Tokophobia, the fear of pregnancy or childbirth, is on the rise, making an increasing number of women vulnerable to postnatal depression.
A new University of Michigan study shows 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 pain or complications.
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, said the study’s authors.
The goal of the study 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.
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, said Lee Roosevelt, adding that the study, while relatively small, illuminates the need for more research on the topic.
“Women who have significant fear of childbirth are more likely to have C-sections, longer labours, and to need induction or augmentation,” said Roosevelt, who is also a midwife. “They’re more likely to have postpartum depression.”
One of the greatest fears is being abandoned by the clinician, Roosevelt noted. 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 that 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.
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 women.
The study appears in Journal of Obstetric, Gynecologic and Neonatal Nursing.
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