Appraisal, Coping, &Emotions in Pregnancy After Loss

Syracuse University, Syracuse NY

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Linked publications & trials

Abstract

DESCRIPTION: (provided by applicant) While nearly 25% of women experience a perinatal loss, little is known about how women cope with the subsequent pregnancies and which ways of coping are the most effective in reducing negative emotions. Findings from all published studies on pregnancy after perinatal loss (PAL), using either quantitative or qualitative methodologies, report that women in PAL have significant higher anxiety. Specifically, women in PAL fear recurrence of loss are hypervigilant throughout the pregnancy and attempt to protect/cushion themselves emotionally. High anxiety during pregnancy has been associated with increased negative obstetrical outcomes, neonatal difficulties and hypervigilant parenting styles. However, no longitudinal study of women's anxiety associated with subsequent pregnancy after a previous loss has been conducted. Thus, there are no evidence-based guidelines by which to guide care to pregnant women with a previous prenatal loss. Therefore, this proposed longitudinal study will examine the relationships between threat appraisal, coping (problem-focused and emotion-focused), and emotional states (positive affect, negative affect, pregnancy anxiety) at three points in time across the pregnancies of one group of 68 multigravidas with a history of perinatal loss. Lazarus and Folkman's (1984) framework of cognitive appraisal will be used to guide the study. Specifically, the primary purpose is to examine the effects of time on threat appraisal, coping, and emotional state (pregnancy anxiety, positive affect, and negative affect) in women pregnant after perinatal loss. The secondary purpose is to determine whether coping mediates the effect of threat appraisal on emotional states and what type of coping predicts more positive affect, less negative emotions, and less pregnancy anxiety. Data will be collected once each trimester, at 10 week intervals, beginning at 10-15 weeks gestation on the main study variables operationalized by the Moneyham Threat Index, the Ways of Coping Checklist-Revised, the MAACL-R, and Pregnancy Anxiety Scale. Multiple regression and path analysis will be used to answer the research questions.