There’s a version of pregnancy care that focuses almost entirely on your body: your weight, your bloodwork, your baby’s growth chart, your test results.

And then there’s everything else — how you’re feeling, what you’re afraid of, what stories you’ve absorbed about birth from movies and family members and strangers on the internet, whether you feel like yourself or like a stranger in your own life. That part? It rarely makes it onto the agenda at your 10-minute OB appointment.

This post is about that part.

I’m Anne — holistic pregnancy and infant and toddler sleep coach. My second pregnancy was one of the lowest mental health periods of my entire life. Anxiety, panic attacks, insomnia, a full catalog of physical symptoms — things I had never experienced before and had absolutely no tools to navigate. I was in standard care, being told that some of what I was experiencing was “common,” and I remember thinking: common doesn’t mean okay, and I need actual help.

What pulled me through was a set of intentional practices for my pregnancy mindset. And the birth that followed — despite one of the hardest pregnancies I’d had — was empowered, prepared, and positive. Difficult pregnancy and positive birth experience are not mutually exclusive. That’s one of the most important things I want you to leave this post knowing.

First, Let’s Talk About What’s Actually Happening

According to the Maternal Mental Health Leadership Alliance (published October 2024), one in five mothers is impacted by a maternal mental health condition. Of those women, 75% remain untreated — which increases the risk of long-term negative impacts on mothers, babies, and families. And if anxiety or depression in the postpartum period goes untreated, those symptoms can persist for up to three years.

Here’s the breakdown that really stopped me: 40% of maternal mental health symptoms develop following childbirth. But 33% develop during pregnancy — and 27% of women enter pregnancy already experiencing anxiety or depression.

That’s more than a quarter of pregnant women starting their journey already carrying something heavy. And most of them will move through the entire pregnancy in standard care without that ever being meaningfully addressed.

This is not a personal failure. This is a gap in how our system is designed to care for pregnant women. OBs often have 10 to 15 minutes with low-risk patients — barely enough time to cover the clinical bases, let alone ask how someone is really doing. Midwifery care tends to do better here, but the truth is that maternal mental health support during pregnancy is widely, systemically under-resourced.

Which means we have to build it ourselves. And we can.

Why “Just Go With the Flow” Can Actually Be Dangerous

Before we get into the practices, I want to address something. There’s a popular idea — I see it in comments and DMs constantly — that the most empowered thing a pregnant woman can do is surrender: go with the flow, let birth unfold, stop trying to control things.

On the surface that sounds wise. In practice, it can be one of the most harmful things a pregnant woman tells herself.

Going with the flow often means putting the full weight of your care in the hands of the system. It means going into birth with a lot of assumptions about how your team will handle things, and discovering in the delivery room that some of those assumptions were wrong. That gap — between what you expected and what actually happened — is one of the most common roots of birth trauma.

Taking control of your pregnancy is not the opposite of being flexible. It’s doing the education, the inner work, the preparation — and then holding that alongside an open, fluid mindset that can adapt to whatever the birth itself brings. That’s the balance. That’s what this post is helping you build.

Step 1: Get Underneath Your Beliefs

Before you can do anything else, you need to know what you’re actually working with.

Every woman comes into pregnancy with a set of underlying beliefs — conscious and subconscious — about pregnancy, birth, her body, and her own capacity. Some of those beliefs are hers. Some were adopted from family stories, cultural messaging, social media, movies, traumatic stories she overheard at a baby shower ten years ago.

Start by simply asking yourself: How do I actually feel about pregnancy and birth?

Do you believe birth is meant to be painful and terrifying? Do you believe your body is capable? Do you believe you’ll be supported? Do you believe you have any say in what happens? These beliefs are operating in the background of every decision you make — and if they’re fear-based rather than informed, they’ll steer you toward fear-based decisions rather than self-aligned ones.

This is where to start. Not with a birth plan, not with a provider choice — with yourself.

Step 2: Identify Your Fears — and Ask Where They Came From

Once you’ve started to identify your beliefs, go one layer deeper: name your fears. And for each one, ask yourself — is this actually my fear, or did I adopt it from someone else?

This distinction matters. There are valid, informed fears worth working with. And there are fears that were handed to you by someone else’s experience, someone else’s story, someone else’s anxiety — and you’ve been carrying them as your own ever since.

When you know specifically what you’re afraid of, you can get educated around it. You can ask your provider direct questions. You can seek out support. Fear in the abstract is paralyzing. Fear that’s been named, examined, and educated around becomes something you can actually work with.

Step 3: Start Early — Don’t Wait Until the Third Trimester

The moment you know you’re pregnant, your mindset work can begin. I’ve had moms reach out to me at six weeks pregnant already in a fear spiral, and the best thing I can tell them is: you don’t have to wait to get support.

The standard advice to start birth preparation in the third trimester means skipping two full trimesters of potential support, education, and grounding. You’re making significant decisions about your care from the first positive test — your provider, your care model, how you’re managing your body and your mental health. Those decisions deserve to be made from an informed, supported, centered place.

Your pregnancy mindset is not a third-trimester project. It’s a full-pregnancy practice.

Step 4: Build a Care Team That Actually Supports You

This sounds obvious, but it’s worth saying directly: the people around you during pregnancy and birth will shape your experience. Your provider’s willingness to answer your questions, engage with your preferences, and treat you as an active participant in your own care will directly affect how safe and supported you feel.

A provider who brushes off your questions is not a neutral inconvenience — they’re a source of anxiety. A partner who is disengaged, dismissive, or carrying their own unexamined fears about birth is not just unhelpful — they can actively undermine your confidence.

