{"id":89202,"date":"2026-03-13T06:48:06","date_gmt":"2026-03-13T12:48:06","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=89202"},"modified":"2026-04-22T13:14:05","modified_gmt":"2026-04-22T19:14:05","slug":"care-trial-reducing-fear-improving-mental-health-outcomes-high-risk-pregnancy","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/care-trial-reducing-fear-improving-mental-health-outcomes-high-risk-pregnancy\/","title":{"rendered":"Clinical trial focuses on reducing fear and improving mental health outcomes in high-risk pregnancies"},"content":{"rendered":"
<\/div>
\"Many
Many women who are experiencing complications during pregnancy deal with a lot of fear about how the delivery of their baby or babies will go, especially when they’re likely to need a cesarean birth. A new UCHealth clinical trial aims to ease that fear through education, support and an immersive look at what to expect if they do need to have a cesarean birth. Photo: Getty Images.<\/figcaption><\/figure>\n

Fear can be dangerous for pregnant women because it can contribute to painful and sometimes deadly outcomes before and after birth.<\/p>\n

In an attempt to reduce what\u2019s known as anxiety sensitivity<\/a> \u2013 or fear of fear \u2013 in patients who have complicated pregnancies and are likely to need cesarean births, two Colorado medical experts have launched a clinical trial at UCHealth University of Colorado Hospital<\/a>.<\/p>\n

The researchers, obstetric anesthesiologist, Dr. Cristina Wood<\/a>, and psychologist, Allison Dempsey<\/a>, are exploring whether better education about cesarean births during pregnancy can reduce fear and improve outcomes.<\/p>\n

\u201cWe know that maternal patients face a disproportionately high risk of mental health conditions and suicide, which are among the leading indirect causes of maternal death<\/a> in the United States,\u201d said Wood, a UCHealth obstetric anesthesiologist who is also an associate professor<\/a> at the University of Colorado Anschutz School of Medicine<\/a>.<\/p>\n

\u201cWe knew we had to help improve these outcomes,\u201d Wood said.<\/p>\n

\"Anesthesiologist
Anesthesiologist Dr. Cristina Wood seeks to ease the fears of mothers facing complicated deliveries. Photo courtesy of University of Colorado Anschutz.<\/figcaption><\/figure>\n

\u201cThe burdens of anxiety sensitivity may have long-term consequences, not only for mothers, but also their babies,\u201d added Dempsey, who also is a professor<\/a> in the Department of Psychiatry at the University of Colorado Anschutz School of Medicine.<\/p>\n

\u201cMood, anxiety and trauma disorders can affect the way that mothers interact with their babies, she said. \u201cIt affects their bonding. It affects the way that they react and respond to their babies\u2019 cues. And we know that in the long term, babies of mothers who have mental health challenges in the post-partum period have a higher likelihood<\/a> of ending up with their own anxiety, depression and other disorders.\u201d<\/p>\n

The clinical trial that the researchers created focuses on preventing these damaging symptoms with an intervention they call CARE (Communication, Agency, Readiness, Empowerment) for cesarean delivery.<\/p>\n

Preparing patients for cesarean delivery through exposure sessions and immersive training<\/strong><\/h2>\n

The program relies on one session of cognitive behavioral therapy<\/a> and an \u201cimmersive experience\u201d that is a kind of dress rehearsal for patients with complicated pregnancies before cesarean delivery.<\/p>\n

The central scene plays out in an operating room, where the patients and their partners get a detailed look at the environment where their deliveries will take place and learn what they can expect. They also get a chance to ask any questions they want of their providers.<\/p>\n

\"Allison
Allison Dempsey\u2019s work in the Colorado Fetal Care Center led to work with Wood to ease mothers\u2019 anxiety before delivering their babies. Photo courtesy of University of Colorado Anschutz.<\/figcaption><\/figure>\n

The three-year randomized trial, which is recruiting patients, is approaching the end of year two. It aims to enroll 80 patients who are placed in one of three groups. Forty will get the CARE intervention, while 20 will meet face-to-face with a nurse educator and 20 will receive the standard medical care provided to all patients.<\/p>\n

The study will measure patients\u2019 levels of anxiety sensitivity in each of the three groups at baseline and shortly after they receive the care designated for their group. The lower the score, the less vulnerable they are to fearing what lies ahead with their delivery and their ability to care for themselves and their babies.<\/p>\n

The researchers will follow the patients for three months after they deliver, looking for symptoms of anxiety, depression and suicide, Dempsey said.<\/p>\n

Anxiety sensitivity in pregnant women: The fear of fear itself<\/strong><\/h2>\n

The concept of anxiety sensitivity can be summed up in the simple question, \u201chow am I going to react in a situation that I am afraid of?\u201d said Dempsey, who practices at the UCHealth Neonatal Intensive Care Unit<\/a> at University of Colorado Hospital and is also director of the Department of Psychiatry\u2019s Connections Program for High-Risk Infants and Families<\/a>.<\/p>\n

