title: Health insurance status and mood during pregnancy and following birth: a longitudinal study of multiparous women.
abstract: OBJECTIVE
  The objective of this study was to investigate the relationship between health insurance status and mood during pregnancy and following childbirth.
  
  
  METHODS
  320 women were recruited in the early stage of pregnancy to participate in a longitudinal, prospective study of the psychological aspects of childbirth among multiparous women. Study volunteers were surveyed during each trimester of pregnancy and 2 and 8 months following childbirth. A range of self-administered psychometric tests were used to assess mood (Profile of Mood State), locus of control, defence style and partner support. Demographic information including health insurance status was noted at study entry.
  
  
  RESULTS
  Public patients consistently had a more disturbed mood compared with private patients. This difference reached statistical significance during the second and third trimesters of pregnancy and 8 months after birth. Multivariate analysis was undertaken to identify predictors of mood during pregnancy and following birth. A better mood score was positively associated with private health insurance, a more caring partner and mature defence style, and negatively associated with external locus of control and immature defence style. A distinct mood pattern during pregnancy and following childbirth was observed and is described.
  
  
  CONCLUSIONS
  Public patients have a more disturbed mood during pregnancy and following childbirth compared with private patients. This information is relevant when planning social, psychological and psychiatric services that target childbearing women.
authors.affiliation: Key Centre for Women's Health, The University of Melbourne, Royal Women's Hospital, Carlton, Victoria, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Kermode
authors.forename: J
authors.initials: J
authors.lastname: Fisher
authors.forename: D
authors.initials: D
authors.lastname: Jolley
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D002391:Catchment Area, Health; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data*; D019964:Mood Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D010298:Parity; D011247:Pregnancy; D011446:Prospective Studies; D011594:Psychometrics / Q000706:statistics & numerical data; D011644:Puerperal Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D013997:Time Factors