Risk Perceptions and Stress Mindsets during Pregnancy: Associations with Prenatal and Postpartum Mental Health Indices

Maternal anxiety and depression are common complications of the peripartum period that can have long-term consequences for women, children, and families. While cognitive processes are known to impact psychological outcomes, they are understudied as risk factors in the context of pregnancy. Addressing gaps in the literature, the present study aimed to examine: (1) risk perceptions, given modern pregnancies involve exposure to increasing amounts of risk-based and potentially empirically unfounded information and advice, and (2) stress mindsets, given the culturally salient message that stress is harmful and especially so during pregnancy. A national survey-based study was conducted in partnership with obstetricians and gynecologists (ob-gyns), belonging to the American College of Obstetricians and Gynecologists (ACOG)’s Collaborative Ambulatory Research Network (CARN). The physician sample consisted of 73 ob-gyns, while the prenatal patient sample consisted of 388 women, 103 of whom completed a follow-up survey postpartum. Analysis of the data showed that patients underestimated the safety of exposure to a range of behaviors during pregnancy compared to average physician ratings of those same behaviors. Greater overestimation of risk was predicted by greater consumption of pregnancy related information and advice, but did not predict adverse mental health or obstetric outcomes other than unplanned cesarean delivery, above and beyond general perceived stress. Increasingly positive stress mindsets weakened the effect of stress on anxiety and depression symptoms during pregnancy, -+. Stress mindsets also moderated the effect of prenatal ratings of the pregnancy as a stressor on postpartum depression symptoms. While limitations are noted, this study contributes novel findings to the literature and suggests avenues for future research. Pregnancy-specific appraisals warrant further examination as potential risk factors for adverse outcomes and targets for maternal mental health initiatives.