Effects of perinatal distress, satisfaction in partner relationship and social support on pregnancy and outcome of childbirth

Aim: The aim of this thesis was to achieve a deeper understanding of the situation among women experiencing perinatal distress during pregnancy and childbirth and the effects that dissatisfaction in partner relationship and weak social support from family and friends could have on pregnancy and childbirth. Methods: Following screening for perinatal distress, 562 expecting mothers came for a semi-structured interview. This screening, done with the Depression Anxiety Stress Scales and the Edinburgh Postpartum Depression Scale, categorized 360 (64.1%) women into the perinatal distressed group (PDG) and 202 (35.9%) into the non-distressed group (NDG). During the interview women answered the Dyadic Adjustment Scale and the Multidimensional Scale of Perceived Social Support. Data were collected with these instruments for study I. Additional data for the three other studies were gathered from the women´s pregnancy records (II), electronic medical records (II, III), and childbirth records (IV). Results of the four studies were obtained by using descriptive statistics; parametric and nonparametric statistics and regression modeling. Results: Women in the PDG were significantly more likely than the NDG to be dissatisfied in their partner relationship, continue smoking during pregnancy, be dissatisfied with division of household tasks and child-rearing, have elementary or lower education, and to be students or unemployed. They were also significantly more likely to experience fatigue, vomiting and pelvic girdle pain during pregnancy. Women in the PDG who received weak family support reported nausea and heartburn more frequently than those with strong family support. Women in the PDG utilized more antenatal care service and were allocated more part time as well as earlier sick leaves during pregnancy, than those in the NDG. Women in the PDG were significantly more likely to use epidural anesthesia as a single pain management during labor. Conclusion: Perinatal distress affects pregnancy and childbirth. It is more common among women who are dissatisfied in their partner relationship and with the division of household tasks and child-rearing. Perception of weak social support also affects pregnancy among distressed women. Distressed women along with their partners and families should be offered support and consultation to relieve distress and strengthen their bonds during pregnancy and childbirth.