When Zaneta Thayer, an anthropologist at Dartmouth College, asked students in an evolutionary class what words came to mind when they thought of childbirth, almost all of them were negative: pain, screaming, blood, I was terrified.
She then asks if any of the students have ever seen a woman giving birth. Most do not.
Interested in how cultural attitudes and expectations affect the physical experience and outcome of childbirth, Dr. Thayer identified the prevalence of tokophobia, a medical term for a morbid fear of childbirth. We have started a study to evaluate.
Tokophobia is well-studied in Scandinavian countries, and some countries are testing and providing treatment for pregnant women, but little research has been done in the United States. Dr. Thayer’s online survey of about 1,800 American women found that early in the pandemic, the majority of American women may have been affected by stage phobia. Sixty-two percent of pregnant respondents reported high levels of fear and anxiety about childbirth.
of The results were published in a magazine last month. Evolution, medicine, public health.
Other scientists studying childbirth said fear levels in the US were higher than those reported in Europe and Australia (less than 20%). But they noted that childbirth conditions in the United States are different and that the pandemic situation may have exacerbated the fears.
Some degree of anxiety about childbirth is universal. Karen Rosenberg, professor of anthropology at the University of Delaware, said encouraging women to seek help and emotional support during childbirth may be an adaptive behavior favored by evolution.
“Other animals may give birth in social settings, but humans are the only primate that actively seeks help during birth and actively seeks help on a daily basis,” says New Mexico. Anthropologist Wenda Trevathan, senior fellow at the School of Advanced Studies in Santa Fe, Santa Fe, said. think tank.
However, extreme morbid fear can be maladaptive and may lead some women to needlessly undergo C-sections or refrain from becoming pregnant.
New research has limitations. Prenatal and postnatal data were collected during his first ten months of the pandemic, when the health system was under extreme strain. This sample was not nationally representative and consisted of a disproportionate proportion of whites and high-income women.
Half of the women had never given birth, and more than one-third had high-risk pregnancies.
More than 80% of women fear that the pandemic will prevent their preferred caregiver from attending the hospital during childbirth, or that their baby will be taken away if diagnosed with COVID-19. said there is. Because if she had the virus, she could infect her baby.
Black mothers were nearly three times more likely to die from pregnancy-related complications and were almost twice as likely to have a strong fear of childbirth than white mothers.
One pregnant woman answered, “Black women are more likely to have complications or die during childbirth,” because they don’t know if their families and supporters will be hospitalized with them because of the new coronavirus. added that anxiety had increased. . “Who will speak up for me?”
The study found that women with floor phobia were almost twice as likely to give birth prematurely, that is, to have a baby before 37 weeks’ gestation. Premature babies are more likely to have health problems, are at higher risk of disability and death, and often spend time in the neonatal intensive care unit.
This association does not prove a causal relationship between fear and preterm birth. However, the risk of preterm birth among women with high levels of fear and worry remained high even after adjusting for other factors such as caesarean section.
The study also found an association between fear and increased rates of postnatal depression and the use of formula to supplement breastfeeding. No association was found between floor phobia and high cesarean section rates or low birth weight in newborns.
Thayer said fear of childbirth may be “underrepresented as a contributor to health inequalities.”
“People who fear mistreatment or discrimination in the obstetric setting may have more fear of childbirth, which may lead to increased complications throughout the perinatal period,” she says.
In the United States, black women experience premature births more than any other race or ethnicity. That percentage is about 50 percent higher than for white women. About 14 percent of black infants are born prematurely, compared to just over 9 percent of white and Hispanic infants.
While previous studies have linked preterm birth with psychosocial stress, this is the first time a link has been found with sympathophobia, Thayer said.
Fear of childbirth was higher among all socially disadvantaged women, including low-income and less-educated women. Single women, women in obstetric care, and women who had their first child were also more likely to have fear.
Thayer found that women with high-risk pregnancies and women suffering from prenatal depression were also more likely to fear childbirth.
