Annals of Behavioral Medicine

, Volume 24, Issue 2, pp 132–140 | Cite as

Coping in normal pregnancy

  • Anja C. Huizink
  • Pascale G. Robles de Medina
  • Edu J. H. Mulder
  • Gerard H. A. Visser
  • Jan K. Buitelaar


Background: In high-risk populations (e.g., adolescents, substance abusers), coping strategies in pregnancy have been studied. Avoidance of the stressful situation and aggressive coping are frequently used and related to postnatal depression and other negative outcomes. Little is known about coping strategies in nulliparous normal-risk pregnancy. Objective: To examine the factor structure of the 19-item Utrecht Coping List (UCL-19) in a sample of nulliparous normal-risk pregnant women and to explore the stability, change, and correlates of coping strategies throughout pregnancy. The associations between a particular coping strategy and the reported pregnancy complaints and experienced distress were examined. Methods: The UCL-19 was filled out and self-report data were collected about neuroticism, locus of control, depression, general anxiety, perceived stress, and physical pregnancy complaints in nulliparous women in early, mid-, and late pregnancy. Results: Confirmatory factor analysis on the UCL-19 revealed 2 coping strategies: emotion-focused coping and problem-focused coping. The factor structure of the UCL-19 had a good stability throughout pregnancy. Some changes in emotion-focused coping and problem-focused coping scores were found, although the absolute differences were rather small. High educational level and low internal locus of control predicted a high score on emotion-focused coping in the early period of pregnancy, F(2, 228) = 11.49, p < .005, R2 = .22. High educational level also predicted a high score on problem-focused coping in early pregnancy, F(1, 229) = 4.80, p < .05, R2 = .06. Emotion-focused coping was negatively and problem-focused coping was positively related to pregnancy complaints (r = -.23, p < .05 and r = .25, p < .005, respectively). Emotion-focused coping in early pregnancy and problem-focused coping in mid-pregnancy were negatively related to experienced distress in early and mid pregnancy, respectively (r = -.27, p < .0005 and r = -.18, p < .01).Conclusion: Two coping strategies were consistently found throughout pregnancy: emotion-focused coping and problem-focused coping. Coping in nulliparous normal-risk pregnancy is a process with small temporal variations. Emotion-focused coping was negatively related to the number of reported pregnancy complaints and to experienced distress.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. (1).
    Killison CM: Special health care needs of homeless pregnant women.Advances in Nursing Science. 1995,18:44–56.Google Scholar
  2. (2).
    Dukewich TL, Borkowski JG, Whitman TL: Adolescent mothers and child abuse potential: An evaluation of risk factors.Child Abuse and Neglect. 1996,20:1031–1047.PubMedCrossRefGoogle Scholar
  3. (3).
    Blechman EA, Lowell ES, Garrett J: Prosocial coping and substance use during pregnancy.Addictive Behavior. 1999,24:99–109.CrossRefGoogle Scholar
  4. (4).
    Eugster A, Vingerhoets AJ: Psychological aspects of in vitro fertilization: A review.Social Science in Medicine. 1999,48:575–589.CrossRefGoogle Scholar
  5. (5).
    Lukse MP, Vacc NA: Grief, depression, and coping in women undergoing infertility treatment.Obstetrics and Gynecology. 1999,93:245–251.PubMedCrossRefGoogle Scholar
  6. (6).
    Nikcevic AV, Kuczmierczyk AR, Nicolaides KH: Personal coping resources, responsibility, anxiety and depression after early pregnancy loss.Journal of Psychosomatic Obstetrics and Gynaecology. 1998,19:145–154.PubMedCrossRefGoogle Scholar
  7. (7).
    Bifulco A, Brown GW: Cognitive coping response to crises and onset of depression.Social Psychiatry and Psychiatric Epidemiology. 1996,31:163–172.PubMedCrossRefGoogle Scholar
  8. (8).
