Why pregnancy anxiety?
It is not clear why ‘pregnancy anxiety’ has such
powerful effects on mothers and their babies. In
fact, the nature of this concept has not yet received
sufficient attention to be fully explicated. Possibly
what makes it potent is that measures of pregnancy
anxiety capture both dispositional characteristics,
or traits, and environmentally influenced states.
For example, women who are most anxious about
a pregnancy seem to be more insecurely attached, of
certain cultural backgrounds, more likely to have a
history of infertility or to be carrying unplanned
pregnancies, and have fewer psychosocial resources
[49]. These results suggest that existing vulnerabilities
that predate pregnancy may interact with
the social, familial, cultural, societal, and environmental
conditions of pregnancy to increase levels
of pregnancy anxiety, producing effects on the
maternal–fetal–placental systems, especially during
sensitive periods such as early pregnancy. This process
can then adversely influence fetal development
by programming the fetus’s HPA axis and also have
effects on the initiation of labor via maternal, fetal,
and placental hormonal exchanges. Although there
is much we do not know, a worthwhile future goal
for clinical researchers may be to identify women
high in anxiety before conception, as well as women
high in anxiety during pregnancy, and especially
those women who are anxious about specific aspects
of their pregnancies – about this child and this birth,
and about competently parenting with this partner.
These women would appear to be targets for early
intervention such as evidence-based interventions
for stress reduction, mood regulation treatments
such as cognitive behavioral therapies, pharmacological
treatments, and follow-up care during postpartum
to prevent a range of adverse outcomes for
mother, child, and family.