Understanding mothers' perceptions of pregnancy anxiety
A qualitative study
Keywords:
Pregnancy anxiety; Antenatal anxiety, Maternal anxiety, Parenting anxietyAbstract
Background and Objective: Anxiety in pregnancy has severe complications for a mother and her developing baby. Despite this fact, few studies have been done about antenatal anxiety and its risk factors, so this research aimed to explore components and dimensions of this kind of anxiety. Methods: This qualitative study was conducted in Tehran city from May 2016 to December 2017. The participants were twenty-eight pregnant women who referred to health care services. In order to collect data, purposive sampling and face-to-face semi-structured in-depth interviews were used. Data were analyzed simultaneously with data collection using qualitative content analysis with a conventional approach. Results: Mothers from different social backgrounds, educational levels and ethnicities, aged 18-41 years old participated in this study and after analysis, mothers’ perceptions of anxiety-provoking factors were classified into nine domains: including lack of information and planning, mothers’ loss of well-being, conflict with spouse, sociocultural issues, financial problems, parental challenges, healthcare related, fetal health and lack of support. Conclusion: With respect to what was found in this study, it seems that identification and screening of vulnerable mothers would be a dramatic help for the timely prevention and control of this mental health disorder and its complications.References
Highet N, Stevenson AL, Purtell C, Coo S. Qualitative insights into women's personal experiences of
perinatal depression and anxiety. Women and Birth. 2014 Sep 1; 27(3):179-84. DOI:
1016/j.wombi.2014.05.003, PMid: 24951157
Lederman RP. Anxiety and conflict in pregnancy: relationship to maternal health status. Annual review of
nursing research. 1984; 2 (27). DOI: 10.1891/0739-6686.2.1.27, PMid: 6568119
Huizink AC, Mulder EJ, de Medina PG, Visser GH, Buitelaar JK. Is pregnancy anxiety a distinctive
syndrome? Early human development. 2004 Sep 1; 79 (2):81-91. DOI: 10.1016/j.earlhumdev.2004.04.014,
PMid: 15324989
Salari, P., Firoozi, M. and Sahebi, A. Study of the stressors associated with pregnancy Sabzevar medical
university science, 2005.12 (3) 34-40.
Bayrampour H, Ali E, McNeil DA, Benzies K, MacQueen G, Tough S. Pregnancy-related anxiety: a
concept analysis. International Journal of Nursing Studies. 2016 Mar 1; 55:115-30. DOI:
1016/j.ijnurstu.2015.10.023, PMid: 26626973
Rafiee B, Akbarzade M, Asadi N, Zare N. Comparison of attachment and relaxation training effects on
anxiety in third trimester and postpartum depression among primipara women. Journal of hayat. 2013 Jul
; 19 (1):76-88
Shahhosseini Z, Pourasghar M, Khalilian A, Salehi F. A review of the effects of anxiety during pregnancy
on children’s health. Materia socio-medica. 2015 Jun; 27 (3):200. DOI: 10.5455/msm.2015.27.200-202,
PMid: 26236168, PMCid: PMC4499279
Swallow BL, Lindow SW, Masson EA, Hay DM. Psychological health in early pregnancy: relationship
with nausea and vomiting. Journal of Obstetrics and Gynaecology. 2004 Jan 1; 24 (1):28-32, DOI:
1080/01443610310001620251, PMid: 14675977
Skouteris H, Wertheim EH, Rallis S, Milgrom J, Paxton SJ. Depression and anxiety through pregnancy and
the early postpartum: an examination of prospective relationships. Journal of affective disorders. 2009 Mar
; 113 (3):303-8. DOI: 10.1016/j.jad.2008.06.002, PMid: 18614240
Kang YT, Yao Y, Dou J, Guo X, Li SY, Zhao CN, Han HZ, Li B. Prevalence and risk factors of maternal
anxiety in late pregnancy in China. International journal of environmental research and public health. 2016
May 4; 13 (5):468. DOI: 10.3390/ijerph13050468, PMid: 27153080, PMCid: PMC4881093
Alipour Z, Lamyian M, Hajizadeh E. Anxiety and fear of childbirth as predictors of postnatal depression in
nulliparous women. Women and Birth. 2012 Sep 1; 25(3):e37-43. DOI: 10.1016/j.wombi.2011.09.002,
PMid: 21959041
Azizi S, Molaeinezhad M. Anxiety status in pregnant mothers at third trimester of pregnancy and its related
factors in referrals to Bandar Abbas Hospitals in 2012. The Iranian Journal of Obstetrics, Gynecology and
Infertility. 2014; 17 (122):8-15.
