Stress Perception Among Rural and Urban Perinatal Patients (original) (raw)

2010, Online Journal of Rural Nursing and Health Care

Pregnancy can be a source of both physical and emotional stress for the pregnant woman. Stress can greatly impact one's well-being by increasing blood pressure, reducing coping mechanisms, and ultimately threatening one's homeostasis. Anecdotal data indicates that urban and rural areas afford different sociocultural stress. There is a dearth of studies that explore perceptions of stress among pregnant women and no known studies that explore the perception of stress among pregnant women who live in different sociocultural areas of the United States. The purpose of this pilot study was to explore perceptions of stress among rural and urban pregnant women. Findings indicated that rural participants attended prenatal classes more than urban participants and that urban participants perceived greater overall stress than rural participants. The study lends feasibility to future research exploring perinatal stress as influenced by geographical, sociocultural factors. BACKGROUND Numerous studies indicate that pregnancy can be a stressful time for expectant mothers (Nierop, Wirtz, Bratsikas, Zimmermann, & Ehlert, 2008; Orr, Reiter, Blazer & James, 2007). Maternal stress in pregnancy is associated with elevated blood pressure, excessive weight gain, weight loss, sleeplessness, fatigue, and decreased coping skills (Hobel, Dunkel-Schetter, Roesch, Castro & Arora, 1999). Chronic maternal stress can lead to cardiovascular issues and increased susceptibility to infectious disease (March of Dimes Birth Defects Foundation, 2009). In a meta-analysis of the literature, Glover and O'Connor (2006) noted that stress in pregnancy has negative implications for the fetus and could have a long-term negative effect on the child's behavior and neurodevelopment. Weinstock (2008) explored the effect of stressinduced levels of cortisol and corticotrophin releasing hormone in pregnancy. Based on animal studies, Weinstock postulated that increased maternal levels of cortisol and glucocorticoids could cause learning deficits in the child by altering neurological development of the fetus. Van den Bergh, Mulder, Mennes, and Glover (2005) found that high levels of maternal anxiety caused an increase in adrenaline and a reduction of placental blood flow, exposing the developing fetus to possible hypoxia. Nierop et al. (2008) found that complications such as low infant birth weight, gestational complications, postpartum depression and developmental issues in infancy were associated with women who reported high levels of stress throughout pregnancy.