Coping in normal pregnancy

Background: In high-risk populations (e.g., adolescents, substance abusers), coping strategies in pregnancy have been studied. Avoidance of the stressful situation and aggressive coping are frequently used and related to postnatal depression and other negative outcomes. Little is known about coping strategies in nulliparous normal-risk pregnancy. Objective: To examine the factor structure of the 19-item Utrecht Coping List (UCL-19) in a sample of nulliparous normal-risk pregnant women and to explore the stability, change, and correlates of coping strategies throughout pregnancy. The associations between a particular coping strategy and the reported pregnancy complaints and experienced distress were examined. Methods: The UCL-19 was filled out and self-report data were collected about neuroticism, locus of control, depression, general anxiety, perceived stress, and physical pregnancy complaints in nulliparous women in early, mid-, and late pregnancy. Results: Confirmatory factor analysis on the UCL-19 revealed 2 coping strategies: emotion-focused coping and problem-focused coping. The factor structure of the UCL-19 had a good stability throughout pregnancy. Some changes in emotion-focused coping and problem-focused coping scores were found, although the absolute differences were rather small. High educational level and low internal locus of control predicted a high score on emotion-focused coping in the early period of pregnancy, F(2, 228) = 11.49, p < .005, R2 = .22. High educational level also predicted a high score on problem-focused coping in early pregnancy, F(1, 229) = 4.80, p < .05, R2 = .06. Emotion-focused coping was negatively and problem-focused coping was positively related to pregnancy complaints (r = -.23, p < .05 and r = .25, p < .005, respectively). Emotion-focused coping in early pregnancy and problem-focused coping in mid-pregnancy were negatively related to experienced distress in early and mid pregnancy, respectively (r = -.27, p < .0005 and r = -.18, p < .01).Conclusion: Two coping strategies were consistently found throughout pregnancy: emotion-focused coping and problem-focused coping. Coping in nulliparous normal-risk pregnancy is a process with small temporal variations. Emotion-focused coping was negatively related to the number of reported pregnancy complaints and to experienced distress. This research was supported by the Van der Gaag Stichting and by the Praeventiefonds (28-2685).