Psychological research shows that when we name and accept an emotion, its intensity diminishes. This is sometimes called “name it to tame it.” When you say, “I am feeling terrified right now,” you engage your prefrontal cortex—the thinking part of your brain—which helps dampen the alarm bells in your amygdala.

Creating emotional fluency

By allowing yourself to feel grief, anger, fear, or ambivalence about your pregnancy, you are building emotional fluency. You are teaching yourself that you can survive difficult feelings. This is a crucial skill for parenthood. Babies cry, toddlers tantrum, and teenagers rebel. If you can’t tolerate your own negative emotions, it will be very hard to tolerate theirs.

Protecting the bond

When you stop fighting your feelings, you free up mental bandwidth. This actually allows you to connect better with your baby. You can say, “Hey baby, mom is feeling really scared right now, but I am safe and you are safe.” This is honest and grounding. It models repair and resilience, rather than perfection.

Strategies for Managing Pregnancy Anxiety (Without Faking Positivity)

If we toss out “good vibes only,” what do we replace it with? Here are practical, trauma-informed strategies to support your mental health during pregnancy.

1. Practice “Both/And” Thinking

Anxiety often traps us in black-and-white thinking. “If I’m anxious, I’m a bad mom.” “If I’m not happy, I don’t want this baby.”

Replace this with dialectical thinking—the ability to hold two opposing truths at once.

• “I am grateful to be pregnant and I am miserable physically.”
• “I love this baby and I am terrified of childbirth.”
• “I want to be a mom and I am grieving my old life.”

Using “and” creates space for the complexity of the human experience. It validates your struggle without erasing your joy.

2. Set Boundaries with “Support”

You have permission to protect your peace. If certain friends or family members are sources of toxic positivity, you can limit your interactions with them or set explicit boundaries.

• Script: “I know you want me to be positive, but right now I just need to vent. Can you just listen without trying to fix it?”
• Script: “I’m feeling overwhelmed, so I’m going to take a break from talking about the pregnancy for a bit.”

If social media is making you feel inadequate with its curated images of glowing, carefree pregnancies, unfollow or mute those accounts. Curate a feed that shows the messy, real side of motherhood.

3. Engage in Somatic Grounding

Since anxiety lives in the body, we need body-based tools to address it. Somatic therapy offers excellent techniques for this.

• The 5-4-3-2-1 Technique: Identify 5 things you see, 4 you can touch, 3 you hear, 2 you smell, and 1 you taste. This pulls you out of the “what if” future and into the “right now.”
• Weighted Comfort: Use a weighted blanket (safely, on your legs) or wrap yourself tight in a shawl to provide proprioceptive input, which calms the nervous system.
• Slow Exhales: Focus on making your exhale longer than your inhale. This physically signals your heart rate to slow down.

4. Schedule “Worry Time”

If your thoughts are racing all day, try containing them. Set a timer for 15 minutes a day to write down every single worry. Go wild. Write down the irrational ones, the scary ones, the silly ones.

When the timer goes off, close the notebook and say, “I have worried enough for today.” If a worry pops up later, tell yourself, “I’ll save that for tomorrow’s worry time.” This gives your anxiety a place to live without letting it take over your entire house.

5. Educate Yourself (With Limits)

Fear of the unknown drives a lot of pregnancy anxiety. Educating yourself about birth and postpartum can be empowering. However, there is a fine line between preparation and obsessive Googling.

Stick to evidence-based sources. Take a childbirth education class that focuses on physiology and coping, not just medical interventions. If you find yourself spiral-searching symptoms at 2 AM, use a website blocker or hand your phone to your partner.

6. Connect with Honest Parents

Find a community where “fine” isn’t the required answer. Look for prenatal support groups, either in person or online, that explicitly state they are safe spaces for mental health. Hearing another pregnant person say, “I hate being pregnant,” can be the most validating experience of your life.

When to Seek Professional Support

While some anxiety is normal, there is a point where it requires professional intervention. You do not have to white-knuckle through this.

Consider seeking help if:

• Your anxiety is interfering with your ability to sleep or eat.
• You are having panic attacks (racing heart, shortness of breath, feeling like you are dying).
• You feel detached from reality or your baby.
• You have thoughts of harming yourself.
• You are unable to find any moments of peace or enjoyment.

Therapy can be a game-changer. At Therapy and Play, we utilize a variety of therapy modalities tailored to the perinatal period.

EMDR for Pregnancy Anxiety

Eye Movement Desensitization and Reprocessing (EMDR) is highly effective for trauma and anxiety. If your pregnancy anxiety is rooted in a past traumatic birth or a loss, EMDR can help process those memories so they don’t haunt your current pregnancy. It is safe to do while pregnant and focuses on reducing the emotional charge of triggering thoughts.

Cognitive Behavioral Therapy (CBT)

CBT helps you identify the distortion in your thoughts. It doesn’t ask you to be “positive,” but it asks you to be accurate. For example, it helps you move from “Something is definitely wrong” to “I feel anxious, but my last check-up showed the baby is healthy.”

Internal Family Systems (IFS) / Parts Work

This approach looks at anxiety as a “part” of you that is trying to protect you. Instead of hating your anxiety, you learn to communicate with it. You might thank your anxious part for trying to keep the baby safe, while gently letting it know that you (the adult self) are in the driver’s seat.

Postpartum Preparation: The Ultimate Anxiety Antidote

One of the best ways to manage pregnancy anxiety is to shift the focus from the birth (which is one day) to the postpartum period (which is forever). Anxiety often fixates on the event of birth, but true safety comes from having a plan for after.

Preparing for the “Fourth Trimester” can give you a sense of agency.

• Build your village: Who will bring meals? Who can you call at 3 AM?
• Plan for mental health: Have the number of a therapist or a support line ready before the baby arrives.
• Set boundaries for visitors: Decide now who you want in your space during those vulnerable first weeks.

You Are Doing a Good Job

If you take nothing else from this article, please take this: Your anxiety does not make you a bad mother. It does not mean you are ungrateful. It means you care deeply, and you are navigating a massive life transition in a culture that doesn’t always support the emotional reality of women.

You don’t have to enjoy every moment. You don’t have to glow. You just have to keep putting one foot in front of the other. It is okay to be scared. It is okay to be angry. It is okay to be human.

True strength isn’t about pretending everything is perfect. It is about acknowledging the storm and anchoring yourself through it.

If you are struggling to find that anchor, we are here to help. Whether you need to process past trauma, learn regulation skills, or just have a safe space to say “I’m not okay,” Therapy and Play offers compassionate services for adults navigating the journey to parenthood.

You deserve to feel supported, not just “positive.” Let’s work together to make space for your whole story.