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THE STRESS RISKS INVOLVED IN PREGNANCY: PREMOTHERHOOD
Premotherhood is a psychological period, not a time period. It may begin before conception, during pregnancy, or even after the onset of labor! Tension can build, drain energy from happy anticipation, and aggravate postpartum Female Stress Syndrome symptoms.
The cases of Sarah, Edna, and Sandy reflect some of the stresses that can be associated with conception.
Sarah had been working as a production assistant in a Chicago advertising agency, dating Ray, and feeling good about her self-directed life-style. Although she stated that in principle birth control was the responsibility of both members of a couple, she preferred the sexual spontaneity that an intrauterine device gave her to the "clumsiness" of a condom. Since she had, therefore, taken on the responsibility of contraception, she was particularly stressed when she accidentally conceived. Although she decided that she wanted the child, she found that she was upset about having lost control over this area of her life decisions, resentful of the changes that were coming, and guilty about her resentment.
Stress for Sarah, therefore, began during premotherhood when she experienced a dip in the predictability of her life. Her pregnancy represented both a wish and a fear, and such ambivalent feelings are always associated with some degree of discomfort or stress.
Although Edna's pregnancy was unplanned, it was a welcome surprise. Edna had worried that she and her husband were not ready for parenthood, that they had more "playing" to do before settling down to the responsibilities of a family. She also suspected, however, that they might never feel ready to make a conscious decision about having a baby, and might delay such a decision far too long. So she put her concerns aside, and prepared for delivery with great excitement. As the time for delivery loomed, however, the realities of parenthood began to frighten Edna and her husband. They became irritable with each other, and each began to see the other as responsible for their plight.
For Edna, stress had begun to build as she approached delivery. She felt that her course was set, that she no longer had a choice about parenting, and that she had betrayed herself by leaving the conception of her child to chance.
Sandy pondered the considerations of timing, finances, and emotional readiness before she and her husband tried to conceive a child. When the situation seemed right, Sandy was ready. Unfortunately, almost 15 percent of all pregnancies end in miscarriage or spontaneous abortion before the eighth week, and this was Sandy's experience. Following her miscarriage, Sandy's efforts to conceive again were unsuccessful for many months. By the time she did conceive, her anxiety level was high and her focus on motherhood was all-consuming. Even her relationship to her husband was overshadowed by the prospect of the mother-child relationship to come.
Fear and unrealistic expectations combined to produce a high level of stress for Sandy during her pregnancy. Again, motherhood stress began during premotherhood.
Sandy, Edna, and Sarah are by no means unusual cases—their stories are representative of many women's. Premotherhood concerns are a very real part of the Female Stress Syndrome. Some pregnancy fears are symptomatic of a generalized anxiety about the demands that are made on mothers, as in the case of Edna. Other fears, however, are probably literal—fear of miscarriage, of having a defective baby, of labor pain, or even of delivery procedures or cesarian section. Either way, motherhood becomes associated with fear.
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