PSYCHOSOCIAL ADAPTATION TO PREGNANCY : seven dimensions of maternal development.

Preface
Acknowledgments
Contents
About the Authors
1: Psychosocial Anxiety, Stress, and Adaptation in Pregnancy: Assessment of Seven Dimensions of Maternal Development
	1.1	 Introduction
	1.2	 Foundation Research Projects for Theory Development of the Seven Dimensions of Maternal Prenatal Adaptation
		1.2.1	 Maternal Psychological and Physiological Correlates of Progress in Labor and Fetal/Newborn Health
			1.2.1.1	 Theory and Design
			1.2.1.2	 Methods
			1.2.1.3	 Results
		1.2.2	 Relationship of Maternal Prenatal Psychosocial Adaptation and Family Functioning to Pregnancy Outcomes
			1.2.2.1	 Background and Theory
			1.2.2.2	 Design and Methods
			1.2.2.3	 Results
		1.2.3	 Maternal Prenatal Psychosocial Adaptation Predictors of Infant Birth Weight and Gestational Age
			1.2.3.1	 Theory and Background
			1.2.3.2	 Research Summary
	1.3	 The Far-Reaching Effects of Prenatal Anxiety, Birth Outcomes, Demographic Variables, and Health of the Mother and the Fetus/Newborn/Child
		1.3.1	 Maternal Anxiety and Stress in Pregnancy, Demographic Factors, and Traumatic Life Events
		1.3.2	 Maternal Prenatal Anxiety and Stress, and Adverse Child and Adult Health Outcomes
	1.4	 Theoretical Foundations of the Seven Dimensions of Adaptation to Pregnancy
	References
2: Acceptance of Pregnancy
	2.1	 Planning and Wanting the Pregnancy
	2.2	 Happiness Versus Depression During Pregnancy
	2.3	 Discomfort During Pregnancy
	2.4	 Body Change During Pregnancy
	2.5	 Ambivalence Toward Pregnancy
	2.6	 Summary
	References
3: Identification with a Motherhood Role
	3.1	 Motivation for Motherhood
	3.2	 Preparation for Motherhood
		3.2.1	 Fantasizing
			3.2.1.1	 Envisioning Oneself as a Mother
			3.2.1.2	 Characteristics Desired as a Mother
			3.2.1.3	 Anticipating Future Life Changes as a Mother
		3.2.2	 Dreams About Pregnancy and Motherhood
			3.2.2.1	 Reliving Childhood
			3.2.2.2	 School Dreams
			3.2.2.3	 Motherhood–Career Conflict
			3.2.2.4	 Confidence in Maternal Skills
			3.2.2.5	 Food Dreams and Infant Intactness
			3.2.2.6	 Life Experience
	3.3	 Conflict Resolution
	3.4	 Maternal–Fetal Attachment Representation and Maternal Role Evolution
	3.5	 Summary
	References
4: Relationship with Mother
	4.1	 Availability of the Mother
		4.1.1	 Infancy and Childhood
		4.1.2	 Availability During Pregnancy
	4.2	 Reactions to Pregnancy
	4.3	 Respect for Autonomy
	4.4	 Willingness to Reminisce
	4.5	 Empathy with the Mother
	4.6	 Summary
	References
5: Relationship with Husband or Partner
	5.1	 The Husband’s Concern for His Expectant Wife’s Needs
		5.1.1	 Empathy
			5.1.1.1	 Empathic Partners
			5.1.1.2	 Unempathic Partners
		5.1.2	 Increased Cooperativeness and Flexibility
		5.1.3	 Availability
		5.1.4	 Trustworthiness and Reliability
	5.2	 The Wife’s Concern for Her Husband’s Needs as an Expectant Father
	5.3	 Effects of the Pregnancy on the Marital Bond
		5.3.1	 Closeness and Intimacy
		5.3.2	 Increased or Decreased Conflict in the Marital Bond
	5.4	 Identification of a Fatherhood Role
	5.5	 The Transition to Fatherhood
		5.5.1	 Readiness for Fatherhood
		5.5.2	 Stress Associated with Fatherhood
		5.5.3	 Paternal–Infant Attachment
		5.5.4	 Paternal Involvement in Childcare
		5.5.5	 Marital and Partner Relationship Support and Education During Pregnancy
	5.6	 Summary
	References
6: Preparation for Labor
	6.1	 Planning for Labor: Practical Steps to Gather Information
		6.1.1	 Prenatal Classes
		6.1.2	 Conversing with Other Women
		6.1.3	 Books, Films, and Media
		6.1.4	 Other Practical Steps
	6.2	 Planning for Labor: Maternal Thought Processes
		6.2.1	 Thinking Versus Avoidance of Thinking About Labor
	6.3	 Congruence Between Fantasy and Reality
		6.3.1	 Labor Contractions
		6.3.2	 Work and Pain
		6.3.3	 Risks and the Unknown
		6.3.4	 Doubts and Fears About Labor
	6.4	 Level of Confidence Regarding Labor
	6.5	 Envisioning the Challenges of Labor for Oneself and the Fetus
		6.5.1	 Dreams About Labor
	6.6	 Summary
	References
7: Prenatal Fear of Pain, Helplessness, and Loss of Control in Labor
	7.1	 Loss of Control Over the Body
	7.2	 Loss of Control Over Emotions
	7.3	 Ability to Trust the Medical/Nursing Staff
	7.4	 Attitudes Toward Being “Awake and Aware” and the Use of Medication
	7.5	 Summary
	References
8: Prenatal Fears of Loss of Self-Esteem and Well-Being in Labor
	8.1	 Overview
	8.2	 Measures of Self-image
	8.3	 Evaluation of Self-worth
	8.4	 Behaviors That Reflect Self-esteem
		8.4.1	 Tolerance of Self
		8.4.2	 Value of Self
		8.4.3	 Body Image and Appearance