O'connor TG, Heron J, Golding J, Beveridge M, Glover V. Maternal antenatal anxiety and children's
behavioural/emotional problems at 4 years: Report from the Avon Longitudinal Study of Parents and
Children. The British Journal of Psychiatry. 2002 Jun; 180 (6):502-8. DOI: 10.1192/bjp.180.6.502, PMid:
Nasreen HE, Kabir ZN, Forsell Y, Edhborg M. Prevalence and associated factors of depressive and anxiety
symptoms during pregnancy: a population based study in rural Bangladesh. BMC women's health. 2011
Dec; 11 (1):22. DOI: 10.1186/1472-6874-11-22, PMid: 21635722, PMCid: PMC3117808
Ali NS, Azam IS, Ali BS, Tabbusum G, Moin SS. Frequency and associated factors for anxiety and
depression in pregnant women: a hospital-based cross-sectional study. The Scientific World Journal. 2012;
DOI: 10.1100/2012/653098, PMid: 22629180, PMCid: PMC3354685
Elo S, Kyngäs H. The qualitative content analysis process. Journal of advanced nursing. 2008 Apr,62
(1):107-15. DOI: 10.1111/j.1365-2648.2007.04569.x, PMid: 18352969
Speziale HS, Streubert HJ, Carpenter DR. Qualitative research in nursing: Advancing the humanistic
imperative. Lippincott Williams & Wilkins; 2011.
Rosario MK, Premji SS, Nyanza EC, Bouchal SR, Este D. A qualitative study of pregnancy-related anxiety
among women in Tanzania. BMJ open. 2017 Aug 1;7 (8):e016072. DOI: 10.1136/bmjopen-2017-016072,
PMid: 28775187, PMCid: PMC5629724
Sereshti M, Nahidi F, Simbar M, Ahmadi F, Bakhtiari M, Zayeri F. Mothers’ perception of quality of
services from health centers after perinatal loss. Electronic physician. 2016 Feb; 8 (2):2006, DOI:
19082/2006, PMid: 27054012, PMCid: PMC4821318
Madhavanprabhakaran GK, D’Souza MS, Nairy KS. Prevalence of pregnancy anxiety and associated
factors. International Journal of Africa Nursing Sciences. 2015 Jan 1; 3:1-7. DOI:
1016/j.ijans.2015.06.002
Forouzandeh N, Delaram M, Deris F. The quality of mental health status in pregnancy and it's contributing
factors on women visiting the health care centers of Shahrekord,(2001-2002). Journal of Reproduction &
Infertility. 2003; 4 (2).
Joffe H, Cohen LS, Harlow BL. Impact of oral contraceptive pill use on premenstrual mood: predictors of
improvement and deterioration. American Journal of Obstetrics and Gynecology. 2003 Dec 1; 189
(6):1523. DOI: 10.1016/S0002-9378(03)00927-X
Størksen HT, Garthus-Niegel S, Adams SS, Vangen S, Eberhard-Gran M. Fear of childbirth and elective
caesarean section: a population-based study. BMC pregnancy and childbirth. 2015 Dec; 15 (1):221. DOI:
1186/s12884-015-0655-4, PMid: 26382746, PMCid: PMC4573308
Martini J, Petzoldt J, Einsle F, Beesdo-Baum K, Höfler M, Wittchen HU. Risk factors and course patterns
of anxiety and depressive disorders during pregnancy and after delivery: a prospective-longitudinal study.
Journal of affective disorders. 2015 Apr 1, 175: 385-95. DOI: 10.1016/j.jad.2015.01.012, PMid: 25678171
Mwape L, McGuinness TM, Dixey R. Socio-cultural factors surrounding mental distress during the
perinatal period in Zambia: a qualitative investigation. International journal of mental health systems. 2012
Dec; 6 (1):12. DOI: 10.1186/1752-4458-6-12, PMid: 22954173, PMCid: PMC3464809
Nilsson C, Lundgren I. Women's lived experience of fear of childbirth. Midwifery. 2009 Apr 1; 25 (2):e1-9.
