The pregnancy panic attack

Victoria Clayton • E-mail

A few years ago when I was blissfully naive about such things as the one-hour post-glucose check or a Britax car seat, I also was clueless about the level of anxiety lurking in the hearts and minds of pregnant women. Of course, it only took two little pink lines on the home pregnancy test and, like magic, I’d joined the sisterhood. That is, Our Sisters of the Anxious Pregnancy.

Check out any pregnancy chat room and you’ll immediately get what I’m talking about. Moms-to-be — including me when I was expecting — seem to worry about everything. And how can they help it? Impetus for anxiety abounds.

I couldn’t walk into my doctor’s office and pick up a magazine without reading the bad news that awaited my unborn child and me. Words like “ectopic pregnancy,” “blighted ovum,” “gestational diabetes” and, of course, the most dreaded word of all “miscarriage” popped out at me from magazines. Amniocentesis had barely entered my vocabulary before I was informed by a (well-meaning, I’m sure) woman about the hazards of having one — no, not the fear of that long needle that everyone else talks about; she was referring to the risk of miscarriage due to having an invasive test. (The risk, I was later informed by my doctor, is less than minuscule. There’s something like a .03 percent chance that anything negative could happen.)

As a pregnant woman, I was astonished that I couldn’t have a symptom — or, more seriously, not have a symptom — before someone would inform me that it was ominous. I didn’t have morning sickness. Yes, I admit it. And I have a healthy 21-month-old son who is right this minute escaping the clutches of his father to pound on Mommy’s office door.

Yet, when I was several months pregnant and told a woman who I was interviewing for a story that I had no hyperemesis gravidarum, she lowered her voice and said, “Oh, please tell me you were maybe a little queasy a few times.” She was suggesting there was something wrong if I wasn’t sick!

So I did what any sane person would do: I lied to get her off my back. I just wanted her to stop freaking me out. The minute I hung up the phone I started calling recently pregnant friends and Googling “morning sickness” and “hyperemesis gravidarum.” After some Medline research and a few phone conversations, I learned that roughly half of pregnant women have some morning sickness and half don’t. In some cultures, a word for the condition doesn’t even exist.

So either I was a displaced native of the Republic of Seychelles or I was just one of those 50 percent who didn’t get sick. The point is there was nothing wrong with me just because I didn’t have morning sickness — but I spent a couple of sleepless nights worrying about it.

Women scared silly
When I brought my concerns to my Los Angeles obstetrician, Dr. Stuart Fischbein, he told me how frustrated he’d become. In the last decade or so — maybe because of the increasingly litigious nature of our country — with the various alarming consent and disclaimer forms now required in medical practices, the government warnings on everything from gas pumps to public buildings, all the new tests that are often helpful but also scare women silly and the increased access to sometimes dubious medical information or reports, pregnancy anxiety has drastically escalated.

Tips for a less anxious pregnancy — Select a medical team you agree with. Some women only feel comfortable with an ob-gyn while some prefer a nurse-midwife. Others hire doulas as a sort of personal assistant in the pregnancy and birthing process. Research your options (including birth options). Most importantly, make sure you feel that you can ask questions of your medical practitioner and get them answered satisfactorily. — Get an early ultrasound and, subsequently, whatever testing will make you feel calmer. An ultrasound around six weeks is the most accurate way to date a pregnancy — plus it allows you to see the baby’s heartbeat, which is reassuring. Later, a number of tests will be available. None of them — even the invasive ones such as CVS or amniocentesis — carry much risk, but knowing the results may be a way to gain further peace of mind. — Eat, drink and be yourself (for the most part). Five small meals a day keep blood sugar stable and eating a variety of foods helps ensure you and the baby get a full complement of nutrients. But don't obsess over what you eat or drink. The average woman’s diet, while probably not nutritionally perfect, provides far and away enough nutrients for a healthy baby — especially if you’re supplementing with a prenatal vitamin. And while it's advisable to avoid caffeine and alcohol, don't panic if you have an occasional cup of coffee or a Pepsi. Overall, just be you. Whatever you do when you’re not pregnant — save for drugs, alcohol and risky sports — you can do when you’re pregnant unless otherwise advised by your practitioner.

It has become so bad, according to Fischbein, that he spends half his day not practicing medicine but simply calming fears. As I spoke with more doctors, midwives and birthing educators, I was repeatedly told the same thing. Perhaps the profession closest to the subject of maternal anxiety, however, is the doula.

Officially, doulas are professionals who provide emotional, physical and informational support and advocacy to women and families before, during and immediately after birth. But Ann Grauer, president of DONA International, an association representing doulas, has a more interesting definition for them: birthing Sherpas. “When you hire a doula we can’t have the baby for you but we’re with you every step of the way,” explains Grauer.

The doula’s primary role is to give pregnant women confidence and do whatever she can to decrease their anxiety. As pregnancy anxiety in our society grows, says Grauer, so does the demand and need for doulas. (To wit, in 1994, DONA had 750 members. Today the organization has 5,718 members).

“Within the last five years even I’ve seen pregnancy fear grow to unbelievable proportions,” says Grauer, who has been a birthing instructor and doula for 16 years.

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