Distress in Pregnant Women: a Literature Review



The article presents an analysis of literary sources on the topic of psychological adaptation to pregnancy and motherhood. Psychological adaptation can be defined as the process of establishing the optimal correspondence of the individual and the environment during the implementation of human-specific activities, which allows the individual to meet urgent needs and realize significant goals, while ensuring compliance with the maximum human activity, behaviour, and environmental requirements. Psychological adaptation is a continuous process, which also includes such aspects as optimization of the constant impact of the individual with the environment and establishing an adequate correspondence between mental and physiological characteristics. Pregnancy and motherhood as situations of adaptation are due to two circumstances: adaptation to pregnancy as a physiological and psychosomatic condition; adaptation to motherhood as the adoption of the role of a mother and the forma tion of a mother’s position, the adoption of a child and all changes related to the appearance in the personal, family, social and professional spheres. In this process, all physiological and psychological adaptation systems are involved, and the very situation of pregnancy and motherhood can be considered as an acute crisis situation, since there is a radical change in all aspects of a woman’s life. The article discusses in detail the factors affecting a woman’s adaptation to pregnancy, in particular the lack of adaptation mechanisms, motivational factor (conflict), and the presence of objective reasons that complicate the adaptation process. The concepts of prenatal, maternal, and parental stress are presented. Also, the features of coping strategies are discussed and the results of modern research on the topic are presented. The current sphere requires more detailed research and additional studies based on a single theoretical and methodological model, taking into account all ethical standards when conducting studies with a person, since pregnant women are included in a vulnerable group of respondents.

General Information

Keywords: pregnancy, distress, prenatal stress, coping strategies, psychological adaptation

Article type: review article

DOI: https://doi.org/10.21638/spbu16.2020.311

Funding. The reported study was funded by RFBR, project No. 19-013-00417а.

For citation: Burina E.A., Ababkov V.A., Kapranova S.V., Pazaratskas E.A. Distress in Pregnant Women: a Literature Review. Vestnik of Saint Petersburg University. Psychology, 2020. Vol. 10, no. 3, pp. 367–378. DOI: 10.21638/spbu16.2020.311. (In Russ., аbstr. in Engl.)


