The Impact of Pregnancy on Resilience in Women Seeking Obstetric Care at an Urban Community Health Center - Abstract
Introduction: Pregnancy and childbirth, as significant life events, are often associated with stress, which in turn is associated with poor perinatal outcomes. Resilience may mediate these outcomes, but there is limited research on how resilience changes during pregnancy. We aimed to measure the change in resilience from a prenatal to a postnatal period and identify associated factors.
Methods: We conducted a mixed methods prospective cohort study at an urban community health center. Surveys were conducted at two time points: prenatal after 20 weeks’ gestation and postnatal up to 12 weeks postpartum. Interviews were conducted among a subset of participants and were analyzed to identify themes important in understanding the context of pregnancy and childbirth. A retrospective chart review was conducted to assess antepartum, intrapartum, and postpartum factors.
Results: Twenty-six participants were included in the study. While the mean resilience score increased between the prenatal and postnatal time points, this change was not statistically significant. There were no demographic or psychosocial factors, medical history, or obstetric factors associated with change in resilience, except for diagnosis of a sexually transmitted infection during pregnancy, which was associated with a decrease in resilience. Social support, a positive outlook, and self-efficacy were prominent themes identified from the interviews.
Conclusion: Quantitative data did not demonstrate significant changes in resilience as a result of maternal or obstetric factors, but qualitative interviews revealed important themes to understand the role resilience may play in pregnancy, or conversely how pregnancy may shape resilience. Future studies should explore resilience scores at different time points in the postnatal time period and further account for the role of social support and self efficacy in mediating resilience.