New evidence suggests that a woman with a high-risk pregnancy needs strong psychosocial support. If the support is not available, women may struggle with fears and concerns while feeling isolated and worried.

Rutgers University researchers say keeping anxiety and stress to a minimum during pregnancy is important but is especially critical for high-risk pregnancies where it is believed to be a factor in premature birth.

Experts explain that about 15 percent of pregnancies worldwide are high-risk, making premature delivery, low infant birth weight and other poor outcomes more likely. In the United States, 10 percent of pregnant women require hospitalization because they have hyperemesis gravidarum, pre-eclampsia, kidney infections, gestational diabetes or are at risk for imminent delivery, among other conditions.

For the study, investigators interviewed 16 women hospitalized during high-risk pregnancies. They found that when women attempt to manage their emotions by themselves, an additional burden was added to an already stressful experience. Researchers used a phenomenological research method that involved in-depth interviews designed to elicit rich interpersonal data.

The study’s participants included heterosexual women ages 21 to 42 from diverse racial and ethnic groups. The researchers analyzed how they tried to manage their emotions, what rationales they used and how they interpreted advice from health care providers and family members.

The study appears in the journal Psychology of Women Quarterly.

“We noticed a common theme among the women we spoke to — they were trying to force themselves to feel certain emotions like “thinking positive” while trying to perform mind tricks to get themselves there,” said Dr. Judith McCoyd, lead author and associate professor at the School of Social Work.

“More surprisingly, the women informed us that they did not receive explicit advice on how to cope, think positive, or calm down.”

The researchers suggest that professional intervention using visualization, mindfulness, cognitive-behavioral work and/or Acceptance and Commitment Therapy, a type of psychotherapy that helps you accept difficulties, may all be useful interventions to try with this vulnerable group.

Aside from anxiety or depressive symptoms, study participants experienced an inherent dilemma; needing to choose between two options and feeling that neither is good.

For instance, researchers discovered women may believe they must think positively to enhance fetal health despite their anxiety and sadness. Moreover, they may be concerned that their fears could harm the fetus. Additional emotions and concerns found among the study group included feeling responsible for housework yet being told not to do it; and needing medical treatments they fear would harm their fetus.

The women also stifled their emotional expression with their medical providers to portray that they are a good “mother” and a “good patient.” Researchers discovered the effort to manage their emotions caused the women to expend significant energy, leaving themselves depleted and less able to cope.

The investigators believe women considering pregnancy should think about what emotional support they might receive if they have a high-risk pregnancy.

Women can speak with their obstetrician-gynecologist about receiving consistent medical and psychosocial care, and ask for a health navigator, perinatal social worker or an integrated behavioral health specialist if they require hospitalization, McCoyd said.

Source: Rutgers University