    Demyttenaere K, Lenaerts H, Nijs P, Van Assche FA: Individual coping style and psychological attitudes during pregnancy predict depression levels during pregnancy and during postpartum.Acta Psychiatrica Scandinavia. 1995,91:95–102.CrossRefGoogle Scholar
  9. (9).
    Righetti-Veltema M, Conne-Perréard E, Bousquet A, Manzano J: Risk factors and predictive signs of postpartum depression.Journal of Affective Disorders. 1998,49:167–180.PubMedCrossRefGoogle Scholar
  10. (10).
    Terry DJ, Mayocchi L, Hynes GJ: Depressive symptomatology in new mothers: A stress and coping perspective.Journal of Abnormal Psychology. 1996,105:220–231.PubMedCrossRefGoogle Scholar
  11. (11).
    Lazarus RS, Folkman S:Stress, Appraisal, and Coping. New York: Springer, 1984.Google Scholar
  12. (12).
    Parker JDA, Endler NS: Coping with coping assessment: A critical review.European Journal of Personality. 1992,6:321–344.CrossRefGoogle Scholar
  13. (13).
    Suls J, Fletcher B: The relative efficacy of avoidant and non-avoidant coping strategies: A meta-analysis.Health Psychology. 1985,4:249–288.PubMedCrossRefGoogle Scholar
  14. (14).
    Carver CS, Scheier MF, Weintraub JK: Assessing coping strategies: A theoretically based approach.Journal of Personality and Social Psychology. 1989,56:267–283.PubMedCrossRefGoogle Scholar
  15. (15).
    Cameron RP, Wells JD, Hobfoll SE: Stress, social support and coping in pregnancy: Taking gender and ethnicity into account.Journal of Health Psychology. 1996,1:195–208.CrossRefGoogle Scholar
  16. (16).
    Banyard VL, Graham-Bermann SA: Can women cope? A gender analysis of theories of coping with stress.Psychology of Women Quarterly. 1993,17:303–318.CrossRefGoogle Scholar
  17. (17).
    Hobfoll SE, Dunahoo CL, Ben-Porath Y, Monnier J: Gender and coping: The dual-axis model of coping.American Journal of Community Psychology. 1994,22:49–82.PubMedCrossRefGoogle Scholar
  18. (18).
    McQueeney DA, Stanton AL, Sigmon S: Efficacy of emotion-focused and problem-focused group therapies for women with fertility problems.Journal of Behavioral Medicine. 1997,20:313–331.PubMedCrossRefGoogle Scholar
  19. (19).
    Yali AM, Lobel M: Coping and distress in pregnancy: An investigation of medically high-risk women.Journal of Psychoso matic Obstetrics and Gynaecology. 1999,20:39–52.CrossRefGoogle Scholar
  20. (20).
    Lazarus RS:Stress and Emotion: A New Synthesis. New York:Springer, 1999.Google Scholar
  21. (21).
    Carver CS, Scheier MF: Situational coping and coping dispositions in a stressful transaction.Journal of Personality and Social Psychology. 1994,66:184–195.PubMedCrossRefGoogle Scholar
  22. (22).
    Bosworth HB, Feaganes JR, Vitaliano PP, Mark DB, Siegler IC: Personality and coping with a common stressor: Cardiac cath-eterization.Journal of Behavioral Medicine. 2001,24:17–31.PubMedCrossRefGoogle Scholar
  23. (23).
    Mayes BT, Johnson TW, Sadri G: Personality, job level, job stressors, and their interaction as predictors of coping behavior.Psychological Report. 2000,87:61–81.CrossRefGoogle Scholar
  24. (24).
    Schreurs PJG, Willige G van de, Tellegen B:Utrecht Coping List: A Manual [Dutch]. Lisse, The Netherlands: Swets en Zeitlinger, 1988.Google Scholar
  25. (25).
    Cox JL, Holden JM, Sagovsky R: Detection of postnatal depression: Development of the Edinburgh Postnatal Depression Scale.British Journal of Psychiatry. 1987,150:782–786.PubMedCrossRefGoogle Scholar
  26. (26).
    Green JM, Murray D: The use of the Edinburgh Postnatal Depression Scale in research to explore the relationship between antenatal and postnatal dysphoria. In Cox J, Holden J (eds),Perinatal Psychiatry: The Use and Misuse of the Edinburgh Postnatal Depression Scale, London: Gaskell, 1994, 180–215.Google Scholar
  27. (27).
    Wilde GJS:Neurotic Lability Measured With a Questionnaire. [Dutch]. Amsterdam: Van Rossen, 1963.Google Scholar
  28. (28).
