Challenges of a Pregnancy Gone Wrong: Pregnancy Complications, Illness Perceptions and Distress

Abstract

Women with pregnancy complications need to cope with a pregnancy that can have life changing consequences. The objective of this research project was to understand the experience of women who had been diagnosed with a pregnancy complication. The research involved an exploratory investigation into illness perceptions of pregnant women with complications and how these relate to depression and anxiety. First a literature review was divided into two parts. The first part dealt with anxiety specific to pregnancy complications. The second part dealt with illness perceptions. Since no published literature on illness perceptions in pregnancy complications was found, a literature review was conducted into illness perceptions in hypertension, diabetes and pain which are all closely associated to pregnancy complications. The research was divided into two studies. The first was a mixed method study in which six women were interviewed regarding their experience in dealing with a pregnancy complication and a pilot was conducted using the Illness Perception Questionnaire (Revised). The second study consisted of an online survey further exploring the relationship between illness perceptions and distress in this population. Recruitment for participation proved very difficult and there were only thirty-six participants who complete the full online study. This survey comprised of a battery of self-report questionnaires including background information, rating of health scale, the Illness Perception Questionnaire (Brief), Edinburgh Postnatal Depression Scale and State Trait Anxiety Inventory Scale (State).

Results from both studies indicated that women in experienced significantly higher degrees of distress and anxiety than those in normal populations. They perceived their pregnancy complications as being outside of their personal control and they don’t see treatment as likely to be effective in controlling their medical condition. They also perceived their pregnancy complication as having high consequences in their lives and they are concerned about the impact of the pregnancy complication has on themselves and on their child. The women who did not have detectable symptoms (asymptomatic) and who could not directly experience cues to their illness were significantly more depressed. This research adds to the international findings on illness perceptions in general and is a starting point for understanding illness perceptions for women with pregnancy complications. The psychological needs of women with pregnancy complications are significant, and are often under-rated and under-evaluated by treatment providers. Understanding illness perceptions of this population can provide a framework for the development of further interventions for this vulnerable population.