Ways of Coping with Stress during Pregnancy: Differences Revealed through Meta-Analysis

Abstract

Substantial research demonstrates that high stress during pregnancy is a potent risk factor for adverse maternal, infant, and child outcomes. Strategies to cope with prenatal maternal stress have the potential to alleviate or exacerbate stress impacts. Yet we lack sufficient understanding of how frequently pregnant women use various ways of adaptive and maladaptive coping and whether coping practices differ by individual characteristics or by the circumstances of pregnancy. This meta-analysis evaluated 21 studies of commonly used instruments that assess coping with prenatal stressors: the Prenatal Coping Inventory (PCI; k = 6) and its successor, the Revised Prenatal Coping Inventory (NuPCI; k = 15). Across studies, pregnant women used adaptive coping strategies most frequently: [Planning-]Preparation and Spiritual-Positive coping. They used Avoidant coping least often. There were also differences in ways of coping by study trimester, racial and ethnic composition of samples, parity, and gravidity. Coping factors from the PCI and NuPCI exhibited good internal consistency in different countries and languages. Findings confirm that these instruments are reliable tools to assess prenatal coping and indicate that coping during pregnancy is influenced by individual and contextual factors. Understanding how women cope with prenatal stress can improve the ability of interventions to promote resilience.