I read with interest a recent article in the Journal of Perinatology that evaluated the use of animal-assisted therapy (Pet therapy) in the antepartum setting.1 The women were hospitalized for more than 72 hours because of common complications of pregnancy that are encountered every day in every obstetrical area. After 1 encounter with a therapy dog, both their scores on The Beck Depression Inventory decreased and the scores on the Spielberger State-Trait Anxiety Inventory improved significantly.1 Pet therapy exists in both acute- and long-term care facilities, as well as hospice, for pediatric, adult, and geriatric patients. Benefits include decreased heart rate, blood pressure, respiratory rates, anxiety, stress as well as increases in comfort and support, distractions from pain/illness, and quality of life.2,3 I can think of no reason why the high-risk antepartum patient would not likely benefit from the animal visit, especially those who required transport to a tertiary center too far from their family and friends to easily come by to see how they are doing.

Many types of animals, such as rabbits, cats, and birds, have been used in pet therapy; however, the most common animal used is a dog. There are specific health requirements-including the veterinarian verifying that the animal is healthy, has a negative fecal test, and all shots are current-that must be met.3 My veterinarian could do that! Dogs are also required to have certification to enable them to be considered for pet therapy. They must be at least 1-year old and reliably respond to simple commands, such as sit, stay, down, and heel.3 My dog can do that too! Even though I would welcome a visit from any pooch if I was hospitalized, having my Jack Russell with me would make a much more positive impact. He is my baby, and I know he would be missing me as much as I needed him. The dog should also be screened for methicillin-resistant Staphylococcus aureus because there is a risk that an asymptomatic dog may transmit the microbe to vulnerable patients.4 It is not unheard of to have a family pet rather than a therapy dog visit a patient.

Think of the benefits for our patients! With decreased stress and anxiety, would there be a decrease in the severity/incidence of preeclampsia, eclampsia, preterm labor, hyperemesis, fetal distress, and postpartum depression? Research has shown that petting your pet, whether it is a cat or a dog, promotes relaxation and improves cardiopulmonary parameters and neurohormone levels.5 Studies could be designed using a therapy dog as compared to the effects the family pet may have on the pregnant woman. Additional variables could include length of time the dog/pet is allowed to visit, number of visits, effects of having the dog/pet in bed with the patient as compared to just seeing the animal in the room, which complications of pregnancy are impacted the most, and long-term outcomes such as postpartum depression, bonding, and physiologic sequelae related to antepartum conditions. It goes without saying the costs of care should also be investigated as an outcome of pet therapy.

Women with complicated pregnancies are concerned for their health and the well-being of their unborn child. Anxiety and distress may promote proinflammatory mediators that negatively influence her condition as well as the environment for the fetus. Nursing interventions are aimed at making the woman feel comfortable and decreasing stress levels to promote the best outcomes possible. We are hesitant to use many medications for psychological stress because of trepidations regarding how the medications may affect the fetus. Animal therapy has been used for patients with postoperative pain with joint replacements, clinical depression, dementia, hospice, cancer patients to name a small few. I think it is time we investigated pet therapy as a novel mechanism to promote optimal outcomes of the long-term hospitalized antepartum patient.

-M. Terese Verklan, PhD, CCNS, RNC, FAAN

Professor and Neonatal Clinical Nurse Specialist

University of Texas Medical Branch

School of Nursing and Graduate School of Biomedical Sciences

Galveston, Texas

References