    Conley JJ: Longitudinal stability of personality traits: A multitrait-multimethod-multioccasion analysis.Journal of Personality and Social Psychology. 1985,49:1266–1282.PubMedCrossRefGoogle Scholar
  29. (29).
    Sanderman R, Ranchor AV: Stability of personality traits and psychological distress over six years.Perception and Motor Skills. 1994,78:89–90.Google Scholar
  30. (30).
    Brosschot JF, Gebhardt WA, Godaert GLR: Internal, powerful others and chance locus of control: Relationships with personality, coping, stress and health.Personality and Individual Differences. 1994,16:839–852.CrossRefGoogle Scholar
  31. (31).
    Westerlaak JM van, Kropman JA, Collaris JWN:Trade Directory [Dutch]. Nijmegen, The Netherlands: Instituut voor Toegepaste Sociologie, 1976.Google Scholar
  32. (32).
    Cohen S, Williamson GM: Perceived stress in a probability sample of the United States. In Spacapan S, Oskamp S (eds),The Social Psychology of Health. Newbury Park, CA: Sage, 1987, 31–47.Google Scholar
  33. (33).
    Goldberg DP:The Detection of Psychiatric Illness by Questionnaire. London: Oxford University Press, 1972.Google Scholar
  34. (34).
    Koeter MWJ, Ormel J:General Health Questionnaire [Dutch version]. Lisse, The Netherlands, Swets Test Services, 1991.Google Scholar
  35. (35).
    Spielberger CD, Gorsuch I, Lushene RE:Manual for the State-Trait Anxiety Inventory. Palo Alto, CA, Consulting Psychologists Press, 1970.Google Scholar
  36. (36).
    Parker JDA, Endler NS: Coping with coping assessment: A critical review.European Journal of Personality. 1992,6:321–344.CrossRefGoogle Scholar
  37. (37).
    Tennen H, Herzberger S: Ways of Coping Scale. In Keyser DJ, Sweetland RC (eds),Test Critiques, 3. Kansas City, MO: Test Corporation of America, 1985, 686–697.Google Scholar
  38. (38).
    Lederman R, Miller DS: Adaptation to pregnancy in three different ethnic groups: Latin-American, African-American, and Anglo-American.Canadian Journal of Nursing Research. 1998,30:37–51.PubMedGoogle Scholar
  39. (39).
    Salmela-Aro K, Nurmi JE, Saisto T, Halmesmaki E: Women’s and men’s personal goals during the transition to parenthood.Journal of Family Psychology. 2000,14:171–186.PubMedCrossRefGoogle Scholar
  40. (40).
    Moskowitz DS, Suh EJ, Desaulniers J: Situational influences on gender differences in agency and communion.Journal or Personality and Social Psychology. 1994,66:753–761.PubMedCrossRefGoogle Scholar
  41. (41).
    Dunkel-Schetter C: Maternal stress and preterm delivery.Prenatal and Neonatal Medicine. 1998,3:39–42.Google Scholar
  42. (42).
    Lou HC, Hansen D, Nordentoft M, et al.: Prenatal stressors of human life affect fetal brain development.Developmental Medicine and Child Neurology. 1994,36:826–832.PubMedGoogle Scholar
  43. (43).
    Wadwha PD, Sandman CA, Porto M, Dunkel-Schetter C, Garite TJ: The associationbetweenprenatal stress and infantbirth weight and gestational age at birth: a prospective investigation.American Journal of Obstetrics and Gynecology. 1993,169:858–865.Google Scholar

Copyright information

© The Society of Behavioral Medicine 2002

Authors and Affiliations

  • Anja C. Huizink
    • 1
    • 2
  • Pascale G. Robles de Medina
    • 3
  • Edu J. H. Mulder
    • 3
  • Gerard H. A. Visser
    • 3
  • Jan K. Buitelaar
    • 4
  1. 1.University Medical Center UtrechtDepartment of Child and Adolescent Psychiatry and Rudolf Magnus Institute for NeurosciencesThe Netherlands
  2. 2.Department of Social Medicine, Institute for Research in Extramural MedicineVU University Medical CenterBT AmsterdamThe Netherlands
  3. 3.Department of Obstetrics, Neonatology and Gynaecology and Rudolf Magnus Institute for NeurosciencesUniversity Medical Center Utrecht, Wilhelmina Children’s HospitalThe Netherlands
  4. 4.Department of Child and Adolescent Psychiatry and Rudolf Magnus Institute for NeurosciencesUniversity Medical Center UtrechtThe Netherlands

Personalised recommendations