• A Charles Sturt University researcher is doing world-leading research into pregnancy-related anxiety
• Women with a history of childhood abuse are more likely to have pregnancy-related anxiety than other women
• The research team has developed a comprehensive scale that assesses pregnancy-related anxiety, and will publish the first book on the topic later in 2021

‘Pregnancy-related anxiety’ has been identified as a distinct form of anxiety, and researchers at Charles Sturt University and the Australian Catholic University are exploring the condition in order to develop interventions to assist pregnant women.

Lecturer Dr Robyn Brunton (pictured) in the Charles Sturt School of Psychology in Bathurst has been researching pregnancy-related anxiety for more than nine years, and has interviewed thousands of pregnant mothers to develop an Australian-first screening method to more accurately identify the condition and prescribe intervention strategies.

She said many clinical and research anxiety scales do not screen for this anxiety adequately, and in most countries (such as Australia, the US, and the UK) there is no formal screening for it.

“Pregnancy-related anxiety is contextualised by pregnancy and characterised by unique pregnancy-specific fears and worries,” Dr Brunton said.

“We first started examining pregnancy-related anxiety in 2012, and 9,107 women have participated in our research since then.

“What really encourages me in this research is that usually when we have a fear (anxiety is fear-based) we avoid it to lessen those anxious feelings; for example, if you get anxious about flying, you tend to drive.

“However, for many pregnant women if they have fears and worries, such as about childbirth, they can’t avoid them.

“I am also motivated by the fact that the woman’s body is the baby’s environment, so whatever happens to the mother (or is happening) can impact the child who is most vulnerable.”

The researchers found:

• Pregnancy-related anxiety is multidimensional with women concerned about various aspects of pregnancy – e.g., the health of their unborn baby, childbirth, motherhood.

• Many clinical/research anxiety scales do not screen for this anxiety adequately, and in most countries (Aust, US, UK) there is no formal screening for this anxiety.

• Pregnancy-related anxiety is distinct from other anxieties (general, anxiety disorders) and depression during pregnancy (i.e., we have replicated other similar research).

• A pregnant woman’s beliefs around her inabilities as a parent make it more likely she will have greater concerns during pregnancy particularly in areas about body image, worrying about herself, concerns for the unborn baby, accepting her pregnancy, medical staff and childbirth, and may have avoidance behaviours during pregnancy (e.g. want a caesarean).

• Women who have never had a child are more likely to have greater pregnancy-related anxiety than women who have had previous pregnancies.

• Older women may have greater pregnancy-related anxiety in the area of baby concerns than younger women.

• Women with a history of childhood abuse are more likely to have pregnancy-related anxiety than other women.

• The prevalence of women with a history of child sexual abuse in pregnancy could be as high as 37.25 per cent.

• Compared to women with no history of abuse, child sexual abuse survivors may have more concerns with their antenatal care and greater health complaints. They may fear childbirth more and have greater difficulties with delivery. They could have a higher likelihood of post-traumatic symptomology and anxiety, consume more harmful substances (e.g., alcohol, cigarettes, and drugs) and have greater concerns with their appearance, poorer health and sleep, and may also have a higher risk of re-victimisation (of abuse).

• Two important protective factors between child abuse and pregnancy-related anxiety are resilience and social support.

The research team has developed a comprehensive scale that assesses pregnancy-related anxiety which they have thoroughly tested to ensure it is reliable and valid.

They are currently developing a shorter version of this scale (a screener) that will be suitable for clinical use and it is expected to be published this year.

The team is currently developing a longitudinal study into child maltreatment and perinatal outcomes, and examining the influence of parity (if the woman has had a previous pregnancy or not) and age on pregnancy-related anxiety.

Dr Brunton said they need to examine the effectiveness of this screener in clinical settings, compare its effectiveness against current clinical methods, and do more research on interventions.

“There is no point identifying women with pregnancy-related anxiety if we can’t help them,” she said.

Dr Brunton said if women feel they are experiencing this anxiety they should talk to their medical professional, and if they have specific concerns that they can identify, such as fears about childbirth, talk about these with their antenatal carer (e.g., midwife, doctor).

They can also reach out to various organizations such as the Gidget Foundation Australia and PANDA.

Dr Brunton and colleague Dr Rachel Dryer (now at the Australian Catholic University ) are about to publish the first book on the topic, Pregnancy-related Anxiety – Theory, Research and Practice (Routledge, October 2021).

Interventions are currently in the early stages of research, and their book examines different types of interventions and the research around them.

“While several interventions show promise in this area, more needs to be done,” Dr Brunton said.