As far back as 2018, she recalled hearing versions of that worry from mothers when she brought mental health services to the Colorado Fetal Care Center<\/a>. These mothers and their partners delivered their babies at the center due to known fetal anomalies, such as heart defects.<\/p>\n

\u201cI found that of course they were worried about their babies\u2019 development and long-term outcomes, but something that repeatedly came up was that they were really worried about the delivery,\u201d Dempsey said. \u201cThere was just so much uncertainty.\u201d<\/p>\n

Wood, who is also the medical director of anesthesia at the Fetal Care Center, said her years-long interest in administering trauma-informed care<\/a> that focuses on shared decision making with patients drew her and Dempsey together at that time and ultimately led to the current trial.<\/p>\n

Improving mental health outcomes in high\u2011risk pregnancies<\/strong><\/h2>\n

The CARE intervention aims to help mothers answer anxiety-producing questions by shedding light that pierces the darkness of doubt.<\/p>\n

During the immersive experience, the patients go into the OR to familiarize themselves with what could be an intimidating environment of bright lights, masked providers, sterile drapes and high-tech equipment.<\/p>\n

To part the clouds of uncertainty, the patients and their partners don gowns, masks, hats and shoe covers similar to what they will wear on the day of delivery. They get a roughly 45-minute simulated exposure to the surgical steps, from receiving their anesthesia and lying on the OR table, to experiencing the sensations of a cesarean and what happens after delivery, all without any invasive procedures or medications.<\/p>\n

\u201cWe provide a very realistic experience to the operating room with all of the sights and sounds and feelings they will encounter on the day of their delivery,\u201d Wood said. After the simulation, they receive a laminated CARE card that contains the personal preferences of each patient.<\/p>\n

A commitment to listening to patients and improving experiences<\/strong><\/h2>\n

The hope, bolstered by the success of the study\u2019s first-year pilot<\/a>, is that immersive sessions can drain the fear of a looming birth for families, Dempsey said.<\/p>\n

\u201cCan we actually improve this experience for families so they can go in saying, \u2018I\u2019m not afraid of how this is going to be. I\u2019m not afraid of how I\u2019m going to react. I\u2019m instead going to be focused on birthing my child, which is a big event in and of itself,\u2019\u201d she said.<\/p>\n

Wood believes that easing patients\u2019 struggles with fear of what lies ahead can reduce their risk of anxiety and depression, as well as their physical pain. Conversely, mental anguish can exacerbate physical pain and lead to other problems, like dependence on opioids, she said.<\/p>\n

\u201cIf we can target better mental health outcomes for these patients, can we also reduce the amount of pain medication they take?\u201d Wood said. \u201cWe know that physical pain and mental pain are related. Treating mental pain may help improve physical pain for these patients.\u201d<\/p>\n

A continuously evolving trial shaped by patient feedback<\/strong><\/h2>\n

Both Dempsey and Wood emphasized that the design of the trial relied in large part on feedback from those who experienced the CARE intervention in a user testing design setting and in national focus groups.<\/p>\n

The participants included people with \u201clived experiences,\u201d such as patients, doulas and parent advocates, as well as hospital leaders, administrators and health care providers. Their comments and suggestions during the first-year pilot phase drove changes in the approach for the second year.<\/p>\n

For example, first-year participants underscored that the success of the intervention relies on providing trauma-informed care by a dedicated mental health and medical team.<\/p>\n

A broader aim to bring CARE intervention to more hospitals<\/strong><\/h2>\n

The process reflects a broader ambition that Dempsey and Wood have to eventually test the CARE intervention in a multi-site trial, Wood said.<\/p>\n

\u201cWe\u2019ve created a novel protocol,\u201d Wood said, adding that \u201cmajor academic institutions across the United States\u201d have shown \u201cincredible interest\u201d in a larger trial. \u201cWe hope this study will provide objective evidence to support the need for widespread adoption of this intervention,\u201d Wood said.<\/p>\n

The pay-off could be greatest for patients and their families who could be spared the considerable fear and trauma of facing a difficult birth with little preparation and the possibility of long-term physical and mental pain afterward, Wood added.<\/p>\n

\u201cWe\u2019re making healthier, psychologically safer families who are going to move forward in a healthy way,\u201d Dempsey said.<\/p>\n","protected":false},"excerpt":{"rendered":"

Fear can be dangerous for pregnant women because it can contribute to painful and sometimes deadly outcomes before and after birth. In an attempt to reduce what\u2019s known as anxiety sensitivity \u2013 or fear of fear \u2013 in patients who have complicated pregnancies and are likely to need cesarean births, two Colorado medical experts have […]<\/p>\n","protected":false},"author":2143,"featured_media":89279,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[5],"tags":[167,4001,25,4010,4781,212],"class_list":["post-89202","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-innovative-care","tag-clinical-trials","tag-high-risk-pregnancy","tag-labor-delivery","tag-pregnancy-childbirth-and-newborn-care","tag-research-in-health-care","tag-womens-care"],"acf":[],"yoast_head":"\nStudy focuses on improving mental health outcomes in high-risk pregnancies - 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