title: Maternal stress exposures, reactions, and priorities for stress reduction among low-income, urban women.
abstract: BACKGROUND
  Maternal psychosocial stress has been associated with adverse maternal-child outcomes. Vulnerable women's experiences with stressors during pregnancy and their desires and priorities for appropriate and useful stress reduction interventions are not well understood.
  
  
  METHODS
  Qualitative interviews with low-income, urban women explored their stress exposures and reactions during pregnancy, ways that stressors overlapped and interacted, and their priorities for stress reduction. Quantitative measures (Perceived Stress Scale; My Exposure to Violence Instrument Danger Assessment; Center for Epidemiologic Studies of Depression Scale, Revised; and Posttraumatic Stress Disorder Checklist-Civilian) supplemented qualitative descriptions of women's stress exposures and reactions. Analyses explored relationships between stressors and women's priorities for stress intervention. Lay advisors from the sample population reviewed qualitative interview guides for appropriateness, completeness, and language prior to interviews and reviewed study findings for validity. Study findings were returned to the community in newsletter form.
  
  
  RESULTS
  Twenty-four low-income, urban women participated in interviews. Women in the sample reported high stress, lifetime violence exposure, depression, and posttraumatic stress disorder symptoms. The most common stressors reported were financial strain, violence exposure, and feelings of intense isolation and loneliness. Few participants reported having discussed psychosocial stressors with prenatal care providers. Participants in this study described connections with other women as desirable to relieve their stress and provided input on ways health care providers could facilitate such connections.
  
  
  CONCLUSIONS
  Clinical and research implications of findings are discussed, including approaches that health care providers may find useful to facilitate connections among vulnerable pregnant women.
authors.affiliation: Sinclair School of Nursing, Columbia, MO 65211, USA. bloomt@missouri.edu
authors.forename: Tina
authors.initials: T
authors.lastname: Bloom
authors.forename: Nancy
authors.initials: N
authors.lastname: Glass
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Curry
authors.forename: Rebecca
authors.initials: R
authors.lastname: Hernandez
authors.forename: Gayle
authors.initials: G
authors.lastname: Houck
mesh_terms: D000293:Adolescent; D000328:Adult; D003142:Communication; D003863:Depression; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D007182:Income; D007398:Interpersonal Relations; D007407:Interviews as Topic; D008132:Loneliness; D011203:Poverty; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology*; D011295:Prenatal Care; D012944:Social Support; D013313:Stress Disorders, Post-Traumatic; D013315:Stress, Psychological / Q000628:therapy; D014505:Urban Population; D014754:Violence; D035862:Vulnerable Populations; D055815:Young Adult