Use your prenatal appointments as temperature checks. Are your questions being answered? Do you feel heard? Do you feel like a person or a number? If the answer points toward the latter, you have more options than you might think — and earlier in pregnancy is always better to discover that than in the delivery room.

And connect meaningfully with your partner. Their fears, their beliefs, their engagement in your pregnancy journey aren’t separate from yours. Getting aligned — educating together, navigating the emotional terrain together — makes the whole experience less isolating and more powerful.

Step 5: Build Your Daily Practices

This is the toolkit. Take what resonates, leave what doesn’t, and make it yours. These are the practices that made the difference for me and for the women I work with.

Meditation. I know — some of you just rolled your eyes. I used to do the same. But here’s the reframe: meditation doesn’t have to be a 30-minute silent ritual with perfect stillness. It can be two minutes. It can be sitting and focusing on your breath. It can be a guided YouTube meditation while you’re lying in bed at night. The goal is simply to give yourself time to be with yourself — to step out of the mental chatter and into your body. For pregnant women, this is especially powerful: it regulates your nervous system, it connects you with your baby, and it builds the same kind of grounded calm you’ll need in labor.

Journaling. You don’t need beautiful handwriting or a structured practice. You need to get things out of your head and onto paper. Brain dumps — just opening a document and pouring out whatever is circling in your mind — are as valid as structured journaling. The act of writing what you’re feeling creates just enough distance to process it.

Birth affirmations. I want to be honest with you about how these work, because “just say positive things” is incomplete advice. If you’re carrying deep fear or genuine doubt, an affirmation you don’t believe won’t shift anything. What makes affirmations powerful is feeling into them — connecting with the energy of what they’re saying, not just reciting words. Find affirmations that feel true, or at least possible, for where you are right now. Sometimes a softer, more neutral affirmation lands better than a bold one. Start there. (My free 21 Birth Affirmations guide is in the freebie vault at empoweredwithann.com — grab it and find the ones that feel right for you.)

Daily movement. Even in my hardest pregnancy, when I was on rest and couldn’t do my usual workouts, movement still mattered. Standing and swaying. A short walk. Dancing in the kitchen. Energy gets stuck in the body during pregnancy — emotional energy, physical tension, stress. Moving it out doesn’t require a workout. It requires intention.

Hypnobirthing. I took a course and I cannot recommend it enough. I came to it as preparation for my unmedicated birth, but I found it was one of the most powerful tools for my mental health throughout pregnancy. The breathwork, the visualizations, the nervous system regulation — all of it was deeply supportive long before I was in labor.

Somatic exercises and breathwork. Both work with the body rather than just the mind, and for pregnancy — where so much of what we’re experiencing is physical, hormonal, embodied — that matters. Breathwork in particular can be genuinely transformative for anxiety and overwhelm.

Prayer and energy work. For those whose faith or spiritual practice is meaningful to them: lean into it. This is not a time to put that aside.

Phone reminders. This one is simple and underrated. I use an app called Nudge to set reminders throughout the day — little notes that say things like “I am safe. Take a breath.” When you’re in the thick of pregnancy stress, you forget to ground yourself. These reminders do that work for you. Set them up with your affirmations, with grounding phrases, with anything that pulls you back to center.

Step 6: Write Down Your Questions and Get Them Answered

You will have questions throughout your pregnancy — about symptoms, about procedures, about birth, about your options. Write them down. Every single one. Bring them to every appointment and get them answered.

This sounds small. It isn’t. Every answered question is one less thing feeding the anxiety spiral. Every time you walk out of an appointment with more information than you walked in with, your confidence level rises incrementally. Over the course of a full pregnancy, those increments add up to something significant.

Step 7: Create and Use Your Birth Plan

I have an entire episode and post dedicated to this — so I’ll keep it brief here — but your birth plan is not just a checklist to hand your L&D team. It is a living tool for your own journey. It’s you educating yourself, clarifying what you want, communicating your intentions, and building the informed confidence that comes from knowing you’ve done the work.

Think of it as a work in progress, not a finished document. Start it early, return to it often, and let it evolve as you grow and learn throughout pregnancy. Grab my birth plan template and guide (just $7) at empoweredwithanne.com — it includes the guidance to actually use it so you don’t get stuck.

When Practices Aren’t Enough — Please Seek Support

I want to be direct about this: everything in this post is supportive, not clinical. If you are struggling with your mental health during pregnancy — truly struggling, in a way that feels like more than mindset work can touch — please talk to your provider and seek professional support.

Seventy-five percent of women with maternal mental health conditions go untreated. Please don’t be part of that statistic because you thought you should be able to handle it with journaling and affirmations alone. You deserve actual care. Asking for it is one of the most courageous and self-aligned things you can do.

You Deserve an Elevated Pregnancy Experience

You are allowed to want more than standard care offers. You are allowed to ask questions, build your team, do the inner work, and step into your pregnancy as someone who is actively shaping her experience rather than passively moving through it.

That’s not controlling. That’s ownership. And it is available to every pregnant woman — regardless of how easy or hard the pregnancy itself is.

📋 Empowered Pregnancy and Birth Checklist — Your free step-by-step checklist for navigating pregnancy with clarity and confidence. Grab the free checklist here.

🤰 Birth Prep Made Simple: Your Mind-Body Toolkit for an Empowered Pregnancy — Everything you need to feel fully prepared for pregnancy and beyond — the mindset tools, practical guidance, and support to help you show up confident every step of the way. Get the bundle here.

📞 Book a Pregnancy Support Call — Looking for personalized support as you navigate your pregnancy journey? Let’s connect and talk through exactly what you need. Book your call here.

You are not alone in this. Lots of love, mama.