  1. Filippova G. G. The Psychology of Maternity. Moscow, Izd-vo Instituta psihoterapii Publ., 2002. (In Russian)
  2. Clinical Psychology and Psychotherapy. 3rd ed. Rus. ed. St. Petersburg, Piter Publ., 2012. (In Russian)
  3. Berezin F. B. Mental and Psychophysiological Adaptation of a Person. Moscow, Nauka Publ., 1988. (In Russian)
  4. Brutman V. I., Filippova G. G., Khamitova I. U. The Dynamics of the Psychological State of Women During Pregnancy and After Childbirth. Voprosi psikhologii, 2002, vol. 1, pp. 59–68. (In Russian)
  5. Burina E. A., Grandilevskaya I. V. Psychological Adaptation to Motherhood in Women Who Have Recently Given Birth. Tezisy II Obshcherossiiskoi konferentsii s mezhdunarodnym uchastiem «Perinatal’naia meditsina: ot pregravidarnoi podgotovki k zdorovomu materinstvu i detstvu». Sankt-Peterburg, February 18–20. Moscow, StatusPraesens profmedia, 2016, pp. 9–10. (In Russian)
  6. Takahashi M., Adachi M., Kuribayashi M., Nakamura K. Coordination Difficulties in Preschool-aged Children are Associated with Maternal Parenting Stress: a Community-based Cross-sectional Study. Research in Developmental Disabilities, 2017, vol. 70, pp. 11–21.
  7. Woodman A. C., Mawdsley H. P., Hauser-Cram P. Parenting Stress and Child Behavior Problems Within Families of Children with Developmental Disabilities: Transactional Relations Across 15 Years. Research in Developmental Disabilities, 2015, vol. 36, pp. 246–276.
  8. Ababkov V. A., Perre M. Adaptation to Stress. Fundamentals of Theory, Diagnosis, Therapy. St. Petersburg, Rech Publ., 2004. (In Russian)
  9. Lobel M., DeVincent C. J., Kaminer A., Meyer B. A. The Impact of Prenatal Maternal Stress and Optimistic Disposition on Birth Outcomes in Medically High-risk Women. Health Psychology, 2000, vol. 19, no. 6, pp. 544–553.
  10. Pan W. L., Gau M. L., Lee T. Y., Jou H. J., Liu C. Y., Wen T. K. Mindfulness-based Programme on the Psychological Health of Pregnant Women. Women and Birth, 2019, vol. 32, no. 1, pp. e102–e109.
  11. Psychosomatics: Physicality and Culture: Textbook for High Schools. Ed. by V. V. Nikolayeva. Moscow, Akademicheskii Proekt Publ., 2009. (In Russian)
  12. Tolchinskaya E. A. The Dynamics of the Mental State of Pregnant Women in the Process of Music Therapy. Abstract of PhD dissertation (Psychology) . St. Petersburg, 2010. (In Russian)
  13. Goletzkea J., Kocalevent R.-D., Hansena G., Rosed M., Bechere H., Hechera K., Arcka P. C., Diemerta A. Prenatal Stress Perception and Coping Strategies: Insights From a Longitudinal Prospective Pregnancy Cohort. Journal of Psychosomatic Research, 2017, vol. 102, pp. 8–14.
  14. Peñacoba-Puente C., Carmona-Monge F. J., Marín-Morales D., Naber K. Coping Strategies of Spanish Pregnant Women and Their Impact on Anxiety and Depression. Research in Nursing and Health, 2013, vol. 36, no. 1, pp. 54–64.
  15. Faisal-Cury A., Savoia M. G., Menezes P. R. Coping Style and Depressive Symptomatology During Pregnancy in a Private Setting Sample. The Spanish Journal of Psychology, 2012, vol. 15, no. 1, pp. 295–305.
  16. Ruiz J. R., Gennaro S., O’Connor C., Marti N., Lulloff A., Keshinover T., Gibeau A., Melnyk B. Measurng Coping in Pregnant Minority Women. Western Journal of Nursing Research, 2015, vol. 37, no. 2, pp. 257–275.
  17. Dementiy L. I., Vasilevskaya U. G. Features of Coping Strategies of Pregnant Women with Different Types of Psychological Component of Gestational Dominant. Vestnik Omskogo universiteta, 2012, no. 4, pp. 251–255. (In Russian)
  18. Zanardo V., Messina P., Trivellato P., Cavallin F., Giustardi A., Straface G., Trevisanuto D. Coping Strategies in Low-risk Pregnant Women: the Influence of Low and Late Fertility. The Journal of Maternal-Fetal & Neonatal Medicine, 2014, vol. 27, no. 2, рp. 145–148.
  19. Talge N. M., Neal C., Glover V. Antenatal Maternal Stress and Long-term Effects on Child Neurodevelopment: How and Why? Journal of Child Psychology and Psychiatry and Allied Disciplines, 2007, vol. 48, pp. 245–261.
  20. Vetchanina E. G., Malgina G. B. Features of the Reactions of Pregnant Women to Psychoemotional Stress at Different Stages of Pregnancy. Sibirskii psihologicheskii zhurnal, 2001, no. 14–15, pp. 150. (In Russian)
  21. Akbirova R. R., Abitov I. R., Ilchenko M. V. Investigation of the Peculiarities of Coping with Stress in Women with a Normal and Complicated Pregnancy. Lichnost’ v trudnykh zhiznennykh situatsiiakh: resursy i preodolenie. Omsk, Omsk State Univ. Publ., 2018, pp. 68–71. (In Russian)
  22. Borrelli S. E., Walsh D., Spiby H. First-time Mothers’ Expectations of the Unknown Territory of Childbirth: Uncertainties, Coping Strategies and ‘Going With the Flow’. Midwifery, 2018, vol. 63, pp. 39–45.
  23. Dobryanskaya R. G. Research on Strategies for Coping with Emotional Stress in Pregnant Women. Sibirskii psihologicheskii zhurnal, 2003, no. 18, pp. 65–67. (In Russian)
  24. Dobryanskaya R. G., Evtushenko I. D., Kuzmina U. V. Features of the Course of Pregnancy, Childbirth and the Postpartum Period in Pregnant Women, Differing in Coping Behaviour Strategies. Sibirskii psihologicheskii zhurnal, 2007, no. 25, pp. 215–218. (In Russian)
  25. Shuvalova M. P., Chausov A. A., Grebennik T. K., Prikhodko N. A. Medical and Social Aspects That Determine the Values of the Mother in Relation to the Preservation, Strengthening and Restoration of Health of her Newborn. Akusherstvo i ginekologiia, 2016, no. 3, pp. 76–79. (In Russian)
  26. Psychotherapeutic Encyclopedia, ed. by B. D. Karvasarskij. St. Petersburg, Piter Publ., 2006. (In Russian)
  27. Dobryakov I. V. Perinatal Psychology. St. Petersburg, Piter Publ., 2010. (In Russian)
  28. Vasserman L. I., Ababkov V. A., Trifonova E. A. Coping with Stress: Theory and Psychodiagnostics: A Training Manual, ed. by L. I. Vasserman. St. Petersburg, Rech Publ., 2010. (In Russian)
  29. Burina E. A. Ethical Aspects of Biomedical and Psychological Research in Women of Reproductive Age. Vestnik Yuzhno-Uralskogo gosudarstvennogo universiteta. Seriia: Psihologiia, 2015, vol. 8, no. 2, pp. 88– 93. (In Russian)

Information About the Authors

Ekaterina A. Burina, PhD in Psychology, St.Petersburg, Russia, e-mail: e.a.burina@spbu.ru

Valentin A. Ababkov, Doctor of Medicine, Professor, Professor, Chair of Medical Psychology and Psychophysiology, Psychological Department, Saint-Petersburg State University, St.Petersburg, Russia, ORCID: https://orcid.org/0000-0003-1925-8397, e-mail: valababkov@mail.ru

Sofia V. Kapranova, Postgraduate Student, St. Petersburg State University, St.Petersburg, Russia, e-mail: sph.sph92@gmail.com

Elena A. Pazaratskas, Medical Psychologist, Women Consultation N 33, St.Petersburg, Russia, e-mail: 9446642@gmail.com