Postpartum Anxiety: Why It Deserves as Much Attention as Postpartum Depression

By Birth & Baby University · Last updated: October 2026 · 3 min read

Postpartum depression gets most of the attention in classes and handouts, but anxiety is at least as common, and it can look like being a careful new parent. Doulas often see a client’s worry before anyone else does. This article reviews what the research says about postpartum anxiety and how to respond within scope.

Key takeaways

• A review of diagnostic-interview studies estimated that about 8.5 percent of postpartum mothers have one or more anxiety disorders.
• A 2025 review states that anxiety and related disorders affect about one in five pregnant and postpartum people and are more common than depression.
• About 9 percent of perinatal women experience anxiety and depression together, according to a 2025 meta-analysis of 122 articles.
• Screening and diagnosis belong to clinicians. ACOG’s 2023 guideline covers screening for depression, anxiety, bipolar disorder, suicidality and postpartum psychosis.

What the research says

How common it is

A 2016 systematic review and meta-analysis of 58 studies, restricted to studies using diagnostic interviews, estimated that 8.5 percent of postpartum mothers experience one or more anxiety disorders, and noted small study numbers, methodological limits and considerable heterogeneity. Its authors argued that these disorders warrant greater clinical attention. A 2025 Annual Review of Clinical Psychology article reports that anxiety and related disorders affect one in five pregnant and postpartum people and are more common than depression. The two figures differ because diagnostic-interview studies use stricter criteria than broader symptom-based estimates, which is a reason to quote ranges rather than one number. A 2025 meta-analysis of 122 articles (560,736 women) estimated the prevalence of co-morbid anxiety and depression at about 9 percent, with roughly 8 percent postpartum, varying by assessment time, country and tool.

Why it matters

A Lancet series paper summarizes perinatal non-psychotic mental disorders as among the most common morbidities of pregnancy and the postnatal period, with adverse effects on mother, child and family. It reports that psychosocial and psychological interventions have been tested mostly for postnatal depression, with evidence for effectiveness, that high-quality studies of drug treatment safety and effectiveness are few, and that treatment decisions require individual risk-benefit analysis.

Screening

ACOG Clinical Practice Guideline No. 4 (2023) reviews screening and diagnosis of depression, anxiety and anxiety-related disorders, bipolar disorder, suicidality and postpartum psychosis, with graded recommendations. Treatment is addressed in a separate guideline. Per ACOG’s own page it replaces Committee Opinion 757 (2018) on screening for perinatal depression. Its recommendation text is a member benefit, so this article cites its scope and not its specific recommendations.

What this means for doulas

• Normalize without minimizing. New parents worry. When worry is constant, impairs sleep when the baby sleeps, causes physical symptoms or limits daily life, it deserves a clinician’s attention.
• Ask open questions. “What has your mind been doing at night?” invites more than “Are you okay?”
• Do not diagnose or label. Describe what you observe and encourage the client to tell their provider, offering to help make the call.
• Know the crisis steps. If a client is in crisis or may be in danger, the CDC lists thoughts of harming yourself or your baby among warning signs needing immediate care. In the United States, a call or text to 988 or to the National Maternal Mental Health Hotline (1-833-852-6262) reaches support.

Putting the evidence into practice

• Include anxiety in your prenatal teaching on emotional health, with examples of what it can feel like.
• At each postpartum visit, ask about sleep, appetite, racing thoughts, panic and whether the client feels able to rest.
• Keep a vetted local list of perinatal mental health clinicians, support groups and a hotline number.
• Share your concern with the client’s permission, and follow up after a referral to see whether they connected with care.

The bottom line

Postpartum anxiety is common, under-recognized and treatable. Doulas help by noticing, asking, normalizing and referring, and by never assuming a client who seems to be coping is not struggling.

This article is for professional education. It is not medical, legal or tax advice. Check the standards of your certifying organization and the rules where you work.

Sources and further reading

• Goodman JH, et al. Anxiety disorders in postpartum women: a systematic review and meta-analysis. Journal of Affective Disorders 2016. Read the source
• Fairbrother N, et al. Anxiety and Related Disorders During the Perinatal Period. Annual Review of Clinical Psychology 2025. Read the source
• Ou L, et al. Prevalence of co-morbid anxiety and depression in pregnancy and postpartum: a systematic review and meta-analysis. Psychological Medicine 2025. Read the source
• Howard LM, et al. Non-psychotic mental disorders in the perinatal period. Lancet 2014. Read the source
• ACOG Committee on Clinical Practice Guidelines-Obstetrics. Screening and Diagnosis of Mental Health Conditions During Pregnancy and Postpartum: ACOG Clinical Practice Guideline No. 4. Obstetrics & Gynecology 2023. Read the source
• National Institute of Mental Health. Perinatal Depression. NIH web page, read 16 October 2026 (National Maternal Mental Health Hotline, 1-833-852-6262; 988 Suicide and Crisis Lifeline). Read the source
• Office on Women’s Health, U.S. Department of Health and Human Services. Postpartum depression. Web page (page dated October 17, 2023), read 16 October 2026. Read the source

Recognizing when a parent needs more than doula support is a core professional skill, covered in postpartum doula preparation. See the training and mentorship options on the For Doulas page.

More for professionals: the Professionals Blog.