Anxiety Disorders in Pregnancy Flashcards

A pregnant woman describes intense fear of childbirth, avoidance of childbirth education classes, and requests an elective cesarean section solely due to fear. This presentation is most consistent with:

Answer: Tokophobia

Tokophobia is a specific, debilitating fear of childbirth that can lead to requests for cesarean delivery and avoidance of childbirth-related information.

Which benzodiazepine characteristic is most important when considering short-term use for acute anxiety in a pregnant patient near term?

Answer: Half-life, because long-acting agents accumulate in the neonate

Long-acting benzodiazepines (e.g., diazepam) accumulate in the neonate due to immature hepatic metabolism, causing neonatal sedation and hypotonia; short-acting agents are preferred if use is necessary near term.

A woman with social anxiety disorder is pregnant and relies on avoidance of prenatal group classes, pushing them to see only one provider. What complication of untreated social anxiety is most relevant in the perinatal context?

Answer: Social isolation and reduced social support, increasing postpartum depression risk

Social anxiety often leads to isolation and poor social support, which are key risk factors for postpartum depression.

Which statement best describes the relationship between prenatal anxiety and postpartum depression?

Answer: Prenatal anxiety is one of the strongest predictors of postpartum depression

Prenatal anxiety is consistently identified as one of the strongest independent predictors of postpartum depression across multiple longitudinal studies.

A PMH-C clinician recommends mindfulness-based cognitive therapy (MBCT) to a pregnant patient with recurrent anxiety. What is the primary mechanism of action of MBCT?

Answer: Developing non-judgmental awareness of thoughts to break the anxiety rumination cycle

MBCT teaches patients to observe thoughts non-judgmentally rather than automatically reacting, interrupting the ruminative cycles that sustain anxiety.

When assessing a pregnant immigrant woman for anxiety, which culturally sensitive consideration is most critical?

Answer: Recognizing that somatic presentations of anxiety may predominate in some cultural contexts

In many cultures, anxiety presents primarily through somatic complaints (e.g., headaches, chest pain) rather than psychological language; culturally responsive assessment recognizes this.

A pregnant woman with PTSD from a prior traumatic birth reports that her current pregnancy has triggered severe intrusive re-experiencing. Which specific CBT technique is most evidence-based for trauma-related intrusive symptoms?

Answer: Trauma-focused cognitive restructuring and prolonged exposure

Trauma-focused CBT incorporating cognitive restructuring and prolonged exposure (or its variants like CPT) has the strongest evidence base for PTSD intrusive symptoms.