Coping With Pregnancy Paranoia: Relief Is Possible
Pregnancy paranoia is not an official mental illness or diagnosable disorder. Instead, it's generally seen as a colloquial term people use to describe anxiety related to pregnancy. The phrase "pregnancy paranoia" has been used both to refer to a person's unfounded belief or fear that they have become pregnant, as well as to a pregnant person's unfounded belief or fear that something has gone wrong with their pregnancy.
In this article, we focus on the first type of pregnancy paranoia, which describes a person believing they have become pregnant despite a lack of evidence. This type of pregnancy paranoia often stems from a fear of unintended pregnancy or of giving birth. In mild cases, a person may worry they're pregnant, despite the odds of pregnancy being low for them. In severe cases, a person may become convinced they're pregnant, even believing they have morning sickness, when their symptoms are instead the result of anxiety. If you're worried (or convinced) that you're facing an unplanned pregnancy despite a lack of evidence, read the following tips for coping with pregnancy paranoia and consider speaking with a licensed therapist for support.
Take a pregnancy test (but not too many)
When you believe you have become pregnant, you may experience uncertainty or rising anxiety. Taking a pregnancy test and receiving a negative result may calm fears of unplanned pregnancy. That said, taking too many pregnancy tests, even if they are all negative, could fuel the challenging emotions associated with a pregnancy scare.
When people experience anxiety or fear, they may engage in checking behaviors to assuage their worries. A well-known example may be a person who fears their home will catch fire because they left the stove on. After leaving home, they turn around and go back to make sure the stove is off, which eases their worries.
Similarly, a person who greatly fears pregnancy may be tempted to keep checking by taking repeated pregnancy tests. However, when checking behaviors are done repeatedly, they usually exacerbate anxiety in the long term rather than alleviating it.
Pregnancy test types
The vast majority of pregnancy tests measure beta-human chorionic gonadotropin (beta-HCG) levels. Beta-HCG is a hormone that typically increases after pregnancy begins. Beta-HCG can be measured in either the urine or the blood. Home pregnancy tests normally measure beta-HCG in the urine, while tests taken at a doctor’s office often measure its levels in the blood.
There are also a few other ways to test for pregnancy. A hormone called early pregnancy factor (EPF) can also be tested. This hormone is usually present in the body even before beta-HCG increases. Serum progesterone is sometimes tested as well, as this hormone normally increases with pregnancy, too. Finally, an ultrasound can also confirm pregnancy. Both transabdominal and transvaginal ultrasound methods are available and can potentially confirm a pregnancy.
Pregnancy test accuracy
Pregnancy test accuracy largely depends on when a person takes a pregnancy test and the type of test they take. Blood tests tend to be slightly more accurate than urine tests, but their results are usually comparable.
In general, all tests are most accurate when taken after the first day of a person's missed period. Although there are a variety of pregnancy tests marketed as being able to detect pregnancy prior to a missed period, they can vary widely in accuracy.
Even on the first day of a missed period, results may vary. Pregnancy test brands regularly advertise that their tests are 99% accurate on the first day of a missed period and after this point. However, although updated evidence may be needed, research has found that, in practice, on the first day of a missed period, over-the-counter pregnancy tests can range from 16% to 95% accurate.
Those who desire the most accuracy may want to wait until the second or third day of their missed periods. They may also want to go to the doctor and opt for a blood test rather than a urine test.
Learn about reproduction
Sometimes, people experience worry and paranoia around the possibility of getting pregnant because they don't have a deep understanding of reproduction. Knowing that a woman can usually only get pregnant on approximately six days out of each menstrual cycle may provide reassurance. Similarly, understanding the mechanisms and accuracy of contraceptive use may also relax a person, as they can choose and trust the method (or methods) with which they are most comfortable.
Plan contraceptive use
Some contraceptives or forms of birth control can also protect against sexually transmitted infections (STIs). Contraceptives often vary in terms of their effectiveness, but many are over 99% effective at preventing pregnancy when used as directed. Here are some of the most common types of contraceptives:
- Combined hormonal contraceptives, which typically come in the form of a pill, patch, or vaginal ring
- Progestin-only hormonal contraceptives, which usually come in the form of a pill, injection, implant, or intrauterine device (IUD)
- Non-hormonal copper IUD
- Barrier methods, like condoms and diaphragms
- Behavioral methods, like withdrawal and fertility planning methods
While it generally shouldn’t be a first-line plan, emergency contraception is also available if other contraceptives fail or if a person has unprotected sex. Emergency contraceptives generally describe those that can be used after intercourse to prevent pregnancy.
There are two main types of emergency contraception: morning-after pills and IUDs inserted within five days after unprotected sex. Despite misinformation, emergency contraceptives do not terminate a pregnancy. Instead, they prevent the egg from becoming fertilized.
