Health insurance status and mood during pregnancy and following birth: a longitudinal study of multiparous women

Objective: The objective of this study was to investigate the relationship between health insurance status and mood during pregnancy and following chi ldbirth. Method: 320 women were recruited in the early stage of pregnancy to partici pate in a longitudinal, prospective study of the psychological aspects of c hildbirth among multiparous women. Study volunteers were surveyed during ea ch trimester of pregnancy and 2 and 8 months following childbirth. A range of self-administered psychometric tests were used to assess mood (Profile o f Mood State), locus of control, defence style and partner support. Demogra phic information including health insurance status was noted at study entry . Results: Public patients consistently had a more disturbed mood compared wi th private patients. This difference reached statistical significance durin g the second and third trimesters of pregnancy and 8 months after birth. Mu ltivariate analysis was undertaken to identify predictors of mood during pr egnancy and following birth. A better mood score was positively associated with private health insurance, a more caring partner and mature defence sty le, and negatively associated with external locus of control and immature d efence style. A distinct mood pattern during pregnancy and following childb irth was observed and is described. Conclusions: Public patients have a more disturbed mood during pregnancy an d following childbirth compared with private patients. This information is relevant when planning social, psychological and psychiatric services that target childbearing women.