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Perinatal Anxiety Coaching 


Anxiety in Pregnancy and Beyond: Harnessing Creativity for Coping and Connection

Having a baby can be one of the most wonderful things, a time of immense joy and happiness, but it can also but bring with it a lot of stress and anxiety. From the overwhelming physical changes that come with pregnancy to the emotional rollercoaster of motherhood, the transition mothers go through cannot be understated.***

As an art therapist, and a mother myself, I have experienced firsthand the challenges that pregnant women and new mums face; including a sense of loss; a loss of control over our lives, time, body and relationships, a loss of our former identity and potentially a loss in our social standing connected to career. It comes with overwhelming hormonal changes which create challenges to mood and emotional wellbeing. We also re-experience aspects of our own childhoods as we parent which can be both triggering and painful.

Added to which are the societal pressures on mothers to meet impossible standards. A deeply ingrained aspect of society’s patriarchal ideal of motherhood is our unquestioning and constant prioritising of our children's needs above our own. Expectant mothers are positioned as “glowing” with joy at the prospect of creating new life, and it is presumed that pregnancy and impending motherhood will give our lives “greater purpose and significance”. There is no room to question, or doubt. We are not allowed space to explore the darker, negative feelings we might have towards our new identities as mothers, and so society’s expectations can lead to feelings of guilt, inadequacy, and overwhelm.

These pressures have, I believe, been internalised by women so that our own expectations of pregnancy and motherhood push us further into silence and isolation when things don’t measure up to the idealised dream of motherhood. We believe there is something shameful in any negative feeling we might have towards our bump or baby, being so at odds with how we are “meant to” feel. Many women find themselves alone with their thoughts and feelings, unable to express themselves in a way that feels safe and supportive.

Is it any wonder then that 20% of women are likely to experience a mental health problem during pregnancy or in the first year following birth?!

What is Perinatal anxiety?

Anxiety is a natural response to feeling unsafe or threatened. When we perceive threat, a neurological and physiological chain reaction occurs which activates our sympathetic nervous system; our fight or flight response. The threat only needs to be perceived and not real for this to be triggered.

During the perinatal period (pregnancy until up to a year post-partum), anxiety can be particularly challenging because of the many changes and uncertainties that women go through, often during a time of little or no sleep and heightened hormones. Anxiety works as a negative feedback loop with 3 things happening at once: a trigger or environmental cue, physical reactivity and mental reactivity. For example, a baby's cries can act as a trigger for a new mum. This can lead to physical reactions like rapid breathing and tensed muscles. In a heightened state, negative thoughts can begin to overrun her; “Why can’t I soothe my baby? I must be a bad mother”. These thoughts diminish her ability to think clearly and problem-solve and interfere with her ability to focus on finding effective ways to soothe her baby. Instead, her anxious state makes her feel overwhelmed and helpless, amplifying the negative thoughts and reinforcing the belief that she is inadequate as a mother.

So we can see how the negative feedback loop can create a cycle where anxiety triggers more anxiety, leading to worsening symptoms, further fueling negative thoughts and leaving mums and mums to be feeling trapped, overwhelmed and isolated.

There are ways we can break out of this loop.

Breaking out of the loop

Activating the parasympathetic nervous system, responsible for the "rest and digest" response in the body, is one way to do that.

Breath can be a powerful tool to help break out of the negative feedback loop of anxiety. When anxiety triggers physical reactivity, focusing on the breath can help regulate the body's stress response and activate the body's relaxation response, slowing down the heart rate and reducing muscle tension. It also serves as a focal point, redirecting the mind away from anxious thoughts and bringing it into the present moment. By consciously slowing down and deepening the breath, our body also receives more oxygen, which can support clearer thinking and decision-making. It provides a brief pause in the cycle of anxiety, allowing us to gain perspective, challenge negative thoughts, and consider alternatives.

The thing is, breathing can be hard, despite or maybe because is it so automatic. One slightly more creative approach to breathe that can be effective is called rectangular breathing - where you draw in your mind a short side of the rectangle with your inhale, and the long side with your exhale. It can help to imagine the texture and colour of the rectangle; or emptying the rectangle of a colour to let go of (I imagine a toxic green) and I filling it in with another one (I fill myself up with a warm pink!)

Make the beast beautiful

An important thing to say about anxiety is that it is a way of keeping ourselves safe. Somewhere inside us, that anxious part thinks it is helping, and so it can be useful to acknowledge our anxiety; to thank it, even, for trying to keep us safe. Sarah Wilson’s excellent book says it perfectly in her title “First, we make the beast beautiful.” If we can begin to see our anxiety as a friend, not a terrifying enemy we need to battle, then we can find less anxiety-provoking ways of coping with it.

I have worked with clients to imagine their anxiety as a character - maybe it’s a dragon, or a formless oppressive blob. I might invite someone to imagine into it, what colour is it, does it have a name? Relating to it in this way can be a really powerful way of taking some kind of ownership and control back.

Creativity as a way of coping with anxiety

Another way of gaining some distance from our anxiety is through creative journaling. Journaling is well-known for its positive benefits on mental health and wellbeing. It also plays a big part in the history of women's creativity.

It is a way to allow our anxious thoughts all out on to the paper; which disarms the fear driving the thoughts and creates much needed distance. Reading back and reflecting on what we have written also encourages our “observing eye” to develop.

Journaling can be a place to put down all fears, feelings, grief, hopes - without having to hide or cover up or pretend. It can be incredibly freeing. It doesn’t have to just be writing, and can include scribbles, doodles, drawing, painting, collage, or poetry.

By engaging in creative activities, we can explore our emotions and express ourselves in new ways. We can start to let go of the unrealistic expectations placed on us by a patriarchal society and embrace our imperfections. We can learn to accept ourselves for who we are and find joy in the process of creating, rather than the outcome.

An incredible resource for this is the Maternal Journal movement. The website shares creative tools and techniques to specifically support the huge changes, joys and challenges we go through in pregnancy, birth and parenthood. The groups are an amazing source of social support, as women can connect with others who are going through similar experiences and share their thoughts, feelings, and concerns in a safe and supportive environment.

I run Maternal Journal groups for mums-to-be and new mums and find that creating alongside others in a non-judgmental space provides an incredible sense of support and community. This can help to reduce feelings of isolation and anxiety and increase a sense of connection and community. (I will be running my next Maternal Journal Group in South East London in September, if you’re interested - get in touch!).

Final thoughts

Remember, you are not alone in your anxieties. Reach out, engage in self-reflection, and gradually open up to others. This transition is significant, and it's essential to acknowledge that you deserve support and a safe space to explore your emotions fully. While seeking help may feel overwhelming or even impossible at times, taking small steps towards self-reflection and initiating conversations with yourself can be a powerful starting point. Embracing our innate creativity, (we are mothers after all, arguably the most creative job there is!), can help us release our fears, let go of expectations and start feeling confident in our own abilities as mothers, as women, as human beings, making a real and valuable contribution to the world!

*** It is crucial to recognise that the journey of pregnancy and parenthood is not exclusive to cisgender women, and in fact encompasses a diverse range of gender identities, including trans and non-binary parents. This article is based on my experience as and working with cis-gendered women and as such uses gendered language.***

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