How Do You Deal with Stress

“How Do You Deal With Stress?”: Pregnant Women’s Methods of Coping

Andrea D Clements

East Tennessee State University

Beth A Bailey

James H. Quillen College of Medicine

Heather Wright

James H. Quillen College of Medicine

Poster Submitted for Presentation at

The Conference on Human Development

April 8-11, 2010

New York, NY Abstract

During intake history 1312 rural women admitted for singleton birth were asked “How do you deal with stress?” Responses were categorized into 18 stress coping strategies. Four of these (Social Support,

Exercise, Prayer/Religion, Relaxation Techniques) have been empirically shown to reduce stress and were reported by 18% of women. Four others (Smoking, Medication/Alcohol, Doing Nothing, Not Coping

Well) were categorized as negative coping and were reported by 16% of women, while 69% of respondents reported at least one strategy for which there is currently little empirical effectiveness data.

Findings suggest a need for intervention and further empirical study. “How Do You Deal With Stress?”: Pregnant Women’s Methods of Coping

The current study sought to summarize the stress coping methods pregnant women report using during pregnancy. Obstetric and birth charts were reviewed for 1334 cases, representing all singleton deliveries from 1/1/06 through 12/31/08 at a rural Appalachian hospital. Answers to this question were not recorded for 22 women, thus, the final sample size for this report is 1312. High-risk births were transferred to a nearby teaching hospital, so this sample represents a low-obstetric-risk sample. Data were collected via individual chart review by research project staff using a two page study-designed data collection form.

Over 90% of the deliveries were reviewed by a single examiner, with reliability checks performed early in the process.

All women were asked the following question by the intake nurse when they arrived for delivery:

“How do you deal with stress?”

No response choices were offered, and responses were recorded verbatim. For the first 300 exactly what was written in the chart was recorded, with qualitative methodology used to combine responses into 18 distinct and meaningful categories. These categories allowed for classification of all responses from the first 300 cases, and were then used to record responses dichotomously for the next 200 cases. At the end of those 200 cases it was clear that the categories included all possible responses seen, and were subsequently used as designed for the remainder of the data collection. The final categories of coping were: Support Seeking, Rest, Bath/Shower, Exercise, Reading/Writing, Hobbies, Prayer/Religion,

Housework, TV/Music, Relaxation Techniques, Smoking, Lashing Out, Medication, Eating, Being Alone,

Crying, “Not well”, and Nothing.

Because of the open-ended nature of the stress coping question that was asked of pregnant women in this study, we have based our analyses on the category of stress coping that each reported. While these represent types of coping that came to mind first when asked the question, this does not mean each woman only used these types of coping. Our assumption is that the types of coping reported were the women’s primary coping strategies, but did not necessarily include all of the ways they dealt with stress.

Most women reported only one stress coping strategy (79.3%), 15.5% reported 2, 2% reported 3, 0.2% reported 4, and 3% reported no strategies.

Strategy N Percentage

Crying 202 15.4%

Being Alone 180 13.7%

Lashing Out 134 10.2%

Rest 121 9.2%

Smoking 116 8.8%

Reading/Writing 94 7.2%

Support Seeking* 93 7.1%

Housework 90 6.9%

Nothing 85 6.5%

TV/Music 75 5.7%

Hobbies 74 5.6%

Exercise* 73 5.6%

Bath/Shower 69 5.3%

Relaxation Techniques* 61 4.6%

Eating 27 2.1%

Prayer/Religion* 22 1.7% “Not well” 11 0.8%

Medication/Alcohol 7 0.5%

*Empirically shown in previous research to reduce stress

Stress coping strategies that have been empirically shown to reduce stress in pregnant and non-pregnant populations are indicated, and were reported by 18.5% of respondents. Negative coping strategies (i.e., smoking, using medications/alcohol, doing nothing, or reported not coping well) were reported by 16.6% of respondents. The majority of respondents (68.6%) indicated that they deal with stress using at least one of the remaining strategies for which there is currently little empirical effectiveness data.

Findings revealed a low rate of use of empirically supported stress coping strategies. This, coupled with the known negative effects of prenatal stress indicate that the study population could potentially benefit from an intervention to bolster stress coping.