Second Trimester Anxiety: Why It Can Get Worse, What Helps

If your mental health got harder after the first trimester, that deserves attention. Feeling better physically doesn't put you on a schedule for feeling better emotionally. You can ask for support during pregnancy.

Why might I feel more anxious in the second trimester?

In the video above, I talk about the pregnancy becoming more real while expectations and planning build. Hormones are still changing, too, though hormone levels alone can't explain how any one person feels.

You may be telling work, making financial decisions and trying to choose between more options than you knew existed. If you've had a previous loss, reaching a milestone can bring relief and fresh fear on the same day.

Anxiety doesn't reliably disappear in the middle of pregnancy. A 2017 University of Toronto meta-analysis found that anxiety symptoms were common across all three trimesters, with similar estimates in the first and second (Dennis and colleagues, 2017). That finding describes groups of women, rather than predicting what your pregnancy should feel like.

I'd want to know what the worry is doing in your day. Does it come and go around appointments? Are you able to sleep? Does an answer from your clinician settle the question, or do you immediately need to check again?

What if I'm anxious about the anatomy scan?

The scan can carry a lot of anticipation. You're going to see your baby, and you're also waiting to hear whether everything looks as expected. Sometimes there are follow-up appointments or a wait for someone to explain a finding.

Before you go, ask how you'll receive results and who will explain them. Write down your questions. Bring someone if you'd like support, and leave yourself some room afterward if you can.

If you need a follow-up, ask what the next step is and who you can contact while you're waiting. Your OB, midwife or specialist can interpret what a result means for your pregnancy. Searching a phrase from a report may leave you with frightening information that doesn't apply to you.

What if I keep monitoring every movement or symptom?

Feeling your baby move can be lovely and can also give anxiety a new thing to track. If you're concerned about movement or another symptom, contact your OB or midwife. You don't need to wait until you're certain something is wrong.

Once you've had medical advice, notice whether the same question keeps asking for another answer. Repeated searches and reassurance can bring brief relief while keeping the doubt active. Tell your clinician if that's happening; they can help you distinguish medical follow-up from an anxiety loop.

You might keep two lists: questions for your pregnancy care team and worries you want to discuss with a therapist. Keep urgent concerns out of the waiting list and contact your provider when they arise.

How do I handle anxiety after a previous loss?

You don't have to feel reassured just because this pregnancy has reached a certain week. A previous miscarriage, stillbirth or other loss can change how you experience appointments, announcements and planning.

A 2017 University of Edinburgh meta-analysis found higher anxiety in pregnancies after a loss than in pregnancies without one (Hunter and colleagues, 2017). If that's your experience, tell your OB or midwife about both the loss and how you're feeling now.

You can ask a therapist whether they work with pregnancy after loss. This discussion of mental health after miscarriage includes that experience. It may help to have someone who understands why excitement and fear can arrive together.

What if I'm worried that my anxiety is affecting the baby?

Bring that question to your OB or midwife, who knows your pregnancy. Studies about groups of pregnant people can't tell you what's happening in yours.

You deserve help with anxiety because it's affecting you. You don't need to prove that it affects the baby before asking for care. Tell your provider how much of the day you're worrying, how you're sleeping and what you've stopped doing because of fear.

Try: “I've been more anxious since the first trimester, and it's getting in the way. I'd like help with that.”

What can make the next week more manageable?

• Name the specific worry. “I'm scared about Thursday's scan” gives you and your care team somewhere to start.
• Reduce the research that leaves you worse. If a forum or account sends you into another hour of searching, step away and bring the question to someone who knows your care.
• Set a limit on planning. Choose one task for today. A registry, leave plan and daycare search don't all need finishing tonight.
• Decide what to say about your body. “I'd rather not talk about my size” or stepping back from an unwanted touch is allowed.
• Tell one person how you're actually doing. You don't owe everyone a cheerful answer about the “easy trimester.”

If you're also grieving a change in your identity, matrescence explains the transition into motherhood. If fear of birth is taking over, tokophobia may be a useful topic to discuss with your clinician.

When should I get professional help?

Talk with your OB, midwife, doctor or a therapist if worry is present most days, getting in the way of sleep, eating, work or relationships, or leading you to avoid prenatal care. Panic attacks, repeated checking and a return of symptoms you've had before are also reasons to reach out.

Anxiety can overlap with depression. Feeling low, empty, hopeless or uninterested in things most days for two weeks or more deserves an assessment (NIMH, 2023). Severe or rapidly worsening symptoms need attention sooner. Recognizing prenatal depression early explains more.

Chest pain, a racing heart, dizziness or trouble breathing need medical attention rather than an assumption that they're anxiety. Contact your care team right away and call 911 if symptoms are severe.

If you're thinking about suicide or need crisis support, call or text 988. Call 911 for immediate danger to you or your baby. For non-emergency support, call or text Postpartum Support International's HelpLine at 1-800-944-4773; a trained volunteer will get back to you.

ACOG recommends screening for anxiety and depression during pregnancy and after birth. Ask for that conversation if no one has brought it up. A therapist can help with the worry, and medication questions belong with your OB or psychiatric prescriber.

If you'd like support now, you can book a free 15-minute consultation. I see moms in person in Austin and online across Texas and 40+ PSYPACT states.

Sources

• American College of Obstetricians and Gynecologists. Screening and Diagnosis of Mental Health Conditions During Pregnancy and Postpartum. Clinical Practice Guideline No. 4, Obstetrics & Gynecology, 2023.
• American College of Obstetricians and Gynecologists. Ultrasound Exams. Patient FAQ, last reviewed 2025.
• Dennis CL, Falah-Hassani K, Shiri R. Prevalence of antenatal and postnatal anxiety: systematic review and meta-analysis. British Journal of Psychiatry, 2017.
• Hunter A, Tussis L, MacBeth A. The presence of anxiety, depression and stress in women and their partners during pregnancies following perinatal loss: a meta-analysis. Journal of Affective Disorders, 2017.
• National Institute of Mental Health. Perinatal Depression. NIH Publication No. 23-MH-8116, 2023.
• 988 Suicide & Crisis Lifeline. What to Expect.
• Postpartum Support International. Perinatal Mental Health: Signs, Symptoms and Treatment and Get Help.
• Centers for Disease Control and Prevention. Urgent Maternal Warning Signs and Symptoms. HEAR HER Campaign, 2024.