Personal Growth and Psychological Well-Being in the Transition to Motherhood: The Role of Exposure to Stressors, Perceived Stress and Protective Factors

Background: The transition to motherhood is a major, usually positive, event in a woman's life. During this period, women may experience stress from various sources that may have negative outcomes on their psychological well-being but may also provide an opportunity for personal growth.

Objectives: Based on Schaefer and Moos' (1992) model of personal growth following life crises and transitions, the current series of five studies is composed of cross-sectional, prospective, and longitudinal studies, conducted in three phases: Phase 1, during pregnancy; Phase 2, three months after childbirth; and Phase 3, six months after childbirth. The study has three main goals. The first is to gain a deeper understanding of the association between pregnancy-related stressors (fertility treatment, previous miscarriages, and having an at-risk pregnancy) and perceived stress from various sources during pregnancy (pregnancy stress, stress associated with life events during pregnancy, COVID-19-related anxieties) and psychological well-being and personal growth throughout the transition to motherhood (Studies 1, 2, 4, 5). The second goal is to understand the associations between protective factors measured during pregnancy (gratitude, emotion regulation abilities, relationship quality with the partner, and maternal-fetal bonding), and psychological well-being and personal growth throughout the transition to motherhood (Studies 1, 2, 3, 4, 5). The third goal is to better understand change in personal growth over time and the possible existence of multiple trajectory patterns as different pathways of growth (Studies 4, 5).

Method: The series of studies was based on a large-scale research project that followed women throughout the transition to motherhood. Data collection was performed using a convenience sample recruited through social media networks, by online self-report questionnaires. In Studies 1 and 2, the sample consisted of 1378 pregnant women aged 18–45 (M=28.68 years, SD=4.56) with gestational age 4–41 (M=25.57 weeks, SD=9.00). In Study 1, the participants completed questionnaires assessing pregnancy-related stressors (fertility treatment, previous miscarriages, and having an at-risk pregnancy) and perceived stress from various sources during pregnancy (pregnancy-related stress, stress associated with life events during pregnancy, COVID-19-related anxiety over possible economic damage, and COVID-19-related anxiety over the health of the fetus), gratitude, and personal growth. In Study 2, participants completed questionnaires assessing pregnancy-related stress, COVID-19-related anxieties, psychological well-being, and maternal-fetal bonding. The sample in Study 3 consisted of 515 women aged 18 to 45 (M=28.96 years, SD=4.08) who completed questionnaires in two phases: Phase 1, during the second half of their pregnancy, gestation week 20-41 (M=29.89 weeks, SD=5.62); and Phase 2, around 12 weeks after the birth of their first baby (M=11.69 weeks, SD=1.86). The participants completed questionnaires assessing gratitude, maternal-fetal bonding, relationship quality with the partner, personal growth and psychological well-being. In Studies 4 and 5, the sample was comprised of 403 women aged 18 to 45 (M=29.40 years, SD=4.22) who completed questionnaires in three phases: Phase 1, during the second half of their pregnancy, 20-41 weeks gestation (M=29.85 weeks, SD=5.52); Phase 2, about three months after childbirth (M=11.67 weeks, SD=1.77), and Phase 3, about six months after childbirth (M=24.42 weeks, SD=2.32). In Study 4, participants completed questionnaires assessing maternal-fetal bonding, COVID-19-related anxieties, gratitude, relationship quality with the partner and personal growth. In Study 5, participants completed questionnaires assessing emotion regulation abilities, fertility treatment and personal growth. Background variables were assessed in all studies.

Results:  The findings of Study 1 indicate that dispositional gratitude has a significant contribution to personal growth and that all stress sources except for pregnancy stress contributed significantly to personal growth. The results of Study 2 show that higher COVID-19-related anxiety was associated with higher pregnancy stress, which, in turn, was associated with lower psychological well-being. However, this effect was weaker among women who reported greater maternal-fetal bonding. The results of Study 3 show that gratitude was associated with higher perceived relationship quality during pregnancy, which was associated with higher maternal-fetal bonding, which in turn was associated with higher psychological well-being and personal growth after childbirth. All these indirect effects were significant. The findings of Study 4 indicate that there is a linear increase in personal growth from pregnancy until after childbirth. Higher COVID-19-related anxiety and maternal-fetal bonding predicted higher initial personal growth, but lower change over time. Higher gratitude predicted higher initial levels of personal growth, but not the change over time. Relationship quality with the partner predicted personal growth three and six months after childbirth, but not during pregnancy. The results of Study 5 identify three trajectories that reflect an increase in personal growth with different starting points and slopes, and one trajectory with a quadratic effect. Age, economic status, physical health, fertility treatment, impulse control, and emotional regulation strategies predicted the different growth patterns.

Conclusions and Implications: The study contributes significantly to the theoretical literature on the transition to motherhood by examining issues not previously explored. Firstly, this study related to the different stress sources individually, maintained the theoretical distinction between stress and distress, thus expanding theoretical knowledge regarding stress in the perinatal period and its relation to personal growth and psychological well-being throughout the transition to motherhood. Secondly, the study sheds light on the role of protective factors during pregnancy and their relation to personal growth and psychological well-being throughout the transition to motherhood, as well as the chain of associations between them, therefore producing important insights on positive outcomes in the transition to motherhood. Thirdly, the study adopted a longitudinal design, revealing that there are theoretical and empirical differences between measuring growth at a single timepoint and measuring change in personal growth over time. In addition, the study offers new insights into the trajectory patterns of personal growth in the transition to motherhood and indicates that there are different pathways to growth as well as certain characteristics that may predict the chances of developing in certain pathways rather than in others.

On the practical level, the study offers insights into stress and protective factors during pregnancy that predict psychological well-being and personal growth after childbirth, allowing professionals to develop interventions in the primary stages of the transition to motherhood. Such interventions could include increasing positive emotions such as gratitude, enhancing emotion regulation abilities or focusing on the emotional bond of the mother with her fetus, as a means of decreasing the negative consequences of stress and increasing positive outcomes such as personal growth. Professionals should be informed that different sources of stress during pregnancy may have differential effects on women’s psychological well-being and personal growth throughout the transition to motherhood.