	8.5	 Summary
	References
9: Prenatal Adaptation in Military Women
	9.1	 Military Demands and the Effect on the Family
	9.2	 Dimensions of Maternal Psychosocial Adaptation and Anxiety in Military Women
		9.2.1	 Acceptance of Pregnancy, Deployment, and Support
		9.2.2	 Prenatal Maternal Anxiety and Community Support
		9.2.3	 Prenatal Maternal Anxiety and Birth Outcomes
	9.3	 Intervention for Prenatal Maternal Anxiety
		9.3.1	 Mentors Offering Maternal Support (M-O-M-S™) Development and Piloting
	References
10: Prenatal Adaptation Among Multigravidas
	10.1	 Quantitative Results: Statistical Analysis of Psychosocial Adaptation to Pregnancy Based on Parity
	10.2	 Qualitative Analysis of Psychosocial Adaptation to Pregnancy Based on Parity
		10.2.1	 Acceptance of Pregnancy
			10.2.1.1	 Body Image and Career Transitions During Pregnancy
			10.2.1.2	 The Impact of Experience and Family Planning on Acceptance of Pregnancy
			10.2.1.3	 Other Factors Bearing on Acceptance of Pregnancy
			10.2.1.4	 Financial Considerations of a Larger Family
			10.2.1.5	 Summary: Acceptance of Pregnancy
		10.2.2	 Identification with a Motherhood Role
			10.2.2.1	 Anxiety About Anticipated Life Changes and the Unknown Child
			10.2.2.2	 Preparing Children for a Sibling
			10.2.2.3	 The Impact of Past Experience with Motherhood
			10.2.2.4	 Anticipation of Life Changes
			10.2.2.5	 Summary: Identification with a Motherhood Role
		10.2.3	 Relationship with Mother
			10.2.3.1	 Motherhood as a Maturational and Developmental Milestone
			10.2.3.2	 The Impact of a Current Negative or Nonexistent Relationship with the Mother
			10.2.3.3	 Summary: Relationship with Mother
		10.2.4	 Relationship with Husband or Partner
			10.2.4.1	 Changes in the Sexual Relationship During Pregnancy
			10.2.4.2	 Family and Social Support
			10.2.4.3	 Summary: Relationship with Husband or Partner
		10.2.5	 Preparation for Labor
			10.2.5.1	 Childbirth Preparation Classes and Books
			10.2.5.2	 Summary: Preparation for Labor
		10.2.6	 Fear of Pain, Helplessness, and Loss of Control in Labor
			10.2.6.1	 Summary: Fear of Pain, Helplessness, and Loss of Control in Labor
		10.2.7	 Concerns for Loss of Self-Esteem and Well-Being of Self and Baby in Labor
		10.2.8	 Summary: Fear of Loss of Self-Esteem and Well-Being of Self and Baby in Labor
	10.3	 Summary
	References
11: Methods of Assessment: Psychosocial Adaptation to Pregnancy Questionnaire Scales and Interview Schedules, and Interventions to Enhance Adaptation
	11.1	 Prenatal Self-Evaluation Questionnaire (PSEQ) and Psychometric Data
		11.1.1	 Description of the Seven Scales of the Prenatal Self-Evaluation Questionnaire and Sample Items
			11.1.1.1	 Acceptance of Pregnancy
			11.1.1.2	 Identification of a Motherhood Role
			11.1.1.3	 Relationship with Mother
			11.1.1.4	 Relationship with Husband/Partner
			11.1.1.5	 Preparation for Labor
			11.1.1.6	 Fear of Pain, Helplessness, and Loss of Control in Labor
			11.1.1.7	 Concern for Loss of Self-Esteem and Well-Being of Self and Baby in Labor
		11.1.2	 Psychometric Data
			11.1.2.1	 Descriptive Data and Reliability Coefficients
			11.1.2.2	 Intercorrelations Among the Scales
	11.2	 Prenatal Clinical Interview Schedules and Rating Scales
		11.2.1	 Clinical Practice Recommendations for Conducting Interviews
		11.2.2	 Summary Ratings
	11.3	 Recommendations for Clinical Care and Research
		11.3.1	 Clinical Assessment: Continuity of Care and Assessment of Maternal Developmental Adaptation
		11.3.2	 Suggestions for Clinical Research Studies
			11.3.2.1	 Assessment of Prenatal Adaptation and Determination of Labor and Delivery Outcomes
	11.4	 Research Intervention Trials for General and Pregnancy-Specific Anxiety Reduction
		11.4.1	 Assessment of the Seven PSEQ Dimensions as a Basis for Intervention
			11.4.1.1	 Characteristics of Effective Interventions
	11.5	 The Panoply of Therapeutic Prenatal Interventions to Promote Maternal Psychosocial Adaptation to Pregnancy
		11.5.1	 Assessment and Intervention Research Demonstrating Effectiveness in High-Risk Prenatal Populations
		11.5.2	 Intervention Research Demonstrating Effectiveness in Low-Risk Prenatal Populations
		11.5.3	 Marital/Partner Relationships: Factors Influencing Maternal Stress/Anxiety Responses and Implications for Therapeutic Intervention
		11.5.4	 Maternal and Paternal Coping Strategies and Birth Outcomes
		11.5.5	 Complementary and Alternative Medical (CAM) Therapies
	11.6	 The Significance of Assessment and Screening for Pregnancy-Specific Anxiety and Prenatal Other Life Events
	References
Index