Red Flags & When to Go In Person for Perinatal Anxiety - Triage

Audience: pediatric

Perinatal anxiety is a common condition affecting parents during pregnancy and after childbirth. It involves feelings of excessive worry, fear, or nervousness that can interfere with daily life and caring for a baby. While many parents experience mild anxiety that can be managed with support and self-care, some signs suggest the need for in-person medical evaluation. This guide helps pediatric readers recognize red flags that require urgent attention and explains what telemedicine can and cannot do for perinatal anxiety. Early recognition and support are important to promote the health and well-being of both parent and child. If you or someone you care for is experiencing intense anxiety, mood changes, or thoughts of harm, seek in-person care promptly. Telemedicine can offer helpful education, emotional support, and initial guidance but is not a substitute for emergency or specialized care when needed.

Red flags — go in person / ER

• Thoughts of harming yourself or your baby — seek emergency care immediately.
• Severe mood swings or inability to care for yourself or your baby safely — go to a healthcare facility.
• Hallucinations, hearing voices, or extreme panic attacks not improving — get urgent in-person evaluation.

What telemedicine can do

• Mild to moderate anxiety symptoms discussion
• Education about perinatal anxiety
• Teaching coping and relaxation techniques
• Emotional support and guidance
• Referral to specialists

What telemedicine cannot do

• Emergency situations or suicidal thoughts
• Physical examinations or diagnostic testing
• Medication initiation or complex management
• Safety concerns for parent or baby requiring close monitoring

What Is Perinatal Anxiety?

Perinatal anxiety refers to feelings of intense worry, fear, or nervousness that occur during pregnancy or within the first year after childbirth. It is different from the usual stress of becoming a parent because it can be overwhelming and affect daily activities. Symptoms may include constant worry, trouble sleeping, restlessness, and difficulty concentrating. Recognizing these symptoms early can help parents get the support they need.

Common Signs and Symptoms

Typical signs of perinatal anxiety include:

These symptoms can vary in intensity and may come and go.

When to Seek In-Person Care: Red Flags

Some signs mean you should get in-person medical help right away:

If you notice any of these, go to an emergency room or contact a healthcare provider immediately.

How Telemedicine Can Help

Telemedicine can be a good first step for:

It offers convenience and privacy but has limits.

Limitations of Telemedicine for Perinatal Anxiety

Telemedicine cannot replace in-person care when:

In these cases, seeing a healthcare provider face-to-face is important.

Preparing for Your Telemedicine Visit

To get the most from your tele-visit:

Being prepared helps your provider understand your situation better.

How to prepare for your tele-visit

• Choose a quiet, private space for your tele-visit.
• Prepare a list of symptoms and concerns to discuss.
• Have your current medications and dosages handy.
• Ensure your device is fully charged and has a stable internet connection.
• Consider having a trusted person nearby for support if needed.

After your tele-visit

• Follow any advice or referrals given by your provider.
• Practice recommended coping strategies and self-care.
• Monitor your symptoms and note any changes.
• Schedule follow-up appointments as advised.
• Seek in-person care promptly if red flags appear.

FAQs

What is the difference between normal worry and perinatal anxiety?

Normal worry is common during pregnancy and after childbirth and usually comes and goes without interfering with daily life. Perinatal anxiety involves persistent, intense worry or fear that affects your ability to function and care for your baby.

Can telemedicine provide medication for perinatal anxiety?

Telemedicine providers may discuss medication options, but starting or adjusting medications often requires in-person evaluation and monitoring to ensure safety for you and your baby.

What should I do if I have thoughts of harming myself or my baby?

If you have any thoughts of harming yourself or your baby, seek emergency medical help immediately. Call emergency services or go to the nearest emergency room without delay.

How can I support a loved one with perinatal anxiety?

Offer understanding and listen without judgment. Encourage them to seek professional help and assist with daily tasks if possible. Remind them they are not alone and support is available.

Is perinatal anxiety common?

Yes, many parents experience anxiety during pregnancy or after childbirth. It is a recognized condition and help is available to manage symptoms and support well-being.

Sources

1. Perinatal Anxiety and Depression — MedlinePlus, U.S. National Library of Medicine.
2. Anxiety During Pregnancy — Centers for Disease Control and Prevention (CDC).
3. Postpartum Anxiety and Depression — American Academy of Pediatrics (AAP).
4. Perinatal Mental Health: A Guide for Health Professionals — National Library of Medicine.
5. Perinatal Anxiety and Depression: Clinical Practice Guidelines — Mayo Clinic.

This telemedicine guidance is for educational and triage purposes only. It is not a substitute for professional in-person medical care, diagnosis, or treatment. If you have any urgent symptoms or concerns, please seek immediate in-person medical attention.