Stress Processes in Pregnancy and Birth: Psychological, Biological, and Sociocultural Influences
Regan A. R. Gurung
University of California, Los Angeles
State University of New York, Stony Brook
Pathik D. Wadhwa
University of Kentucky College of Medicine
From the time of its inc:eption, health psychology has accumulated a strong record of research on psychological aspects of various diseases such as heart disease and cancer. In contrast, the field has not delved much into reproductive health. Research in nursing, public health, and medicine has been conducted on the biopsychosocial aspects of infertility, contraception, abortion, miscarriage and stillbirth, on prenatal genetic screening and health behaviors, on labor and delivery, and on maternal and infant health in general. Such issues are prime research topics for attention by health psychology, as any quick reading of the available literature indicates. This chapter focuses on pregnancy and birth specifically, although this is only one of a plethora of important underresearched topics in reproductive health.
A central event in most women's reproductive life cycles is the prenatal period culminated by the birth of a child. During these 9 months, numerous well-established changes in physiology take place. These changes are accompanied by psychological changes that are not as well documented, nor are the interrelations of the physiological changes to psychological factors well mapped out as yet. The effects of pregnancy on mood or affect, social resources, coping processes, and various behaviors are highly variable from woman to woman depending on her circumstances and her condition. To what extent are women anxious about having a first or a subsequent birth? Does prenatal anxiety vary as a function of her available coping resources? Do women with close relationships with the father of the baby have better health and well-being in pregnancy than women who do not have this relationship? Are certain personal characteristics such as self-esteem associated with positive prenatal health behavior? Does the way a woman perceives and copes with challenges in her pregnancy influence her emotional adjustment or. her infant's health? What are the mechanisms accounting for relations of maternal psychosocial factors and maternal, fetal, and infant outcomes? These are the kinds of health psychology questions that can be considered in building a better understanding of pregnancy.
Pregnancy is an ideal condition for study by health psychologists for many reasons. First, it has a clear-cut and finite