Hostname: page-component-8448b6f56d-cfpbc Total loading time: 0 Render date: 2024-04-19T11:06:20.266Z Has data issue: false hasContentIssue false
  • English
  • Français

Pregnancy as a Stressful Life Event

Published online by Cambridge University Press:  07 November 2014

Pamela A. Geller
Get access Rights & Permissions [Opens in a new window]

Abstract

Pregnancy and childbirth typically are associated with positive emotions and with motherhood, but the reality is that this is not the case for all women or for all pregnancies. This review addresses a different aspect of these reproductive events, focusing on stressful circumstances surrounding pregnancy, as well as times when the pregnancy itself becomes a stressful life event. Pregnancy-related topics that tend to receive less attention will be emphasized. These include issues related to infertility; unplanned pregnancy; stress associated with testing and diagnosis of common medical complications; peripartum cardiomyopathy; fear of childbirth; and pregnancy foss as a risk factor for psychopathology. Epidemiologie information wiu be presented, as will relevant psychosocial factors related to each phenomenon. Healtitcare providers should be sensitive to the distress and anxiety experienced by many women and their families as a consequence of these adverse events and the stressful challenge of any consequential decisionmaking, as well as stressors in their broader life context that can further exacerbate their distress, and make mental health referrals as appropriate.

Type
Review Articles
Information
CNS Spectrums , Volume 9 , Issue 3 , March 2004 , pp. 188 - 197
Copyright
Copyright © Cambridge University Press 2004

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Cooper-Hilbert, B. Infertility and Involuntary Childlessness: Helping Couples Cope. New York, NY: W. W. Norton; 1998.Google Scholar
2.Goldman, MB, Missmer S, A, Barbier R, L. Infertility. In: Goldman, MB, Hatch, MC, eds. Women and Health. San Diego, Calif: Academic Press; 2000:196–214.CrossRefGoogle Scholar
3.Stephen, EH, Chandra, A. Updated projections of infertility in the United States: 1995-2025. Fertil Steril. 1997;70:30–34.CrossRefGoogle Scholar
4.Downey, J, McKinney, M. The psychiatric status of women presenting for infertility evaluation. Am J Orthopsychiatry. 1992;62:196–205.CrossRefGoogle ScholarPubMed
5.Greil, AL. Infertility and psychological distress: a critical review of the literature. Soc Sci Med. 1997;45:1679–1704.CrossRefGoogle ScholarPubMed
6.Whiteford, LM, Gonzalez, L. Stigma: the hidden burden of infertility. Soc Sci Med. 1995;40:27–36.CrossRefGoogle ScholarPubMed
7.Lee, C. Women's Health: Psychological and Social Perspectives. London, England: Sage Publications; 1998.Google Scholar
8.Henshaw, SK. Unintended pregnancy in the United States. Fam Plan Perspec. 1998;30:24–29.CrossRefGoogle ScholarPubMed
9.Ventura, SJ, Matthews, MS, Hamilton, BE. Teenage births in the United States: State trends, 1991-2000, an update. National Vital Statistics Report. 2002;50:1–4.Google ScholarPubMed
10.The Alan Guttmacher Institute. Pregnancy and Birth page. Available at: http://www.agi-usa.org/sections/birth.html. Accessed October 9, 2003.Google Scholar