Treat any anxiety disorders you may have
Ultimately, pregnancy paranoia constitutes a form of worry in most people who experience it. Worry can be part of an anxiety disorder, or the symptom can occur on its own. Ultimately, whether a person has an anxiety disorder usually depends on how severely and how frequently they experience worry, as well as how this worry impacts their daily life.
Potential anxiety disorders
Pregnancy paranoia can be seen as a term the general public has given to pregnancy-related anxiety. Pregnancy paranoia is not an official anxiety disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), although it usually involves anxiety.
That said, some people with pregnancy paranoia may be experiencing an anxiety disorder. Potential anxiety disorders often involve worrying about an unwanted outcome of some sort.
- Generalized anxiety disorder (GAD): People with GAD may struggle to control their worries. In addition, they may often experience restlessness, irritability, fatigue, difficulty concentrating, sleep problems, headaches, stomachaches, or other forms of physical pain without a clear cause. In the case of a person with GAD worrying about pregnancy, they could misinterpret their physical anxiety symptoms as pregnancy symptoms.
- Obsessive-compulsive disorder (OCD): Those with OCD often experience unwanted, distressing thoughts referred to as obsessions. They may then engage in activities to relieve stress related to the obsessions, and these behaviors are commonly called compulsions. When the "checking" behavior of taking a pregnancy test becomes excessive, it may constitute a compulsion intended to relieve the obsessive worry that one might be pregnant.
- Phobia: When a person has a phobia, they may intensely fear or feel extremely averse to a specific object or situation. In rare cases, a person's phobia may relate to pregnancy or childbirth. Sometimes, a pregnancy-related phobia is called tocophobia, and research suggests that the prevalence of tocophobia increased during the COVID-19 pandemic.
Recognize and treat panic attacks
Another anxiety disorder that differs from those previously mentioned is panic disorder. People with panic disorder may frequently have panic attacks. These attacks can be described as short-term instances of intense fear or a sense of losing control, and they usually come with physical symptoms. If your pregnancy paranoia involves intense but short-lived attacks of extreme anxiety, these instances could be panic attacks.
Symptoms of panic attacks
Panic attack symptoms can vary from person to person. That said, they normally have several core symptoms that make up their diagnostic criteria. Young women tend to be the group most likely to have panic attacks, and they may also be more likely than others to experience pregnancy paranoia. Panic attacks may involve the following symptoms:
- A fear of dying, going crazy, or losing control
- A sense of unreality, strangeness, or a disconnection from oneself
- Chest discomfort or pain
- Dizziness, faintness, or unsteadiness
- A choking feeling
- Hot flashes or chills
- Nausea or stomachache
- Numbness or tingling
- Heart palpitations or rapid heartbeat
- Shortness of breath
- Sweating
- Shaking or trembling
Once a person begins having panic attacks, they often start to fear the attacks themselves, rather than the trigger that might've initially prompted them. A person may also begin avoiding situations that they suspect could trigger a panic attack. Mental health treatment, including therapy, medication, or both, can often help individuals manage or eliminate panic attacks.
Get screened for other mental health conditions
While so-called "pregnancy paranoia" appears to be a manifestation of worry among people who post about it online, it isn't an official diagnosis or mental illness. Some people who claim to have pregnancy paranoia may have an anxiety disorder, while others likely have no mental illness at all.
In some cases, a person may be facing more serious paranoia or a delusion. A mental health professional can help individuals in that situation determine what they could be experiencing.
If a fear of becoming pregnant or a false belief that you are pregnant interferes with your life, such as your ability to work, your relationships with friends and family members, or your ability to start or maintain a romantic relationship, you may want to ask your healthcare provider to screen you for a mental health condition. Mental health conditions often negatively impact a person's daily life or ability to function at work or in relationships, but people don't always realize they have them.
Treatment for other mental health conditions
In addition to anxiety disorders, treatment is available for a wide variety of mental illnesses, ranging from personality disorders to psychotic disorders. The ideal type of treatment should be determined by a professional who assesses your symptoms and identifies what is most likely to help. Therapy and medication can be common treatments.
Therapy for pregnancy paranoia
If you fear becoming pregnant, and that fear is causing you distress, therapy could be a good option for working through the situation. A therapist can provide a safe, judgment-free space in which you can discuss your worries and explore their potential causes. Remote therapy may be a useful option, too, since sessions can be attended from the safety and comfort of home. BetterHelp can connect you with a remote therapist, often within 48 hours.
Research on therapy for anxiety
Researchers haven't directly studied the effect of therapy on pregnancy paranoia. However, pregnancy paranoia generally involves anxiety and worry, and researchers have studied remote therapy for generalized anxiety disorder (GAD), which usually also involves excessive worry and anxiety. A 2022 meta-analysis of 10 studies found that online cognitive behavioral therapy (CBT) for generalized anxiety disorder usually reduced anxiety among participants as effectively as in-person therapy.
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