The Stresses of Pregnancy

Even though pregnancy can be a time of joy and excitement for some people, others find it challenging and struggle to feel happy about the state of their mind and body. Some people struggle with being treated differently by family, friends, or coworkers. Additionally, women may feel intensely anxious about what they eat, drink, or are exposed to in pregnancy. Others feel guilt that this supposedly joyful time leaves them feeling empty, scared and depressed. Sometimes the identity changes and life transitions that are part of pregnancy lead to sadness and anxiety. Pregnancy after a perinatal loss can be a particularly stressful time for those who are still grieving. And the immense hormonal fluctuations in pregnancy may worsen any mental health issue during this vulnerable life stage.

How BRIA Can Help

To begin, you may connect with our Care Coordinator. She will meet with you, conduct a MINI Mental Health Assessment, and suggest which services will be most helpful. From there, you may decide to begin individual, couples or group counselling services. Alternatively, our Care Coordinator may suggest a more in-depth MAXI Mental Health Assessment, if needed. Regardless of where you start with BRIA, you can stay connected with the BRIA team throughout your journey.

How BRIA works

Get a personalised Care Plan

Start therapy or other services

Get additional MD services, if required

Track mental health symptoms to see progress

Common Challenges

We all face challenges, and it’s ok to ask for help. BRIA can support you throughout your pregnancy.


You may be worrying a lot and notice that your mind just won’t settle down.

Anxiety can refer to a range of symptoms from excessive worries to panic attacks. Often anxiety is associated with physical symptoms such as chest tightness, nausea, shakes, or heart palpitations. During pregnancy, it can be hard to know which physical symptoms may be due to pregnancy and which are due to anxiety. As a result, many pregnant women ignore anxiety symptoms, and live with far too much distress. Many people have anxiety about their pregnancy and all the changes happening, so they may try to over-control things or focus on specific routines that they think will bring them comfort. Some have ruminations: repetitive, unwanted thoughts or images. These can be hard to control and bothersome. It is normal to feel anxious at times, but anxiety becomes a concern when it takes over and interferes with pleasure, relationships, or daily functioning.

BRIA individual therapists can help you learn strategies to manage anxiety. In BRIA group therapy, you can connect with other women who have similar experiences and learn from our skilled group leaders. Mindful Movement classes can also teach you new skills for coping with anxiety. Connecting with our Care Coordinator and completing a MINI Mental Health Assessment will help you understand how BRIA’s services can help you. If your symptoms of anxiety are interfering with your everyday life, a BRIA Care Coordinator may suggest a more in-depth MAXI Mental Health Assessment.


Feelings of sadness and despair can be painful and consuming.

Depression is characterized by low mood, lack of interest, and hopelessness. Depression can also impact sleep, concentration, and energy levels; it is an illness that affects the mind and the body. When women are pregnant, symptoms of depression may be confused with some of the symptoms of pregnancy, so many women ignore their suffering and “forge ahead.”  For example, nausea in the first trimester can be associated with decreased motivation, lack of pleasure, and low mood. Even though there are overlapping symptoms in pregnancy– fatigue, appetite changes, poor concentration, and insomnia–it is not “normal” to feel depressed, hopeless, or very negative while pregnant and these are signs that you need to get some help.

You may find it helpful to talk to one of our individual therapists about what you are going through, and explain your dark feelings. Our therapists are experts in helping women cope with the challenges and transitions of pregnancy. BRIA’s group therapy sessions will help you connect with other women who have similar experiences. Seeing that you are not alone can often ease the feelings of sadness. Connecting with our Care Coordinator and completing a MINI-Mental Health Assessment will help you understand how BRIA’s services can help you. If your symptoms of depression are interfering with your everyday life, a BRIA Care Coordinator may suggest a more detailed MAXI Mental Health Assessment. If you are having any thoughts of self-harm or suicide, this may indicate more severe depression, and you need urgent care from your primary care provider, go to the nearest emergency department, or call the Canadian Suicide Hotline at 1-833-456-4566.


Depression in pregnancy can be associated with social withdrawal and loneliness.

Sometimes being pregnant can feel lonely. This is been particularly true when people struggle with mental health issues, or during the COVID-19 pandemic when pregnant people avoid going out or seeing other people. Pregnant women may feel that they can’t connect with friends who appear to be thriving during pregnancy or they avoid family members who assume they are happy about being pregnant. Relationships may be strained during this time, due to anger and resentment that partners are less impacted by pregnancy or just don’t understand. Or, a single person may be going through a difficult pregnancy and coping alone. It may feel like you are the only one struggling through pregnancy– but you are not alone.

