Research Output
Factors influencing maternal distress among Dutch women with a healthy pregnancy
  Background: Maternal distress is a public health concern. Assessment of emotional wellbeing is not integrated in Dutch antenatal care. Midwives need to understand the influencing factors in order to
identify women who are more vulnerable to experience maternal distress.

Objective: To examine levels of maternal distress during pregnancy and to determine the relationship between maternal distress and aetiological factors.

Methods: A cross-sectional study including 458 Dutch-speaking women with uncomplicated pregnancies during all trimesters of pregnancy. Data were collected with questionnaires between 10 September and 6 November 2012. Demographic characteristics and personal details were obtained. Maternal distress was measured with the Edinburgh Depression Scale (EDS), State-Trait Anxiety Inventory (STAI), and Pregnancy-Related Anxiety Questionnaire (PRAQ). Behaviour was measured with Coping Operations Preference Enquiry-Easy (COPE-Easy). Descriptive statistics and multiple linear regression analysis were used.

Results: Just over 20 percent of the women in our sample (21.8%) had a heightened score on one or more of the EDS, STAI or PRAQ. History of psychological problems (B = 1.071; p = .001), having young children
(B = 2.998; p = .001), daily stressors (B = 1.304; p = <.001), avoidant coping (B = 1.047, p = <.001), somatisation (B = .484; p = .004), and negative feelings towards the forthcoming birth (B = .636; p = <.001) showed a significant positive relationship with maternal distress. Self-disclosure (B = .863; p = .004) and acceptance of the situation (B = .542; p = .008) showed a significant negative relationship with maternal distress.

Conclusion: Maternal distress occurs among women with a healthy pregnancy and is significantly influenced by a variety of factors. Midwives need to recognise the factors that make women more
vulnerable to develop and experience maternal distress in order to give adequate advice about how to best cope with this condition

  • Type:


  • Date:

    07 March 2015

  • Publication Status:


  • Publisher

    Elsevier BV

  • DOI:


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  • Funders:

    Historic Funder (pre-Worktribe)


Fontein-Kuipers, Y., Ausems, M., Budé, L., Van Limbeek, E., De Vries, R., & Nieuwenhuijze, M. (2015). Factors influencing maternal distress among Dutch women with a healthy pregnancy. Women and Birth, 28(3), e36-e43.



Maternal distress; Anxiety; Depression; Midwifery; Pregnancy Health promotion; Mental health

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