gms | German Medical Science

Background: Pregnancy is described in detail in psychology, sociology and ethnology as a transitional phase [1][2][3][4]. Until now, changes during pregnancy have been divided psychologically into phases of uncertainty, adaptation, concretization, anticipation, and preparation [1]. Ethnologically, pregnancy is a phase of separation from the previous role [4] divided into 3 trimesters [3]. Sociologically, pregnancy is divided into stations, but also described as a development and thus not defined as a closed state [2]. Pregnant woman, however, do not just passively endure their social role, but actively support it. It must therefore be clarified whether earlier theory models are sufficient to describe pregnancy.

Aim: The aim of this study is to investigate both the extent of physical and emotional well-being of pregnant women and the social conditions, restructuring and active shaping of pregnancy.

Method: The study is a prospective, longitudinal cohort study. It is affiliated with an ongoing project in the context of studies in the Bachelor's degree program of Midwifery at the University of Health, Bochum. Study participants received a questionnaire [5] validated for the 3rd trimester at three different time points (t₁, t₂, t₃) during pregnancy on current level of well-being and coping mechanisms. A fourth questionnaire (t₄) regarding the birth experience and individual aspects of the birth history will be sent 10 weeks postpartum. The call for project participation will be via local press. Physical, emotional and social well-being will be analyzed in addition to active shaping of pregnancy.

Results: The current data set contains responses from all four time points of 38 women who gave birth in spring 2014 or 2015.

It is striking that during the three survey periods first 89 percent (t₁), then 100 percent (t₂) and finally 97% (t₃) lived with their partners. At t₁ 59 percent of the participants had a college degree; by t₃ this number had increased to 61%. Three-quarters (74%) of respondents to the first survey period (t₁) had experienced stress in the past 12 months. Stress rates were lower (45%) in the final survey during pregnancy (t₃). Reasons given for the high rates of stress were mainly illness or death of a loved one, work, miscarriage, marriage, moving house, exams and family conflicts. After birth (t₄), 40% of the 38 women were enthusiastic about the birth experience. 52% of women who had experienced stress in the last trimester were nevertheless positive about their birth.

Conclusion: Pregnant women are not only faced with bio-psycho-social changes, they also undertake individual restructuring of their lives. This is particularly noticeable with regards to housing and living conditions because pregnant women create new social relationships by getting married and/or moving house. The presence of family conflicts suggests that social relationships are renegotiated in pregnancy. In addition, pregnant women complete their studies or have to negotiate handover or maternity leave at work. The frequent occurrence of stressors such as illness or death of a loved one shows that pregnancy occurs in a social network and greatly affects the well-being of pregnant women.