Anxiety Disorder in Pregnancy

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Table of Contents

Identification of the Problem
Literature Review
The Diagnostics and Its Characteristics
Treatment Questions
Cultural Considerations
Conclusion
References

Identification of the Problem

Pregnancy has always remained a problematic period regarding women’s health and possible disorders, and mental strain is placed among the complications. According to Rubertsson, Hellström, Cross, and Sydsjö (2014), “Around 3–17 % of women suffer from a depressive illness during pregnancy” (p. 221). Although the widespread nature seems to lessen its significance, it is still a health problem that calls for early diagnostics and treatment since it contains various risks.

To be precise, the dangers of anxiety disorder during the pregnancy period can equally affect the mother and the unborn child. As Ding et al. (2014) note, the adverse effects of a mother’s mental problems could potentially lead to “preterm birth (PTB) and/or low birth weight (LBW)” (p. 103). Moreover, the mental condition of the women themselves is critically intervened with the period of pregnancy. This reason may cause severe consequences to their psyche, both during the period and in a long-term perspective.

Due to such health consequences, one should take an exclusive look at the main aspects of the syndrome – its diagnostics and treatment. In other words, the paper will focus on the problems of early diagnosing, the ways of rehabilitation, and cultural features which influence both. Initially, it is necessary to review the literature on the phenomenon in a separate section. The following part will focus on the diagnostics features since the general nature of the disorder makes it less noticeable and can intervene with quick action. Regarding the treatment, it also contains several specific traits which the main topic of the next section will be about.

Firstly, the sensibility of the issue puts in question the accuracy of the standard medication. Secondly, the modern tendencies of treatment that apply interdisciplinary approaches require careful analysis to evaluate their efficiency. Finally, the work will contemplate the cultural context of the women suffering the disorder while dealing with their health. As a result, all the crucial points will be summed up in conclusion.

Literature Review

The base of the literature for the described problem seems quite vast at first glance. The studies akin to the articles of Rubertsson et al. (2014) or Ding et al. (2014) tend to present information about the statistics of the disorder. They are especially useful in analyzing the background of the issue, its scale, and the circumstances of the women affected. Moreover, the research of Martini et al. (2015) and similar scientists contemplate the consequences of mental dangers which extend to the postpartum period of women’s life. However, these studies only provide a basis for further exploring, while work with the core components requires the use of more specialized surveys.

A part of the studies not only identifies the conditions surrounding women’s anxiety disorder during pregnancy but also specifies the treatment approaches. These include, for instance, the work of Misri, Abizadeh, Sanders, and Swift (2015). Also, the research of Selix et al. (2017) gives further into the said theme by identifying the interdisciplinary methods of eliminating the problem. What is also essential, if one resorts to studying the cultural component, one could find the surveys of Fleuriet and Sunil (2014) or Robinson, Benzies, Cairns, Fung, and Tough (2016) as sufficiently detailed. The scientists use the analysis of ethnic minorities in the USA to showcase how the sociocultural factors influence the probability of mothers’ mental disorders in the periods of pregnancy and beyond.

The Diagnostics and Its Characteristics

As already mentioned, the early diagnosis of the disorder is complicated by its features, namely, the attitudes of pregnant women and caregivers. According to Evans, Spiby, and Morrell (2015), due to the general look of symptoms, healthcare personnel needs to focus on the signs’ identification in everyday practice. As a result, the improvement would allow proceeding with the treatment in the early stages instead of letting it develop further.

Furthermore, the women themselves define how swiftly they are diagnosed and attain the proper treatment. As Dennis, Falah-Hassani, and Shiri (2017) note, the diagnosis tends to be revealed by clinical means. Hence, women who do not express enough trust in medical institutions or avoid using them altogether stay at the top of the risk categories. Similarly, the financial state may also relate to the low rates of visiting the healthcare institutions for examination.

Also, there is a danger for mistaking the symptoms for other conditions since the traits manifest as typical features of the stress-induced illnesses or pregnancy state. According to Misri et al. (2015), the latter notion is especially prominent during the examination of the patient. Thus, one must ground even the clinical checkup on reliable and proven methods. Evans et al. (2015) mention that the usual instruments include interviews with the patients. However, more advanced schemes are gradually put into motion as well. One can use the example of the complex GAD-7 questionnaire demonstrated by Zhong et al. (2015) in the survey among pregnant Peruvian women. So, despite the hardships of diagnostics, one can still see room for improvement.

Treatment Questions

Treatment, which follows the diagnostics procedures, also possesses issues that cannot be ignored. The methods themselves include the use of medicine, the work with the psychologist, and non-medical means such as relaxation practices. While the first approach is the most common, it also poses a degree of threat. According to Marchesi et al. (2016), the most common drugs used in rehabilitation are antidepressants or other “atypical antipsychotics” (p. 766). However, the problems revolving around antidepressants are well-known, so one can already assume that they could affect the unborn child. As such, Marchesi et al. (2016) admit that every pregnancy case should be regulated in medicine deployment. In other words, one needs an individual approach and a careful aim of choosing the pharmacy.