11.Passino, AW, Whitman, TL, Borkowski, JG, et al.Personal adjustment during pregnancy and adolescent parenting. Adolescence. 1993;28:97–122.Google ScholarPubMed
12.Corcoran, J. Consequences of adolescent pregnancy/parenting. Soc Work Health Care. 1998;27:49–67.CrossRefGoogle ScholarPubMed
13.McAnarney, ER. Young maternal age and adverse neonatal outcome. AMAJ Dis Child. 1987;141:1053–1059.Google ScholarPubMed
14.Gazmararian, JA, Adam, M, Saltzman, LE, et al.The relationship between pregnancy intendedness and physical violence in mothers of newborns. Obstet Gynecol. 1995;5:1031–1038.CrossRefGoogle Scholar
15.Adler, NE, David, HP, Major, BN, Roth, SH, Russo, NF, Wyatt, GE. Psychological responses after abortion. Science. 1990;248:41–44.CrossRefGoogle ScholarPubMed
16.Copel, JA, Bahado-Singh, RO. Prenatal screening for down's syndrome: a search for the family's values. N Engl J Med. 1999;341:521–522.CrossRefGoogle ScholarPubMed
17.Wald, NJ, Watt, HC, Hackshaw, AK. Integrated screening for Down's syndrome based on tests performed during the first and second trimesters. N Engl J Med. 1999;341:461–467.CrossRefGoogle ScholarPubMed
18.Wald, NJ, Kennard, A, Hackshaw, A, McGuire, A. Antenatal screening for Down's syndrome. J Med Screen. 1997;4:181–246.CrossRefGoogle ScholarPubMed
19.Agency for Healthcare Research and Quality. The Women's Health Page. Available at: http://www.ahcpt.gov/research/womenix.htm. Accessed October 9, 2003.Google Scholar
20.Javanovic, L, ed. Medical Management of Pregnancy Complicated by Diabetes. Alexandria, VA: American Diabetes Association; 2000.Google Scholar
21.Javanovic, L. Controversies in the diagnosis and treatment of gestational diabetes. Cleve Clin J Med. 2000;67:481–488.Google Scholar
22.King, H. Epidemiology of glucose intolerance and gestational diabetes in women if childbearing age. Diabetes Care. 1998;21(suppl 2):B9–B13.Google ScholarPubMed
23.Yue, DK, Molyneaux, LM, Ross, GP, Constantino, MI, Child, AG, Turtle, JR. Why does ethnicity affect prevalence of gestational diabetes? The underwater volcano theory. Diobet Med. 1996;13:748–758.3.0.CO;2-I>CrossRefGoogle ScholarPubMed
24.Cheung, NW, Byth, K. Population health significance of gestational diabetes. Diabetes Care. 2003;26:2005–2009.CrossRefGoogle ScholarPubMed
25.National Institute of Child Health and Human Development. The NICHD Gestational Diabetes page. Available at: http://www.nichd.nih.gov/publications/pubs/gest_diabetes.htm. Accessed December 18, 2003.Google Scholar
26.Venture, SJ, Peters, KD, Martin, JA, Maurer, JD. Births and deaths: United States, 1996. Mon Vital Stat Rep. 1996:46:1–40.Google Scholar
27.Whitehead, SJ, Berg, CJ, Chang, J. Pregnancy-related mortality due to cardiomyopathy: United States, 1991-1997. Obstet Gynecol. 2003;102:1326–1331.Google ScholarPubMed
28.Demakis, JG, Rahimtoola, SH. Peripartum cardiomyopathy. Circulation. 1971;44:964–968.CrossRefGoogle ScholarPubMed
29.Pearson, GD, Veille, JC, Rahimtoola, S, et al.Peripartum cardiomyopathy: National heart, lung, and blood institute and office or rare diseases (National Institutes of Health) workshop recommendations and review. JAMA. 2000;283:1183–1188.CrossRefGoogle ScholarPubMed
30.Brown, CS, Bertolet, BD. Peripartum cardiomyopathy: a comprehensive review. Am J Obstet Gynecol. 1998;178:409–414.CrossRefGoogle ScholarPubMed
