Personal Growth among Mothers to Pre-Term Babies: On the Relationship between Event Severity, Subjective Stress, Personal Resources (Internal & External) and Personal Growth

Parenthood is a joyful event which also gives rise to feelings of anxiety and stress. The birth of premature babies is a form of parenthood which entails unique stressors. These include the parents’ fear for their child, distress caused by an essential physical distance between the parents and child while in a neonatal intensive care unit, as well as feelings of anger, failure, and even grief by the mother who gave birth before reaching full term. This phenomenon of parenting premature babies has been examined recently as a stressful event which may lead to personal growth.  

Studies examining personal growth - in general and specifically among parents, and parents of premature babies - have yielded inconsistent findings regarding the association between perceived levels of stress and personal growth. Several explanations have been offered for these inconsistencies, including the optimal magnitude of the stressful event and the importance of the subjective experience as predictors of personal growth. Accordingly, the current study examined the curvilinear associations between perceived levels of stress and personal growth as reported by mothers of premature babies. To our knowledge, this is the first time this issue has been examined in this population.

Additionally, several studies have consistently found associations between personal growth and environmental resources such as social support in general, and more specifically between personal growth among mothers of infants and the support provided by their mothers (i.e. the grandmothers). Thus, this study examined the specific role of event severity as a moderator of the association between maternal emotional support and personal growth. In addition, as previous studies were not consistent in finding associations between personal characteristics and personal growth, the current study aimed to broaden the knowledge regarding the contribution of internal resources (self-esteem and attachment style) to personal growth. 

The sample comprised 94 mothers of premature babies who had given birth in the maternity ward of the Sheba Medical Center between January 2013 and April 2015: 42 were mothers of babies at low risk levels (or no risk) and 42 were mothers of babies at moderate-high risk levels, according to medical definitions. Questionnaires were administered at two phases: one month after birth and two months after the baby reached full pregnancy age (“adjusted” two months). The study focused on the five dimensions of personal growth, examining the associations between objective event characteristics (risk level), perceived levels of stress, and the mother’s resources (both external - maternal emotional support, and internal - self-esteem and attachment style).

The study findings suggest that mothers belonging to the two risk groups differed only on the spiritual dimension of personal growth, with mothers of babies at moderate-high risk levels experiencing more spiritual change than mothers of babies at low risk. The other dimensions of personal growth did not differ between the two risk groups. Additionally, there were consistent curvilinear associations between perceived levels of stress and personal growth for the following dimensions: new possibilities, personal strength and relating to others (with a similar trend for appreciation of life). Thus, whereas mothers who reported on an average stress level experienced the highest personal growth, higher or lower than average stress levels were related to lower personal growth. As for the moderating role of risk group in the association between maternal emotional support and personal growth, a significant interaction was found in two dimensions (new possibilities and personal strength) and a similar trend in two additional dimensions (relating to others and appreciation of life). In all four dimensions, for mothers of low risk babies, higher levels of maternal emotional support were associated with greater personal growth; for mothers of moderate-high risk babies, there was no association between maternal emotional support and personal growth. In addition to these main findings, this study also indicated  associations between personal characteristics, socio-demographic characteristics and personal growth among mothers of premature babies. 

This study is the first to examine differences in personal growth between mothers of premature babies at different risk levels, and the first to examine curvilinear associations between levels of stress and personal growth in this population. On a practical level, addressing the baby’s level of risk, and having a broader understanding of the predictors of personal growth among mothers, the study can contribute to the design of measures to identify populations at risk and the development of appropriate interventions, while considering the working procedures and support that are currently offered in most neonatal intensive care units in Israel.