BRIA’s pregnancy groups are a comfortable, inclusive and supportive place. In group therapy, women will make connections with others who understand them and are honest about their own struggles. Couples therapy may also help you if you have a partner and want to determine how to communicate your need for support and empathy in a new way,  so that you feel less alone during your pregnancy journey. BRIA individual therapists are always available, if a one-to-one therapeutic connection seems best for you.


Many women feel intense anger and other strong emotions and are not sure what to do about them.

Rage, frustration, irritability — you name it, women experience it. Anger is often a secondary emotion and is really a manifestation of underlying sadness, grief, helplessness or anxiety. Women who are struggling during pregnancy may feel angry that it’s a difficult experience for them and that it seems so “easy” for others. Sometimes pregnancy hormone fluctuations can be associated with intense irritability. Insomnia can also lead to anger or rage. You may feel ashamed that your emotions are getting the best of you, but this is usually a sign that something deeper is going on and you need supportive help.

Talking to a BRIA individual therapist can help you process your feelings during such a stressful time. If you have a partner and find that your relationship is suffering, a BRIA couples therapist can help you and your partner with better communication to diffuse the anger.  In addition, mindfulness meditation and movement classes can allow you to channel strong feelings and release them.


Guilt, self-blame, and doubt lead to an endless loop of negativity that can be paralyzing.

At a time when there is so much pressure to be happy, many women who struggle with mental health issues during pregnancy feel ashamed by their emotions and worry that their anxiety and depression will harm their baby. Others have self-blame for random findings on ultrasounds or genetic testing. Sometimes they feel so guilty that they think this is a sign that they will be a terrible mother, or that they don’t deserve the baby. This endless loop of guilt and self-blame can be devastating. Intense guilt can also be a sign of underlying depression or anxiety.

BRIA Individual therapists can help you address these feelings, develop acceptance, and create a more peaceful state of mind. Group therapy may also be helpful, by connecting you to like-minded individuals and teaching you how to reduce negative thought loops. If you are also experiencing guilt as part of significant depression or anxiety, a BRIA Care Coordinator may suggest a more detailed MAXI Mental Health Assessment to treat underlying concerns.


Pregnant women may feel frightened by the transitions to their mind and body.

Fear can accompany many women throughout their pregnancy, as there are many unknowns along the way. They may feel vulnerable by their lack of control over their pregnant body. People who have had a prior pregnancy loss may try to hide their pregnancy from others until it’s a “safe” time to tell them, for fear that they will have another loss. Some people are scared about possible health concerns of their  baby, while others worry about having a difficult labour and delivery or repeating a traumatic delivery. Being pregnant during the COVID-19 pandemic has added a significant layer of uncertainty and fear for many people– trying to avoid getting ill, transmission of COVID to the baby, concerns about the vaccine, changing hospital policies, and precarious decisions about exposure risks. When fear becomes consuming and interferes with pleasure, you require care and support to help manage these concerns.

A BRIA individual therapist can compassionately listen, guide, and support you through this time. Therapy can help you manage your fear, cope with being in a situation that is beyond your control, and enjoy the pregnancy. Group therapy is another helpful option, so that you can feel connected with other women who are enduring similar struggles, under the guidance of a trained professional. You will feel less alone and learn how to manage the overwhelming experience that pregnancy can be.


Stress, anxiety, and depression can all interfere with quality sleep.

At BRIA, we can help treat insomnia. Our sleep consultant offers expert guidance to get you to a better place. Mindful Movement classes can teach you helpful strategies to get more sleep. We may also recommend a more comprehensive MAXI Mental Health Assessment to determine if you are struggling with a significant underlying mental health issue that can impact your sleep — then we will focus on treating this specific issue. (And we always suggest you speak to your obstetrical provider first to be sure there are no active medical issues that may be contributing to insomnia.)

Medical Issues

Pregnancy complications and illnesses can trigger anxiety and mood symptoms.

Common medical issues in pregnancy, such as anaemia and hypothyroidism, can mimic the symptoms of anxiety and depression. Other illnesses like severe nausea and vomiting, gestational diabetes, hypertension and preeclampsia can worsen anxiety or depression, especially if bed rest is recommended and there are few distractions while life feels very bleak. If there is an issue with the baby, or a previous perinatal loss, the worries are even greater. Pregnancy can be a time of many medical stressors and unknown outcomes for both the pregnant person and the fetus. And this lack of control can have a big impact on mental health.

