Abstract
Introduction: Pregnancy is associated with psychological, physiological and social shifts, and can be a vulnerable time in a woman's life. Despite a growing understanding of the importance of antenatal mental health, there is a paucity of research on psychosocial factors relevant to this phase, especially in developing countries. The aim of the present study was to investigate the associations of expecting mothers' sense of coherence, perceived social support, and maternal-fetal attachment with mental health outcomes.Method: Participants (N = 122) were nulliparous expectant mothers residing in urban India. Cross-sectional data was collected using an online questionnaire.Results: Participant reports of perceived social support and sense of coherence were negatively correlated with symptoms of antenatal depression, while reports of maternal-fetal attachment, sense of coherence, and social support were positively associated with antenatal well-being. In a multilinear regression model, perceived social support and sense of coherence uniquely contributed to symptoms of antenatal depression, while maternal-fetal attachment and sense of coherence uniquely contributed to antenatal well-being.Discussion: The findings of this study highlight the role of perceived social support, sense of coherence and maternal-fetal attachment in contributing to expecting mothers' mental health and well-being in urban India. These findings have implications for clinical practice and research, intending to the subjective experiences of pregnant women to improve antenatal mental health. Future research investigating these psychosocial factors using longitudinal designs is warranted and would help clinicians and practitioners identify women at risk for perinatal mental health concerns.
Highlights
Pregnancy is associated with psychological, physiological and social shifts, and can be a vulnerable time in a woman’s life
To understand the role of psychosocial factors on antenatal mental health in urban India, we examined how expecting mothers’ perceptions of their attachment to the fetus, their sense of coherence, and perceptions of social support related to self-reported antenatal well-being and symptoms of antenatal depression
When asked about a psychological illness, 87.7% participants reported no diagnosis before pregnancy, 9.8% participants reported having a psychological diagnosis before pregnancy, while 2.5% participants did not disclose this information; 91.8% participants reported no diagnosis of psychological illness during pregnancy, 5.7% participants reported having received a psychological diagnosis during, and 2.5% participants chose not to disclose this information
Summary
Pregnancy is associated with psychological, physiological and social shifts, and can be a vulnerable time in a woman’s life. Recent research suggests that the rates of perinatal depression, anxiety and suicidality are higher in LMICs, as compared to countries in the West [9,10,11] Possible explanations for these high rates are greater stigma attached to mental health care and a lack of awareness about perinatal mental health among practitioners and mothers, which subsequently impacts prevention and treatment of mental health concerns [12, 13]. The current understanding of perinatal mental health in India is largely based on a medical model and symptomfocused approach [14,15,16] While these approaches have allowed researchers and practitioners to delineate mental illnesses specific to this period, and devise appropriate interventions [17,18,19], it seems necessary to add to this literature by expanding conceptions of mental health to include subjective experiences of mothers in the domains of psychosocial and individual factors
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