31.Lampert, MB, Lang, RM. Peripartum cardiomyopathy. Am Heart J. 1995;130:860–870.CrossRefGoogle ScholarPubMed
32.Geller, PA, Striepe, MI, Lewis, J III, Petrucci, RJ. Women on heart transplant units: the importance of psychosocial factors among women with cardiovascular disease: Paper presented at: Annual Meeting of the American Psychological Association; Septembet 19-21, 1996; Washington, DC.Google Scholar
33.Geller, PA, Striepe, MI, Petrucci, RJ. Psychosocial factors in peripartum cardiomyopathy: Poster presented at: Third Biennial Conference on Psychiatric, Psychosocial, and Ethical Issues in Organ Transplantation; October 6-8, 1994; Richmond, VA.Google Scholar
34.Bewley, S, Cockburn, J. Responding to fear of childbirth. Lancet North Am Ed. 2002;359:2128–2129.CrossRefGoogle ScholarPubMed
35.Saisto, T, Salmela-Aro, K, Nurmi, JE, Kononen, T, Halmesmaki, E. A randomized controlled trial of intervention in fear of childbirth. Obstet Gynecol. 2001;98:820–826.Google ScholarPubMed
36.Soderquist, J, Wijma, K, Wijma, B. Traumatic stress in late pregnancy. J Anxiety Disord. 2002;447:1–16.Google Scholar
37.Kurki, T, Hiilesmaa, V, Raitasalo, R, Mattila, H, Ylikorkala, O. Depression and anxiety in early pregnancy and risk for preeclampsia. Obstet Gynecol. 2000;95:487–490.Google ScholarPubMed
38.Nielsen Forman, D, Videbech, P, Hedegaard, M, Dalby Salvig, J, Sécher, NJ. Postpartum depression: identification of women at risk. BJOG. 2000;107:1210–1217.CrossRefGoogle ScholarPubMed
39.Paarlberg, KM, Vingerhoets, JJ, Passchier, J, Dekker, GA, Heinen, AG, van Giejn, HP. Psychosocial predictors of low birthweight. BJOG. 1999;106:834–841.CrossRefGoogle ScholarPubMed
40.Ryding, EL, Wijma, K, Rydhstrom, H. Fear of childbirth during pregnancy may increase the risk of emergency cesarean section. Acta Obstet Gynecol Scand. 1998;77:542–547.CrossRefGoogle ScholarPubMed
41.Wagner, M. Choosing caesarean section. Lancet North Am Ed. 2000;356:1677–1680.CrossRefGoogle ScholarPubMed
42.Sjogren, B, Thomassen, P. Obstetric outcome in 100 women with severe anxiety over childbirth. Acta Obstet Gynecol Scand. 1997;76:948–952.CrossRefGoogle ScholarPubMed
43.Klier, C, Geller, PA, Neugebauer, R. Anxiety disorders following miscarriage. J Clin Psychiatry. 2002;62:432–438.Google Scholar
44.Klier, CM, Geller, PA, Ritsher, J. Affective disorders in the aftermath of miscarriage: a comprehensive review. Arch Women Ment Health. 2002;5:129–149.CrossRefGoogle ScholarPubMed
45.Kline, J, Levin, B, Kinney, A, Stein, Z, Susser, M, Warburton, D. Cigarette smoking and spontaneous abortion of known karyotype: precise data but uncertain inferences. Am J Epidemiol. 1995;41:417–427.CrossRefGoogle Scholar
46.Nybo Andersen, AM, Wohlfahrt, J, Christens, P, Olsen, J, Melbye, M. Maternal age and fetal loss: population based register linkage study. BMJ. 2000;320:1708–1712.CrossRefGoogle ScholarPubMed
47.Yudkin, P, Redman, C. Prospective risk of stillbirth: impending fetal death must be identified and pre-empted. BMJ. 2000;320:444.Google ScholarPubMed
48.Saraiya, M, Green, CA, Berg, CJ, Hopkins, FW, Koonin, LM, Atrash, HK. Spontaneous abortion—related death among women in the United States–1981-1991. Obstet Gynecol. 1999;9:172–176.Google Scholar
49.Borg, S, Lasker, J. When Pregnancy Fails: Families Coping with Miscarriage, Stillbirth, and Infant Death. Boston, Mass: Beacon Press; 1981.Google Scholar