DOI: 10.1016/j.midw.2007.01.017, PMid: 17512645
Brockington IF, Macdonald E, Wainscott G. Anxiety, obsessions and morbid preoccupations in pregnancy
and the puerperium. Archives of women's mental health. 2006 Sep 1,9 (5):253-63. DOI: 10.1007/s00737-
-0134-z, PMid: 16699837
Deklava L, Lubina K, Circenis K, Sudraba V, Millere I. Causes of anxiety during pregnancy. ProcediaSocial and Behavioral Sciences. 2015 Oct 9; 205:623-6. DOI: 10.1016/j.sbspro.2015.09.097
Staneva AA, Bogossian F, Wittkowski A. The experience of psychological distress, depression, and anxiety
during pregnancy: A meta-synthesis of qualitative research. Midwifery. 2015 Jun 1; 31 (6):563-73. DOI:
1016/j.midw.2015.03.015, PMid: 25912511
Akiki S, Avison WR, Speechley KN, Campbell MK. Determinants of maternal antenatal state-anxiety in
mid-pregnancy: Role of maternal feelings about the pregnancy. Journal of Affective disorders. 2016 May
; 196:260-7. DOI: 10.1016/j.jad.2016.02.016, PMid: 26945124
Sadeghi -Hassanabadi Z. Effect of parenting skills training using the pattern of cognitive-behavioral on
reducing marital conflicts of couples in Isfahan city. MSc [Thesis].Tehran: University of Social Welfare
and Rehabilitation Sciences. 2006.
Prady SL, Pickett KE, Croudace T, Fairley L, Bloor K, Gilbody S, Kiernan KE, Wright J. Psychological
distress during pregnancy in a multi-ethnic community: findings from the born in Bradford cohort study.
PloS one. 2013 Apr 30; 8 (4):e60693. DOI: 10.1371/journal.pone.0060693, PMid: 23637759, PMCid:
PMC3640042
Wernand, J.J., Kunseler, F.C., Oosterman, M., Beekman, A.T. and Schuengel, C, 2014. Prenatal changes in
parenting self‐efficacy: Linkages with anxiety and depressive symptoms in primiparous women. Infant
mental health journal, 35 (1), pp.42-50. DOI: 10.1002/imhj.21425, PMid: 25424405
Coleman PK, Karraker KH. Self-efficacy and parenting quality: Findings and future applications.
Developmental review. 1998 Mar 1; 18 (1):47-85. DOI: 10.1006/drev.1997.0448
Furber CM, Garrod D, Maloney E, Lovell K, McGowan L. A qualitative study of mild to moderate
psychological distress during pregnancy. International Journal of Nursing Studies. 2009 May 1; 46 (5):669-
DOI: 10.1016/j.ijnurstu.2008.12.003, PMid: 19150062
Östberg M, Hagekull B. A structural modeling approach to the understanding of parenting stress. Journal of
clinical child psychology. 2000 Nov 1; 29 (4):615-25, DOI: 10.1207/S15374424JCCP2904_13, PMid:
Azmoude E, Jaafarnejad F, Mazloum S. Effect of self-efficacy-based training on maternal sense of
competency of primiparous women in the infants care. Evidence Based Care. 2014 Oct 1;4 (3):7-14.
Babanazari L, Kafi M. Relationship of pregnancy anxiety to its different periods, sexual satisfaction and
demographic factors. Iranian journal of psychiatry and clinical psychology. 2008 Aug 15; 14 (2):206-13.
Rouhe H,Fear of child birth Academic dissertation of Midwifery of Helsinki University, 2015:41.
Levin JS. The factor structure of the pregnancy anxiety scale. Journal of Health and Social Behavior. 1991
Dec 1:368-81. DOI: 10.2307/2137104, PMid: 1765627
Arfaie K, Nahidi F, Simbar M, Bakhtiari M. The role of fear of childbirth in pregnancy related anxiety in
Iranian women a qualitative research. Electronic physician. 2017 Feb; 9 (2):3733. DOI: 10.19082/3733,
PMid: 28465800, PMCid: PMC5410899
Körükcü Ö, Fırat MZ, Kukulu K. Relationship between fear of childbirth and anxiety among Turkish
pregnant women. Procedia-Social and Behavioral Sciences. 2010 Jan 1; 5:467-70. DOI:
1016/j.sbspro.2010.07.125
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