Health

Pregnant Women’s Biggest Worry

They're fearful of one of the most surprising things ever

New moms stress about a lot of things — will they be a good parent? Will their baby be healthy? What sort of diapers are best — and when should they start saving for college?

“Women who have significant fear of childbirth are more likely to have C-sections or longer labors, and need induction or augmentation,” said one midwife.

The fear of abandonment by their OB/GYN, however, appears to top the list.

A new University of Michigan study has found that women are even more afraid of childbirth than previously thought — and are as concerned about their health care providers and their place of birth as they are about any pain or complications during childbirth.

The findings are a lukewarm endorsement at best of the maternity care given to mothers in the United States compared to more family-friendly countries like Sweden, say the study’s authors.

Their goal was to learn which aspects of childbirth women feared, and whether women’s fears are being acknowledged and addressed by providers. Researchers polled three small, diverse focus groups of women who were pregnant or had recently given birth.

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While some fear in expectant mothers is normal and helpful in planning and asking questions of providers, excessive fear can lead to complications during pregnancy and birth, according to Lee Roosevelt, clinical assistant professor at the U-M School of Nursing. The study, while relatively small, illuminates the need for more research on the topic, she said.

“Women who have significant fear of childbirth are more likely to have C-sections and longer labors, and to need induction or augmentation,” said Roosevelt, who is also a midwife. “They’re more likely to have postpartum depression.”

Women are not just more afraid than previously thought — their fears extend far beyond common worries about pain or birth complications, she said.

Women reported being worried they’d be expected to bear the brunt of decision-making responsibility, or that their decisions wouldn’t be respected.

One of the greatest fears is being abandoned by their clinicians, Roosevelt said. They worry their clinicians won’t treat them respectfully or listen to their concerns — or won’t attend the actual birth.

“The results say a lot about how we do maternity care in this country,” said Lisa Kane Low, associate professor at the U-M School of Nursing.

Women also reported being worried they’d be expected to bear the brunt of decision-making responsibility, or that their decisions wouldn’t be respected. Others worried how they’d be treated if they didn’t have good insurance.

“I knew as a clinician and midwife, myself, that the relationship I have with my patients is so essential, but I didn’t really realize how key it was to women’s fears,” Roosevelt said.

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Kane Low said a better way for clinicians to address fears is to pose open-ended questions about how women regard their pregnancy and childbirth, rather than asking specific questions about common fears.

“Women want to be in a discussion with their provider about their fears,” she said. “They don’t want to be patted on the back and told, ‘Oh, that’s normal, you’re having a baby.'”

Researchers hope to develop a survey tool to accurately assess a woman’s fear of childbirth and examine how fear affects the physiology of pregnant moms.

The U-M study is one of the few on fear of childbirth conducted in the U.S. Most research has occurred in the Netherlands and Sweden, which have more integrated health care systems and maternity-friendly policies, said Kane Low.

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