Why anxiety really isn’t good for pregnant women

By Sade Oguntola

ANXIETY is one of the widespread health problems, especially during pregnancy. In pregnancy, it’s natural to worry about whether the baby is healthy, have fears about being a good parent, or stress about how the relationship with the partner will change.

Although pregnancy is often portrayed as a time of great joy, that’s not the reality for all women. The adverse, long-term, stable, and sometimes, irreparable effects of anxiety during pregnancy can change pregnancy into an agonising and unpleasant event of women’s life span.

If this crisis is not properly managed and controlled, it can turn into a prolonged crisis and will leave countless undesirable consequences on the mother and her baby.

Experts, in a new study, said women that experience anxiety about their pregnancies give birth earlier on average than those who don’t. Unfortunately, babies born too soon are at increased risk for health problems. It was published by the American Psychological Association.

In Nigeria, most recent studies on pregnancy anxiety reported varying prevalence rates ranging from 7.2% to 39% amongst antenatal women. For instance, in Kano, the prevalence of anxiety and depression among pregnant women was found to be 23.2% and 26.6%, respectively.

A study in Abakaliki, eastern Nigeria, showed 13.6%, 11%, and 39.7% prevalence of depression, anxiety, and stress, respectively, among pregnant women during the COVID-19 lockdown.

Also, in 2021, a study at the ObafemiAwolowo University Teaching Hospitals Complex, Ile-Ife, reported that 43.5 per cent of the pregnant women sampled had pregnancy-related anxiety symptoms. It was in the South African Journal of Psychiatry.

It was more in older women and those with socio medical worries due to physical illnesses like hypertension and a previous miscarriage, abortion, difficult labour, a stillbirth or a past pregnancy complication.

Professor Chris Aimakhu, a consultant obstetrician and gynaecologist at the University College Hospital (UCH), Ibadan, in a remark on the study’s findings stated that although anxiety can lead to early delivery, it does not necessarily cause premature delivery.

He stated that early contraction due to anxiety, for example, can happen in a woman whose delivery date is close but the husband keeps on travelling, or who is anxious about her family’s bad financial situation or even a health challenge. This can cause her to fall into labour.

“Those are anxiety related symptoms; she is anxious. If she does not take control of herself, she can go into labour, she can deliver and all those things are coming to play. So, it is psychological,” Professor Aimakhu said.

Dr Jibril Abdulmalik, also a consultant psychiatrist at the University College Hospital (UCH), in a remark said anybody can come down with anxiety and depression, inclusive of pregnant women, and such pregnant women noticed to have high levels of anxiety, depression or worry during antenatal care are always referred for evaluation and treatment from a psychiatrist

According to Dr Abdulmalik, “Anxiety is common with pregnancy and it can have negative consequences. Anxiety during pregnancy is usually said to be U-shaped; very high in the first trimester, comes down in the second trimester and it is high again in the third trimester.

“Why in the first trimester? They are worried, will this pregnancy stay; they’re nauseated, not sleeping well, and uncomfortable. By the second trimester, everything else has calmed down, so it has come down.

“But by the third trimester, they worry if the labour will go smoothly; if their babies will come out alive or have abnormalities. They are worried about having complications during childbirth, including excess bleeding and dying during childbirth. So, it is common with pregnancy.”

The study examined the relationship between pregnancy length and different measures of anxiety, and found anxiety during pregnancy can lead to earlier births. Also, pregnancy-related anxiety in the third trimester was most strongly associated with earlier births. However, general anxiety in the first trimester also contributed to risk for early birth.

To sort out these various effects of timing and anxiety type, the researchers examined data from a diverse sample of 196 pregnant women in Denver and Los Angeles who took part in the Healthy Babies Before Birth study. 45 % of the women identified as non-Hispanic white, 36% as Hispanic white, 10% as Asian and 9% as Black or African American.

The researchers administered four different anxiety scales to the women, in both the first and the third trimesters of their pregnancies. One was a five-question to assess for general anxiety and three were specific to pregnancy: a 10-question and a four-question scale of pregnancy-related anxiety, and a nine-question assessment of a broader range of pregnancy-related stressors, such as medical care and worries about taking care of a newborn.

Although not all women who begin pregnancy with general anxiety symptoms will later experience pregnancy-specific anxiety, the study’s finding suggests that women who do follow this progression are likely to be especially at risk for earlier delivery.

Previous research has found that up to one in four pregnant women has clinically elevated anxiety symptoms and that anxiety can be a risk factor for preterm birth, or birth before 37 weeks of pregnancy. However, it is suggested that doctors should screen for anxiety during pregnancy to help prevent a psychosocial state that may affect birth outcomes.

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