When Jasmine Hanks, 27, was pregnant with her first child, so was Beyoncé, as well as some of the cast of The Only Way is Essex. “I think this is really stupid,” she says, sounding embarrassed, but still pained. “I followed them on Instagram; they had perfect bumps and looked really glam. When you’re heavily pregnant, you think you look an absolute sight in comparison – that does nothing for your self-esteem.”

Hanks checked Instagram first thing in the morning, then Facebook on her lunchbreak, and found an inexorable onslaught of feelings of inadequacy – which she found much more distressing in pregnancy than before. “You’re constantly having these images of perfect, beautiful women thrust in your face all the time. It’s quite difficult to see past what’s in front of you in the mirror.”

Social media was just one element of modern life that Hanks says left her feeling overwhelmed, anxious and isolated. Hanks’s mother, Sandra Monks, says she had three pregnancies and experienced nowhere near the same unmanageable feelings of anxiety.

It is this shift between generations that Rebecca Pearson, a lecturer in psychiatric epidemiology at Bristol university, sought to investigate in her study published recently. She extracted data from the children of a 1990s longitudinal study, which recruited more than 14,000 pregnant women from the Avon area with due dates from 1990-1992, and followed their offspring as they grew up.

Now that some of those children have children of their own, Pearson had a unique opportunity to study how the experience of pregnancy has changed over the last generation. Her findings are bleak. Clinical levels of depression and anxiety among pregnant women aged 19-24 have risen sharply from 17% in 1990 to 25%.

The results are nuanced: “What we would call ‘core depression’ – feeling down in the dumps – actually hasn’t risen. The rise was driven by a cluster of symptoms: feeling overwhelmed, fear, not being able to sleep, crying. We think that’s important. We spoke to a generation of women who identify with an overwhelmed, stressed, anxious feeling, not depression.” Hanks, who classifies her anxiety as moderate rather than severe, describes a similar state.

Social media is one of the stressors mentioned by the younger generation of women in her study, who were young teenagers when Facebook launched. This shift is something Claudia De Campos, parent-infant psychotherapist at the Anna Freud Centre in London has watched develop in real time.

“On Instagram, I think what everybody wants to portray is a perfect life. This contributes to an image of the world that is not real. Pregnancy is a very real bodily change, that one cannot get away from. The unglamorous aspects of pregnancy are not talked about, and that can leave women feeling lonely.” Hanks describes “that feeling of trying to paint a face that everything’s perfect when it’s not necessarily great.” That pressure can easily slip from manageable to overwhelming with the emotional and physical changes brought about by pregnancy.

The proliferation of the internet has also led to information overload for some, says Pearson. Midwifery lecturer Catriona Jones has said that sharing birth horror stories on social media may fuel women’s anxiety about childbirth, opening up a debate on whether that empowers or traumatises women. One clear message to emerge was that those with anxieties about pregnancy need more support.

Hanks acknowledges that the initial anxieties of early pregnancy are natural, but, she says, “I think I made my situation worse because I was constantly googling things.” Every doubt, every worry, every test result would be looked up to check the risks; online forums were helpful at times, providing a sense of community, but other, well-meaning users could not always be relied upon to provide accurate information.

Pearson explains why this can be particularly disturbing: “If you have a slight vulnerability to depression and anxiety, the way you process information is different; if you’re looking up things online, you’re going to pay more attention to the negative and worrying information.”

There is also the combination of work with motherhood, which is much more common today than it was 25 years ago, says Pearson. “There are pressures to keep going to the end of pregnancy, to keep up – people don’t want to tell colleagues that they are pregnant because they don’t want to miss opportunities.”

The evidence still needs to be unpicked, but she suspects that potential policy changes could include more understanding in the workplace, flexible working hours and more support with the increased take-up of joint parental leave.

Beyond these practical measures, there are more searching questions that need to be asked about the expectations on pregnant women and what they expect from themselves. De Campos explains that pregnancy can bring about a sense of ambivalence – not as the word is commonly used, to mean wanting neither one thing nor the other, but in the sense of a destabilising experience of potent contradictory desires, from the Latin “ambi”, meaning both, and “valentia”, strength: to crave a child, and also to wish that nothing in life will change.

There is pressure on pregnant women, both internal and external, to do everything, she says, describing how this can lead to “detaching oneself from one’s own limitations”. She asks, “How can you keep going at the same pace when your body is changing, when you feel more tired? If you, your partner, and society expects you to be just the same, that is an impossible task.” But it does not have to be this way: “The minute that one accepts that actually, I am going to feel an impact, I won’t always be able to be as productive – then the ideal becomes real, and one can manage it a bit more.”

For women who are struggling, the first point of contact is the midwife. Hanks would have liked to have asked hers for more support, she says, but unlike her mother who had the same one throughout her pregnancies, Hanks recalls seeing someone different almost every time. “I found it quite difficult to build a rapport with them – I was feeling a bit isolated, and only had a 15-minute appointment. If I’d been seeing the same person I think I would’ve felt more confident talking about those feelings.”

Janet Fyle, professional policy adviser at the Royal College of Midwives agrees that continuity of care is key, as is recognised by the Maternity Transformation Programme, an NHS initiative aiming to improve the experiences of pregnant women and new mothers. But, she says, to have continuity of care, “you need to have the midwife numbers. If the commissioners and the government don’t put more midwives in to make it happen, it can’t happen.”

There is also a need for more specialist support. Only about half the UK has specialist perinatal mental health teams – and services are desperately needed in Northern Ireland, some parts of Scotland and in Wales.

Anyone wishing to support a woman throughout her pregnancy needs to be aware of the balance to be struck between being uncaring and overbearing. De Campos says: “They’re not invalids, but at the same time it’s not nothing. It is about allowing space for the individuality of each woman, not making any assumptions, and having an open and receptive mind.”

Jones says: “Not all mental health problems need specialised treatments – for many women, just getting some support from friends, family and colleagues may be what’s needed. It’s about all of us offering support sensitively, though that may include encouraging women to talk to a health professional to get more specialised help.”

For some women with pre-existing conditions including OCD, eating disorders, recent bereavement, loss, or sexual abuse, pregnancy may involve a deterioration in mental health, explains De Campos, because of the psychological, physical and life transformations they are experiencing. It is a developmental phase, from daughter to mother. Pregnancy is characterised by feelings of uncertainty, she says, but it is also a time when remarkable psychological growth can happen. “The nine months of pregnancy is what helps you to be ready to become a mother. Much work is done over this time.”

It can be a powerful motivation for parents-to-be to come to therapy, she says. “It becomes easier to recognise one’s difficulties and to want to do something about them. It’s a potentially very creative time, of wanting to change, for one’s own sake, and particularly for the sake of the child.”