Approximately 30% of women experience some type of anxiety disorder during their lifetime. Women with these disorders may experience profound changes in their symptoms during pregnancy and the postpartum period. In addition, some evidence exists that anxiety disorders can affect pregnancy outcomes. It is important that physicians understand the course of these disorders during pregnancy and available treatments so they can appropriately counsel women who are or intend to become pregnant. This article reviews the literature on the course of anxiety disorders during pregnancy and the postpartum period and presents guidelines for management.