Preconception Anxiety: Worrying Before You’re Even Pregnant

Preconception Anxiety is the worry and stress that comes when you’re beginning the process of trying to get pregnant. The phase when you’re trying to become pregnant – “preconception” – is usually a time when you’re learning a lot about your body—and asking a lot of questions:


“Is that a sign of ovulation?”

“The window to conceive is how short?”

“What the heck is folic acid?”

preconception anxiety, anxiety, pregnancy, pregnancy anxiety

In the next month we are going to discover ways to keep your mind healthy and calm through advice given by Dr. Jill Sullivan:

I am a licensed clinical psychologist with more than 15 years of specialized training and expertise in Cognitive Behavioral Therapy (CBT). I am also a mother of two. So, I know firsthand the worries that quickly start popping up once you begin this new journey. There is a lot of uncertainty:


When is the best time for intercourse when trying to get pregnant?

Are the ovulation predictors working?

Will this month be the month I get pregnant?


With my experiences as an assistant clinical professor at Northwestern University Feinberg School of Medicine, cofounder CBT Specialists of Chicago, and creator of the Anxiety-Free Pregnancy Video Series, I can wholeheartedly understand the stress women go through when trying to get pregnant.

Prior to becoming pregnant myself, I had treated many women with anxiety before, during, and after pregnancy. Honestly, my biggest worry was whether I would develop any of their worries. It seemed like everyone had worried about something at some point, and worry can be contagious. Would I worry about genetic problems? About miscarrying? About bringing the wrong baby home from the hospital? Would I get obsessively focused on the “sh” sound in a name I was considering and keep repeating it over and over in my head? The women I had treated had taught me some things to worry about that I would have otherwise never considered! I was worried about becoming worried.  


While you’re learning how to prepare your body to support fertility and a growing embryo, you may be worried about whether you are “really ready.” You may be wondering if you’ll need medical assistance to conceive. And, you are doing most of this under the veil of secrecy. You’ve probably decided not to tell many people (perhaps anyone) that you’re trying, and you might not reveal that you’re pregnant until the 12th week, which makes you more vulnerable to spending too much time in your anxious head.


Before getting pregnant, you begin to make changes to your lifestyle. You have stopped using birth control. You have stopped using alcohol, tobacco, and other drugs. You may have modified your exercise routine, started taking prenatal vitamins and stopped taking some medications. Most women find that they are devoting a lot of time and energy to thinking about their nutrition, health, and menstrual cycles. Even if you aren’t feeling anxious, there’s a lot to think about in preparing for pregnancy.

My Mommy Style believes “there isn’t just one perfect way of being a mother.” Nor is there one perfect way to become pregnant. It’s common at this point to feel that you’re “losing control”— of your body, and of your life as you know it.


Many people respond to uncertainty by finding something to focus on that will give them a sense of control. Often, during the preconception phase, women focus on monitoring their fertility and following guidelines for early pregnancy as closely as possible. All of the things that you are supposed to do once pregnant become rules you try to follow while trying to conceive. “It’s better to be safe than sorry” may seem like a reasonable adage, but anxious women often take this too far.


Taking recommendations to all-or-nothing extremes sets the stage for developing obsessions. Obsessions are persistent, intrusive thoughts that often involve themes of harm, risk, or danger. The most common obsessions involve worry about being contaminated, becoming ill, or contracting disease. In reaction to these worries, you may develop compulsions, which are things you do to neutralize your feelings of anxiety. Compulsions might include preparing foods in particular ways, using multiple ovulation predictor kits within a day “just to be sure,” or sanitizing your keyboard if you’ve been away from your computer because you are anxious about contracting the flu and missing your window to conceive.


Reduce your preconception anxiety by following the guidelines given to you by your doctor. And, if you’re like me, you probably also bought a book or have found a website or a blogpost that seem like good resources. If you have done these things, you have probably done enough. You can keep yourself from developing obsessions and compulsions by observing a few commonsense rules of thumb:


  • Follow general guidelines from trusted sources. Think of the lists you find in books, on reliable websites, or recommendations from your physician. Highlight the “rules” that appear on every list. If the recommendation has been on every list you’ve looked at, it is probably a recommendation you should follow.


  • If you find yourself looking at more than three sources, stop. Three credible sources are sufficient.


  • If you find a recommendation on only one site, stop to consider why. Tips that are not repeated on trusted sites are probably not essential to follow.


  • Prepare to be flexible depending on your needs. For example, you most likely have already begun following the rule about minimizing caffeine. After birth control and alcohol, caffeine is one of the first things that conceiving women try to eliminate. However, if you have migraines and an allergy to acetaminophen (the pain reliever you can take while pregnant), your doctor might suggest that you increase your caffeine intake. If your choice is debilitating headaches or more caffeine, you may need to be flexible with that “rule.”


  • Trust your doctor! She or he has extensive medical training; years of experience delivering many healthy, robust babies; and has examined you and is familiar with your history.


If you catch yourself trying to follow all of the rules that you have ever found and are still searching for more because you want to be 100% safe, you have crossed a line. Remember: Balancing your own needs with and your baby’s needs may be your first step in becoming a well-balanced mother.

About the Author
Dr. Jill Sullivan is a licensed clinical psychologist with more than fifteen years of specialized training and expertise in Cognitive Behavioral Therapy (CBT). She is also the co-founder of CBT Specialists of Chicago. Dr. Sullivan graduated summa cum laude with a degree in Psychology from the University of Michigan and completed her Ph.D. in Clinical Psychology at the University of Minnesota. She completed her clinical internship and post-doctoral fellowship at Northwestern Memorial Hospital, where she also served as a staff psychologist for three years. She is an Assistant Clinical Professor in the Department of Psychiatry and Behavioral Sciences at Northwestern University Feinberg School of Medicine. From 2003 through 2011, Dr. Sullivan practiced with a multidisciplinary group focused on women’s health, including family planning, pregnancy loss, mood management during pregnancy, postpartum adjustment, and the transition to motherhood. She maintains a full-time private practice in Chicago. Additional information about the Anxiety-Free Pregnancy Series can be found at

Have healthy goals for your pregnancy? Read more about how to keep them here:

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