The non-medical methods, while less risky in applying, do not completely encompass all the areas of treatment. However, a certain level of efficiency is proven by recent studies. According to Selix et al. (2017), the projects akin to the support of future mothers in social media lessens the burden of women’s anxiety. Moreover, they elaborate on the interdisciplinary approaches to disorder, like the collaboration with government, scientists, educative workers, or the use of modern technologies. In other words, the means of facilitating include psychological work, educational courses, and promotional programs.

The value of the project mentioned by Selix et al. (2017) included 56.3% of messages being helpful for pregnant women with anxiety. Hence, not only physicians should take part in the facilitation and rehabilitation, but education workers, technical professions, and public activists as well. Moreover, the communication and collaboration between these categories and the contact between women themselves may be able to speed the process. However, while it will become beneficial for the treatment, the development of such initiatives is still underway, so it needs time and more studies for approval.

Cultural Considerations

For both diagnostics and treatment, the cultural factors make their input into the correlation of a problem. First, one can explore their significance for pregnancy anxiety on the example of ethnic minorities. According to the study of Fleuriet and Sunil (2014), the difference between the social status of Mexican American women and Mexican immigrant women leads to a higher rate of disorder for the latter category. Thus, the social circumstances regulate the groups of women who suffer anxiety in pregnancy more intensively.

Furthermore, in both America and Canada, pregnant women from immigrant communities consider themselves “other”, which increases the chance of mental disorders. Robinson et al. (2016) note that in Calgary, the ethnic minorities feel less confident since they do not belong to the native culture of the country. Moreover, the status of an immigrant may interfere with timely diagnosis and complete treatment.

Conclusion

The anxiety disorder among pregnant women is proven as a common problem, which does not make it less dangerous if left unchecked. Crucial aspects of the problem revolve around the features of the diagnostic, treatment, and the cultural environment for both. The first one includes the issue of medical personnel and women themselves hindering the diagnosis, due to the common symptoms and personal unwillingness, respectively. Although the interviewing methods of diagnosing continue to evolve, they still need more research and data.

In the treatment, the medicine used as a prime tool of rehabilitation also is not perfect since the fetus may be affected. Thus, each patient needs an individual approach and the attention of a caregiver. Currently, non-medical means of treatment have substantially grown instead, while the strategies interacting with policy, science, and social media are the most prominent. However, similarly to diagnostics, modern methods require further development.

Finally, as for the cultural grounds, the non-native heritage of the pregnant women could cause additional strain, explained by social and cultural differences. In the end, the tendency leads to a higher risk of anxiety. Moreover, it may interfere with the processes of both diagnosing and treating.

References

Dennis, C.-L., Falah-Hassani, K., & Shiri, R. (2017). Prevalence of antenatal and postnatal anxiety: Systematic review and meta-analysis. British Journal of Psychiatry, 210(05), 315-323.

Ding, X.-X., Wu, Y.-L., Xu, S.-J., Zhu, R.-P., Jia, X.-M., Zhang, S.-F., … Tao, F.-B. (2014). Maternal anxiety during pregnancy and adverse birth outcomes: A systematic review and meta-analysis of prospective cohort studies. Journal of Affective Disorders, 159, 103-110.

Evans, K., Spiby, H., & Morrell, C. J. (2015). A psychometric systematic review of self-report instruments to identify anxiety in pregnancy. Journal of Advanced Nursing, 71(9), 1986-2001.

Fleuriet, K. J., & Sunil, T. S. (2014). Perceived social stress, pregnancy-related anxiety, depression and subjective social status among pregnant Mexican and Mexican American women in South Texas. Journal of Health Care for the Poor and Underserved, 25(2), 546-561.

Martini, J., Petzoldt, J., Einsle, F., Beesdo-Baum, K., Höfler, M., & Wittchen, H.-U. (2015). Risk factors and course patterns of anxiety and depressive disorders during pregnancy and after delivery: A prospective-longitudinal study. Journal of Affective Disorders, 175, 385-395.

Misri, S., Abizadeh, J., Sanders, S., & Swift, E. (2015). Perinatal generalized anxiety disorder: Assessment and treatment. Journal of Women’s Health, 24(9), 762-770.

Marchesi, C., Ossola, P., Amerio, A., Daniel, B. D., Tonna, M., & De Panfilis, C. (2016). Clinical management of perinatal anxiety disorders: A systematic review. Journal of Affective Disorders, 190, 543-550.

Robinson, A. M., Benzies, K. M., Cairns, S. L., Fung, T., & Tough, S. C. (2016). Who is distressed? A comparison of psychosocial stress in pregnancy across seven ethnicities. BMC Pregnancy and Childbirth, 16. Web.

Rubertsson, C., Hellström, J., Cross, M., & Sydsjö, G. (2014). Anxiety in early pregnancy: Prevalence and contributing factors. Archives of Women’s Mental Health, 17(3), 221-228.

Selix, N., Henshaw, E., Barrera, A., Botcheva, L., Huie, E., & Kaufman, G. (2017). Interdisciplinary collaboration in maternal mental mealth. MCN, The American Journal of Maternal/Child Nursing, 42(4), 226-231.

Zhong, Q.-Y., Gelaye, B., Zaslavsky, A. M., Fann, J. R., Rondon, M. B., Sánchez, S. E., & Williams, M. A. (2015). Diagnostic validity of the Generalized Anxiety Disorder – 7 (GAD-7) among pregnant women. PLOS ONE, 10(4). Web.

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