3. Too much stress (74%)
REALITY CHECK Everyday stressors like having to work late, getting stuck in traffic or arguing with your husband are not likely to pose a risk to your pregnancy or your child. But ongoing major stress accompanied by depression (the two often go hand-in-hand) may increase your risk of preterm delivery or having a low-birth-weight baby or a child with long-term behavioral issues.
“If you are impaired in some way by the stress—you aren’t able to get along with your co-workers or partner, say—that’s when it may have an impact,” says Tom O’Connor, Ph.D., a professor of psychiatry and psychology at the University of Rochester Medical Center in New York. “If your stress doesn’t reach that level, it may not be significant in terms of pregnancy complications,” he says.
WHAT YOU CAN DO For ongoing stress or depression, see a cognitive behavioral specialist who can teach you coping strategies, such as questioning the anxiety-causing chatter in your head. She can also teach you relaxation exercises and visualization to lower your stress hormone levels. You can even use the breathing exercises taught in childbirth classes. While practicing deep breathing, imagine what concerns you as you’re inhaling; then, while exhaling, picture yourself releasing the thought or concern that is on your mind. You can also use a phrase like “let it go” when you breathe out, says Shepphird.
4. Prematurity (71%)
REALITY CHECK Prematurity is a legitimate concern. However, worrisome as pre-term birth is, the great majority of babies in the U.S. are born after 37 weeks, which is considered full term (this may be changing; see “Rethinking ‘Full Term'"). An estimated 12 percent are born preterm, which
increases their risk of health problems, but keep in mind that 70 percent of them are born between weeks 34 and 37. These so-called “late-term” babies still have increased risks, but they are less vulnerable than the tiniest ones. The biggest risk factors for preterm birth are having had a previous premature delivery, being pregnant with multiples, and having certain uterine or cervical abnormalities. Still, about half of women who deliver prematurely don’t fall into any high-risk category.
WHAT YOU CAN DO Obesity, high blood pressure and diabetes are risk factors for prematurity, so try to maintain a healthy weight and make sure your blood sugar and blood pressure levels are normal. Avoid smoking, alcohol and recreational drugs (all are linked to prematurity), get good prenatal care and make sure you have all your necessary immunizations and have any infections (even minor ones) treated promptly, as infections are a leading cause of preterm birth. Ongoing major stress can also trigger preterm labor, so be sure to treat any severe anxiety or depression. Many mood-altering medications are considered safe during pregnancy; ask your doctor which ones might be best for you.
5. Labor pain (70%)
REALITY CHECK We’re not going to tell you labor doesn’t hurt—most women rate it as a 7 or 8 out of 10 on the pain scale—but you have options when it comes to easing both your pain and your fear of it. If you want to avoid medication, there’s much you can do to reduce the pain and the anxiety surrounding it, such as laboring in a tub of water, changing positions often during labor and practicing relaxation techniques like guided imagery.
Or, you may want to opt for pain meds. If you’re worried about the risks, rest assured that today’s epidurals are safe and mom-friendly. Though you may have heard that pain medications prolong labor, they don’t prolong the first—and longest—stage of labor, and may even shorten it, says Cynthia A. Wong, M.D., a professor of anesthesiology at Northwestern University Feinberg School of Medicine in Chicago. Epidurals do tend to lengthen the shorter “pushing” phase because they dull the otherwise intense urge to push, but there’s no convincing evidence that they increase the risk of Cesarean section or low Apgar scores for your newborn.
WHAT YOU CAN DO First, educate yourself about all your pain-relief options and their risks and benefits. If you are trying to avoid using medication, research suggests that a birthing coach or doula can help you “go natural” by reminding you to breathe, talking you through the stages of labor and reassuring you that nothing is wrong as the pain intensifies. Also learn what to expect, because the unknown can cause more anxiety. “If you know exactly what is causing the pain, it can reduce your anxiety,” says Erika Bleiberg, a doula in Glen Ridge, N.J. Anxiety can cause tension, which can make breathing more dif-ficult and the pain worse, she adds. Sign up early for a childbirth course, such as Lamaze, the Bradley Method or HypnoBirthing; classes fill up fast.
Also have a birth plan, but don’t make absolute decisions beforehand. “Women get disappointed and feel guilty when they have a plan and things change,” Wong says. If you’re on the fence and not sure how you’ll handle the pain, don’t try to be a hero and wait until you can’t stand it anymore. It takes at least 20 to 30 minutes between the time you say, “Give me the drugs!” until they’ve been administered and you feel relief.