At BRIA, we always suggest you speak to your obstetrical provider to assess and treat underlying medical issues. The BRIA Dietitians can help with proper nutrition and lifestyle guidance for some medical issues that arise in pregnancy, like kidney disease or diabetes. If you are having insomnia due to worrying or obsessive thoughts, our Sleep Consultants can teach you techniques to combat poor sleep. If you feel like your mental health is starting to impact your pleasure and daily functioning, you may need a more in-depth assessment by a BRIA Care Coordinator, mental health specialist and psychiatrist. We work in tandem with your obstetrical team to provide an array of services to help you feel better.

Let’s measure your symptoms

1 in 5 Canadian women is struggling with a mental health problem today — you are not alone.
Start by taking BRIA’s quiz to understand your symptoms and stressors.

BRIA Services

MINI Mental Health Assessment

The BRIA MINI will provide you with a personalized Care Plan.

MINI Mental Health Assessment

When a BRIA Care Coordinator meets with you for a MINI Mental Health Assessment, she will learn about your symptoms, stressors and struggles and will create a Care Plan just for you. Your Care Plan will outline which BRIA services can help you get better. The MINI is your starting point on your MD-designed path to recovery with BRIA.

Individual Therapy

Our team of professional therapists can teach you the tools you need to feel better.

Individual Therapy

People who are pregnant often find that therapy helps them cope with intense worry about pregnancy and the future, as well as shame and sadness that they may be struggling with. BRIA therapists are experts in pregnancy mental health counselling, and have experience addressing many of the issues that commonly arise for people at this stage. Whether you see a therapist with expertise in supportive therapy, Cognitive Behavioural Therapy or Behavioural Activation, a BRIA therapist will listen compassionately, and ensure that you develop the tools you need to feel better.

Couples Therapy

You and your partner can talk to a therapist to address conflict and communication issues.

Couples Therapy

During major life transition times like pregnancy, people may find that the relationship with their partner takes a hit. Pregnancy can be stressful, and even the best relationships can suffer during this time. Plus, if a relationship was strained before pregnancy, it can worsen under stress. BRIA expert couples therapists can help you and your partner learn to communicate better, share your feelings, and help you develop the skills you need to navigate the ups and downs of your relationship as you prepare to become parents or expand your family.

Group Therapy

You will join people who are experiencing similar issues to openly share, receive support, and learn new skills.

Group Therapy

People who are struggling with mental health issues during pregnancy often feel particularly alone and out of sync with their friends, family, and peers. This isolation can be very painful. Group therapy is a safe and confidential place to be honest and open about your struggles. You will get helpful support from others who share the same experiences, under the guidance of a compassionate mental health professional.

MAXI Mental Health Assessment

The MAXI offers an in-depth assessment of mental health concerns by an expert mental health professional.

MAXI Mental Health Assessment

If our Care Coordinator recommends further mental health evaluation after your MINI, you will be referred to the MAXI Mental Health Assessment. This is a more detailed assessment by a mental health professional. In the MAXI, you will get recommendations for therapy and other services to address your concerns

Sleep Consultant

Getting a good night’s sleep is critical for mental health and wellbeing. We can assess sleep issues and get you much needed night time rest.

Sleep Consultant

At BRIA, we know sleep is crucial. We also know how many women struggle with sleep, especially during pregnancy. This is why we have brought together a team of experts to help with your sleep and to help sleep-train your child. A BRIA sleep consultant will assess your sleep, create a sleep plan just for you, and help you implement that plan effectively.

Mindful Movement Classes

Classes by an expert yoga and mindfulness instructor will teach you tools to support your mental health when you are pregnant.

Mindful Movement Classes

BRIA offers an accessible movement class that will include yoga, breath-work, and relaxation. Classes encourage physical openness, strength, stability, and harmony. Mindfulness meditation will be infused throughout the classes to address an array of mental health concerns, such as anxiety, depression, and even insomnia. No previous experience is required.

Much, Much More

BRIA has a team of multidisciplinary experts who can address your challenges when you are pregnant.

Other BRIA Experts

Whether you are struggling with  eating nutritiously, trying to manage a tantruming toddler, or you need support making a career change, BRIA can help. We know that many factors can affect your mental health, so we provide experts–  including career consultants, parenting coaches  and dietitians–who will help improve your overall functioning. We also offer breastfeeding preparation with a certified Lactation Consultant. BRIA care providers are women*-focussed vetted experts.  Stay tuned for webinars and “Ask the Expert” sessions with our BRIA team and guest experts.


As experts in women’s mental health care, we understand that part of recovering from mental health struggles is learning about them. Knowledge improves awareness, reduces stigma, and helps everyone feel less ashamed.