Anxiety in pregnant and postpartum women. An exploratory study of the role of maternal orientations.

Background: Little is known about why some women are anxious during pregnancy but not in the postpartum period, or vice versa. We aimed to determine the influence of maternal antenatal orientations (Raphael-Leff, J. (2005) Psychological Processes of Childbearing, London, The Anna Freud Centre.) on the prevalence of general anxiety symptoms and specific anxiety in pregnant and postpartum women.

Methods: Four hundred and three pregnant women participated in a longitudinal study and completed general (HADS-A) and specific (PRAQ, MSAS) anxiety questionnaires and measures of maternal antenatal orientations, personality traits, cognitive and behavioural coping styles and attachment.

Results: Higher scores on the neuroticism and regulator orientation scale consistently predicted higher scores on the general and pregnancy related anxiety measures. Also, an interaction effect was found between the regulator scale and the neuroticism scale on the general anxiety symptoms and pregnancy related anxiety. Finally, the facilitator orientation scale and the neuroticism scale, predicted maternal separation anxiety in the postpartum period.

Conclusion: Women differ in the risk factors, the nature and timing of heightened anxiety during the transition to motherhood. The anxieties of women tending to the regulator orientation are pregnancy related, whereas women tending to the facilitator orientation fear the separation from their child in the postpartum period.