gms | German Medical Science

Background: Adjusting to motherhood requires coping with profound physical, psychological and social changes, the outcome of which is uncertain and have to be anticipated. In this process, multiple appraisal of the demands are made and compared with the personal coping ressources. The assement of the threat and coping potential takes place against the backgound of consolidated learning experiences, which have become stable personality traits in complex and individually different processes.

Research question: Low socio-economic status and poor family support already been shown tob e influential variables in the process of adjustment to motherhood. The present study aims to extend existing knowledge about vulnerability factors and resources in the maternal emotional adjustment process and to examine the extent to which certain personality traits can predict individual maternal emotional stress and be identified as disadvantaging risk factors.

Methods: The longitudinal study was conducted at the Women`s Hospital in Würzburg, Germany. 444 pregnant women and 385 women in childbirth participated. In a self-report procedure, anxiety (Pregnancy Related Anxiety Questionaire) and worry (Cambridge Worry Scale) as well as the personality variables intolerance of uncertainty (Uncertainty Intolerance Scale-18), social power (Personal Sence of Power Scale) autonomy orientation (Trier Personality Inventory – Autonomy Scale) and locus of control (Extern-Intern-Locus of Control Scale) were measured before and after childbirth. In addition, psychological well-being as well as social-anamnestic and obstetric parameters were collected.

Results: The hierarchical regression model with PRAQ and CWS after childbirth as criterion and the personality variables and psychological well being as predictors explained 41.8% of the variance in criterion. Parity, mental ilness, birth duration, and complications at birth were controlled. Intolerance of uncertainty proved to be the strongest predictor of postpartum anxiety and worry (R2=0.313, β=0.401, 95% KI für β [0.31, 0.49], p<0.001). The other personality variables contributed with ∆R2=0.05 to the prediction, among these only social power made a significant contribution (β=-0.133, 95% KI für β [-0.22, -0.05], p=0.003).

In the further step, psychological well being proved to be a significant predictor (∆R2=0.03, β=-0.193, 95% KI für β [-0.28, -0.10], p<0.001), among the controll variables (∆R2=0.04), only parity made a significant contribution (β=-0.287, 95% KI für β [-0.46, -0.11], p=0.001).

Conclusion: Intolerance of uncertainty proves tobe a risk factor in the process of maternal emotional adjustment. When accompanying pregnant women and mothers by health care professionals, fears and concerns should be specifically addresed and a flexible approach to certainty should be promoted. In addition, individual beliefs about own social power should be reflected, the communication of one`s own needs should be improved and the demand for support in the social environment should be practiced.

Ethics and conflicts of interest: A vote on ethics was obtained. The research was financed by own resources. There are no conflicts of interest.