50.Janssen, HJ, Cuisinier, MC, Hoogduin, KA, de Graauw, KP. Controlled prospective study on the mental health of women following pregnancy loss. Am J Psychiatry. 1996;153:226–230.Google ScholarPubMed
51.Neugebauer, R, Kline, J, O'Connor, P, et al.Depressive symptoms in women in the six months after miscarriage. Am J Obstet Gynecol. 1992;166:104–109.CrossRefGoogle ScholarPubMed
52.Thapar, AK, Thapar, A. Psychological sequelae of miscarriage: a controlled study using the general health questionnaire and the hospital anxiety and depression scale. Br J Gen Pract. 1992;42:94–96.Google ScholarPubMed
53.Klier, C, Geller, PA, Neugebauer, R. Minor depressive disorder in the context of miscarriage. J Affect Disord. 2000;59:13–21.CrossRefGoogle ScholarPubMed
54.Neugebauer, R, Kline, J, Shrout, P, et al.Major depressive disorder in the six months after miscarriage. JAMA. 1997;277:383–388.CrossRefGoogle Scholar
55.Beutel, M, Deckardt, R, Von Rad, M, Weiner, H. Grief and depression after miscarriage: their separation, antecedents, and course. Psychosom Med. 1995;57:517–526.CrossRefGoogle ScholarPubMed
56.Lee, C, Slade, P. Miscarriage as a traumatic event: a review of the literature and new implications for intervention. J Psychosom Res. 1996;4:235–244.CrossRefGoogle Scholar
57.Prettyman, R, Cordle, C, Cook, G. A three-month follow-up of psychological morbidity after early miscarriage. Br J Med Psychol. 1993;66:363–372.CrossRefGoogle ScholarPubMed
58.Geller, PA, Klier, CM, Neugebauer, R. Anxiety disorders following miscarriage. J Clin Psychiatry. 2001;62:432–438.CrossRefGoogle ScholarPubMed
59.Engelhard, I, van den Hout, M, Arntz, A. Posttraumatic stress disorder after pregnancy loss. Gen Hosp Psychiatry. 2001;23:62–66.CrossRefGoogle ScholarPubMed
60.Hughes, P, Turton, P, Hopper, E, McGauley, GA, Fonagy, P. Disorganised attachment behaviour among infants born subsequent to stillbirth. J Child Psychol Psychiatry. In press.Google Scholar
61.Forrest, G, Standisti, E, Baum, J. Support after perinatal death: a study of support and counseling after perinatal bereavement. BMJ. 1982;285:1475–1479.CrossRefGoogle ScholarPubMed
62.Theut, S, Pederson, F, Zaslow, M, Rabinovich, B. Pregnancy subsequent to perinatal loss: Parental anxiety and depression. J Am Acad Child Adolesc Psychiatry. 1988;27:289–292.CrossRefGoogle ScholarPubMed
63.Armstrong, D, Hutti, M. Pregnancy after perinatal loss: the relationship between anxiety and prenatal attachment. J Obstet Gynecol Neonatal Nurs. 1998;27:183–189.CrossRefGoogle ScholarPubMed
64.Janssen, H, Cuisinier, M, Hoogduin, K, de Graauw, K. Controlled prospective study on the mental health of women following pregnancy. Am J Psychiatry. 1996;153:226–230.Google ScholarPubMed
65.Cuisinier, M, de Graauw, C, Bakker, S, Hoogduin, C. Pregnancy following miscarriage: course of grief and some determining factors. J Psychosom Obstet Gynecol. 1996;17:168–174.CrossRefGoogle ScholarPubMed
66.Garel, M, Blondel, B, Lelong, N, Papin, C. Long-term consequences of miscarriage: the depressive disorders and the following pregnancy. J Reprod Infant Psychol. 1994;12:233–240.CrossRefGoogle Scholar
67.Swanson, K. Predicting depressive symptoms after miscarriage. A path analysis based on the Lazarus paradigm. J Womens Health Gend Based Med. 2000;9:191–206.CrossRefGoogle ScholarPubMed
