Fetus to Mom: You're Stressing Me Out! (cont.)

"I think our whole approach to comprehensive prenatal care today is sort of messed up -- a lot of the focus is on the wrong things," says Dr. Hobel. "We measure a woman's blood pressure, her uterine size, listen to the baby's heart tones, but no one asks how things are going with her life."

The big question, he says, is finding the right interventions. He and Dr. Dunkel-Schetter believe some of those components include the usual methods to reduce stress, including biofeedback, guided imagery and yoga. But what may be equally important are a woman's support network and providing enough information about prenatal care and the pregnancy to ward off worries.

And it's clearly a matter of teaching women how to relax, a foreign concept for many. "No one is telling them that they should look at what they're doing," says Dr. Hobel. It might mean taking Wednesdays off and work Saturdays instead, just to break the fatigue of a week's work; or making sure to take time for breakfast and frequent meals.

"Sure, I think there are some super women that can deal with stress, but if you really study them, you'll recognize that they've got some built-in mechanisms, something about the way they're dealing with their lives, that makes a difference," says Dr. Hobel. "Pregnancy itself is a real stress on the body."

Dr. James McGregor, a professor of obstetrics at the University of Colorado Health Sciences Center, uses another type of test to predict pre-term labor. It's a saliva test that measures another hormone, estriol, which can give up to three-weeks notice of the onset of labor. He's even called employers when it indicates a patient needs to kick back a little.

Sometimes, he says, it's hard to persuade pregnant women themselves that they may need to slow down if they're feeling stressed. "Actually everybody knows it, but we kind of deny it," says Dr. McGregor. "Stress comes under the heading of an old wives' tale, but in this case, it happens to be true."

What Is Your Stress Level?

Here are some questions to assess your level of stress during pregnancy, developed by Dr. Calvin Hobel, director of maternal-fetal medicine at Cedars Sinai Medical Center in Los Angeles. For each question, answer "yes," "sometimes" or "no." If you answer "sometimes" or "yes" to three or more questions, says Dr. Hobel, you may have sufficient stress to warrant some form of counseling or intervention. Consult your health-care provider.

  1. I feel tense.
  2. I feel nervous.
  3. I feel worried.
  4. I feel frightened.
  5. I have trouble dealing with problems.
  6. Things are not going well.
  7. I cannot control things in my life.
  8. I am worried that my baby is abnormal.
  9. I am concerned that I may lose my baby.
  10. I am concerned that I will have a difficult delivery.
  11. I am concerned that I will be unable to pay my bills.
  12. I live apart from my partner or spouse.
  13. I have extra-heavy homework.
  14. I have problems at work.
  15. Have you and your partner or spouse had any problems?
  16. Have you been threatened with physical harm?

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