Zaneta Thayer, an anthropologist at Dartmouth College, has found that when she asks students in her evolution class to describe their first thoughts on the topic of delivery, the majority of responses are negative.
Then she turns to the class and inquires whether anybody has seen a birth firsthand. Few people have.
Dr. Thayer wanted to learn more about the prevalence of tokophobia, the medical name for a pathological dread of delivery, since he was curious about how cultural beliefs and expectations impact the physical experience of labour and its effects.
Despite extensive study on tokophobia in Scandinavia, where some nations even test pregnant women for it and provide therapy, very little has been done in the United States. Nearly two-thirds of expectant respondents to Dr. Thayer’s online poll of 1,800 American women indicated significant levels of dread and concern about delivery, suggesting that tokophobia may have impacted the majority of American women in the early days of the epidemic.
In the most recent issue of Evolution, Medicine, and Public Health, the findings were published.
Fear during delivery in the United States is said to be greater than in Europe and Australia, where it is estimated to affect less than 20% of women. However, they did point out that American birthing conditions are unique and that the current epidemic may have contributed to heightened anxiety.
Everyone has at least a little fear of giving birth. University of Delaware anthropology professor Karen Rosenberg has speculated that the need for social and emotional support among labouring women may have evolved as a beneficial adaptation.
Extreme pathological dread may be maladaptive, though, leading some women to avoid pregnancy or have unneeded caesarean sections.
There are caveats to the current research. During the first 10 months of the epidemic, when the health care system was under the most strain, statistics on pregnancy and postpartum care were gathered. A skewed number of white and affluent females made the sample unrepresentative of the general population.
More over a third of the women had suffered high-risk pregnancies, and half of the women had never given birth.
Eighty percent or more of the women expressed concern that they would not be able to bring a loved one with them to the hospital during labour, that their baby would be taken away if they were diagnosed with Covid, or that they would infect their baby with the virus.
Nearly twice as many black moms as white mothers reported a significant dread of delivery, despite black women being nearly three times as likely to die from pregnancy-related problems.
Preterm birth, defined as delivery of the infant before 37 weeks of gestation, occurred in almost twice as many women with tokophobia as those without the fear. The neonatal intensive care unit (NICU) is a common place for premature infants to spend time due to their increased risk of illness, impairment, and death.
The link does not establish a causal association between anxiety and premature birth. However, even after accounting for confounding variables like the prevalence of caesarean sections, the risk of preterm delivery among women with high levels of dread and concern remained elevated.
Higher rates of postpartum depression and supplementation with formula were also associated with maternal anxiety, the research revealed. Tokophobia was not linked to a greater risk of C-sections or low birth weight infants in this study.
Black women in the United States have a greater risk of premature birth than any other racial or ethnic group, around 50% higher than white women. Premature birth affects around 14% of Black babies and just over 9% of White and Hispanic newborns.
She discovered that low-income women and women with less education had the highest rates of delivery anxiety. Fear was also more common among unmarried women, those seeing an obstetrician, and those expecting their first child.
Dr. Thayer discovered that high-risk pregnant women and women with prenatal depression were also more likely to dread delivery.