68.Gorsuch, RL, Key, MK. Abnormalities of pregnancy as a function of anxiety and life stress. Psychosom Med. 1974;36:352–362.CrossRefGoogle ScholarPubMed
69.Norbeck, T, Tilden, V. Life stress, social support, and emotional disequilibrium in complications of pregnancy: a prospective, multivariate study. J Health Soc Behav. 1983;24:30–34.CrossRefGoogle ScholarPubMed
70.Nuckolls, KB, Cassei, J, Kaplan, HB. Psychosocial assets, life crisis, and the prognosis of pregnancy. Am J Epidemiol. 1972;95:431–441.CrossRefGoogle ScholarPubMed
71.Brown, GW, Harris, T. Social Origins of Depression: A Study of Psychiatric Disorders in Women. New York City, NY: Free Press; 1978.Google Scholar
72.Oakley, A. Is social support good for the health of mothers and babies? J Reprod Infant Psychol. 1988;6:3–21CrossRefGoogle Scholar
73.Sosa, R, Kennell, J, Klaus, M, Robertson, S, Urrutia, J. The effect of a supportive companion on perinatal problems, length of labor and mother-infant interaction. N Engl J Med. 1980;303:597–600.CrossRefGoogle ScholarPubMed
74.Pagel, M, Becker, J. Depressive thinking and depression: relations with personality and social resources. J Pers Soc Psychol. 1987;52:1043–1052.CrossRefGoogle ScholarPubMed
75.Newberger, EH, Barkan, SE, Barkan, SE, et al.Abuse of pregnant women and adverse birth outcome. Current knowledge and implications for practice. JAMA. 1992;267:2370–2372.CrossRefGoogle ScholarPubMed
76.Rachana, C, Suraiya, K, Hisham, AS, Abdulaziz, AM, Hai, A. Prevalence and complications of physical violence during pregnancy. Eur J Obstet Gynecol Reprod Biol. 2002;103:26–29.CrossRefGoogle ScholarPubMed
77.Johnson, JK, Haider, F, Ellis, K, Hay, DM, Lindow, SW. The prevalence of domestic violence on pregnant women. BJOG. 2003;110:272–275.CrossRefGoogle ScholarPubMed
78.The American College of Obstetricians and Gynecologists web site. The Violence Against Women page. Available at: http://www.acog.org/from_home/depart-ments/category.cfm?recno=17&bulletin=186. Accessed December 24, 2003.Google Scholar
79.Sarason, IG, Johson, JH, Siegel, JM. Assessing the impact of life changes: development of the life experiences survey. J Consult Clin Psychol. 1978;46:932–946.CrossRefGoogle ScholarPubMed
80.Barnett, BEW, Hanna, B, Parker, G. Life event scales for obstetric groups. J Psychosom Res. 1983;27:313–320.CrossRefGoogle ScholarPubMed
81.Newton, CR, Sherrard, W, Glavac, I. The Fertility Problem Inventory: measuring perceived infertility-related stress. Fertil Steril. 1999;72:54–62.CrossRefGoogle ScholarPubMed
82.Resources for clinicians. Assessment for intimate partner violence in clinical ptactice. J Midwifery Women's Health. 2002;47:386–390.CrossRefGoogle Scholar
83.McFarlane, J, Parker, B. Identifying and helping battered pregnant women. MCN Am J Matern Child Nurs. 1991;16:161–164.Google Scholar
84.Espinosa, L, Osborne, K. Domestic violence during pregnancy: implications for practice. J Midwifery Women's Health. 2002;47:305–317.CrossRefGoogle ScholarPubMed
85.The National Library of Medicine and the National Institutes of Health web site. The Pregnancy and Substance Abuse page. Available at: http://www.nlm.nih.gov/medlineplus/pregnancyandsubstanceabuse.html. Accessed January 5, 2004.Google Scholar