ANN ARBOR, Mich., June 27 (UPI) -- Some fear during pregnancy is normal, but a small survey suggests women's concerns about care during pregnancy are not being addressed based on a lack of confidence in doctors and nurses.
Women said in a survey in Detroit that they worry doctors and nurses will not listen to their opinion or respect their decisions, or they'll be abandoned by their doctors, researchers at the University of Michigan report in a recent study.
Being judged for decisions made during childbirth, having their concerns or wishes dismissed or ignored outright, or even being judged based on the type of insurance they have during pregnancy rank as high for women in the survey as concerns about pain or complications during birth, researchers found.
Excessive worrying during pregnancy is known to lead to complications during pregnancy and birth, with women more likely to have cesarean sections and longer labors. Women who worry more during pregnancy were also shown to be at greater risk for postpartum depression, according to a 2014 study of more than half a million mothers in Finland.
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Instead of asking about common fears, researchers in the new study suggest women be asked open-ended questions about their fears and not be "patted on the back and told, 'Oh, that's normal, you're having a baby.'"
"The results say a lot about how we do maternity care in this country," Dr. Lisa Kane Low, an associate professor at the University of Michigan's School of Nursing, said in a press release.
For the study, published in the Journal of Obstetric, Gynecologic and Neonatal Nursing, researchers recruited 22 women who participated in three focus groups from a health center in Detroit who were either pregnant or had given birth during the last five years. Information from the focus groups was compared to the results of the Wijma Delivery Expectancy Questionnaire.
While women in the focus groups identified many of the concerns already gleaned from the Wijma questionnaire, the researchers say fear of abandonment by clinicians and fear of the function of maternity care -- whether they would be responsible for decisions, judged for them or listened to -- which has not been previously seen in surveys.
The researchers say future studies will need to establish ways to test for and address these fears, and that maternity care should more directly address these types of concerns in pregnant women -- starting by actually listening to patients.
"I knew as a clinician and midwife, myself, that the relationship that I have with my patients is so essential, but I didn't really realize how key it was to women's fears," said Lee Roosevelt, a clinical assistant professor at the University of Michigan.
