Social and Family Pressures on Anxiety and Stress during Pregnancy

Article excerpt

ABSTRACT: This prospective study focused on the relationships between social support, family, and income pressures on anxiety and stress during pregnancy. Four hundred and thirty-three women elected to participate in a study that included completing a medical/psychosocial questionnaire, the Spielberger State Trait Anxiety Inventory, the Jenkins Activity Survey, and stress measures formulated using the Social Readjustment Rating Scale. Each participant was assessed once during each trimester of pregnancy. Results found that lack of social support and experience of family and income pressures were related to anxiety and stress during pregnancy. Analysis of variance found that women with an emotionally supportive husband or an emotional confidante had lower state and trait anxiety. Married women, women with a lower number of stressors, and women who desired their pregnancy had lower state and trait anxiety. State and trait anxiety were also related to having lower incomes. Suggestions for expectant mothers were discussed.

BACKGROUND

Previous studies analyzed the relationships between stress and health of the expectant mother (Brown, 1986) and her infant (Leaderman, 1985; Norbeck and Tilden, 1983) and found social support can moderate stress and birth complications.

Nuckolls, Cassel, and Kaplan (1972) found that pregnancy complications were three times greater among women with high stress and low psychosocial assets (including social support) than among women with equally high stress but with high social assets during early pregnancy. Tietjen and Bradley (1985) indicated that satisfaction with the husband's support was significantly correlated with lower levels of stress and anxiety and better marital adjustment. Brown (1987) found expectant mothers who were employed had greater accessibility to network support.

Methodological weaknesses of studies on relationships between social support and stress included drawing the sample from only one hospital (Chalmers, 1983), choosing measures unsystematically, and using cross-sectional research that failed to measure variables until the second (Brown, 1987; Chalmers, 1983) or third trimester (Norbeck & Tilden, 1983; Tietjen & Bradley, 1985). Previous methodological weaknesses were addressed in the following manner. First, the present sample was drawn from three hospitals and ten OB-GYN clinics. second, a multi-method approach was used to quantify psychosocial functioning: an anxiety inventory, a medical-psychosocial questionnaire that measured psychological pressures (e.g., self reports of family and income pressures), and hospital and physician medical records. Third, psychosocial measurements were obtained during each trimester. Health status of the expectant mother and fetus/infant was measured at three different times (pregnancy, labor and delivery, and six weeks postpartum).

While other research analyzed the relationships among stress, anxiety, Type A and pregnancy complications, this study focused on the relationships between social support, family, and income pressure on anxiety and stress during pregnancy.

METHOD

Subjects

Lists of prospective participants consisted of 546 women in their first trimester of pregnancy obtained from three suburban Detroit hospitals and ten private OB-GYN clinics. When contacted by telephone, 433 women elected to participate in the study; 93% (402 participants) returned the first packet mailed to them; 85% (366 participants) returned the second packet; and 82% (357 participants) returned the third. Women who miscarried (N = 23) could not complete all three packets, but were included in the study.

Materials

Materials used were a medical/psychosocial questionnaire, the Spielberger State-Trait Anxiety Inventory and the Jenkins Activity Survey. Stress measures were formulated using the Social Readjustment Rating Scale.

Procedure

Each participant was contacted by telephone during her first trimester of pregnancy and each trimester thereafter. …