A Comparative Study of Anxiety, Pain and Maternal-fetal Attachment between Women who became Pregnant after Infertility Treatment and became Pregnant Naturally

Hee Ja Yoon; Seung Shin Lee; Song Hee Ye; Ah Reum Han; So Ri Lim; Hyun Jung Chung; Jum Mi Park

doi:10.4069/kjwhn.2016.22.2.71

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Yoon, Lee, Ye, Han, Lim, Chung, and Park: A Comparative Study of Anxiety, Pain and Maternal-fetal Attachment between Women who became Pregnant after Infertility Treatment and became Pregnant Naturally

Original Article

Korean Journal of Women Health Nursing 2016; 22(2): 71-77.

Published online: 28 June 2016

DOI: https://doi.org/10.4069/kjwhn.2016.22.2.71

A Comparative Study of Anxiety, Pain and Maternal-fetal Attachment between Women who became Pregnant after Infertility Treatment and became Pregnant Naturally

Hee Ja Yoon, Seung Shin Lee, Song Hee Ye, Ah Reum Han, So Ri Lim, Hyun Jung Chung, Jum Mi Park

CHA Gangnam Medical Center, Seoul, Korea.

Corresponding author: Park, Jum Mi. CHA Gangnam Medical Center, 566 Nonhyon-ro, Gangnam-gu, Seoul 135-913, Korea. Tel: +82-2-3468-3254, Fax: +82-2-567-1286, jump590813@hanmail.net

Received 23 January 2016 Revised 28 April 2016 Accepted 9 June 2016

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study was a comparative study to understand the levels of anxiety, pain and maternal-fetal attachment between women who became pregnant after infertility treatment and became pregnant naturally.

Methods

This study used a comparative survey design. Data were collected by 50 couples of natural pregnancy and of who became pregnant after infertility treatment who visited delivery room in C Medical hospital, Seoul. These couples were to have first baby, and cervix dilatation of women was less than 3 cm regardless of diagnosis.

Results

The score of anxiety of infertile women was significantly higher than that of naturally pregnant women; however, that of spouses showed no difference. The pain score for infertile women was significantly higher in both the active and transition phases. Pain scores that reported by their spouses did not show differences in either phase. The score of maternal-fetal attachment showed no difference between two groups of women.

Conclusion

The result showed the importance of nursing intervention to reduce women's anxiety and pain, through both antenatal-childbirth education programs and assertive nursing interventions. It is necessary to develop and evaluate new intervention which would be more effective for reducing pain and anxiety for couples who became pregnant after infertility treatment.

Keywords: Anxiety, Pain, Scale of maternal-fetal attachment, Pregnant women

Figures and Tables

Table 1

Comparison of General Characteristics of Subjects between Two Groups (N=100)

Characteristics	Categories	Women who get natural pregnancy (n=50)	Women who get pregnant by infertile treatment (n=50)	χ² or t	p
Characteristics	Categories	M±SD or n (%)	M±SD or n (%)	χ² or t	p
Age (year)		31.16±3.35	34.70±3.09	0.09	.761
Job	Yes	25 (50.0)	24 (48.0)	0.04	.840
Job	No	25 (50.0)	26 (52.0)	0.04	.840
Religion	Christianity	21 (42.0)	14 (28.0)	3.48	.482
	Catholic	8 (16.0)	11 (22.0)
	Buddhism	5 (10.0)	7 (14.0)
	None	15 (30.0)	18 (36.0)
	Others	1 (2.0)	0 (0.0)
Planned pregnancy	Yes	38 (76.0)	49 (98.0)	10.69	.001
Planned pregnancy	No	12 (24.0)	1 (2.0)	10.69	.001
Type of family	Nuclear family	45 (90.0)	48 (96.0)	2.29	.310
	Family-in-Law + Husband	2 (4.0)	0 (0.0)
	Wife's family + Husband	3 (6.0)	2 (4.0)
	Others	0 (0.0)	0 (0.0)
Prenatal education	Yes	31 (62.0)	24 (48.0)	1.98	.161
Prenatal education	No	19 (38.0)	26 (52.0)	1.98	.161
Reason for admission	Labor	21 (42.0)	24 (48.0)	4.48	.110
	Premature rupture of membrane	18 (36.0)	9 (18.0)
	Induction	11 (22.0)	17 (34.0)

Table 2

Comparison of Anxiety and Pain Level at Each Phase between Two Groups: Women and Their Spouses (N=100)

Variables	Categories		Admission		Active phase		Transition phase
Variables	Categories		M±SD	t (p)	M±SD	t (p)	M±SD	t (p)
Anxiety	Pregnant women	Natural (n=50)	4.56±2.57	-3.43 (.001)	5.46±2.33	-3.78 (.001)	5.28±2.53	-4.55 (.001)
	Pregnant women	Subfertility (n=50)	6.30±2.49	-3.43 (.001)	7.12±2.04	-3.78 (.001)	7.50±2.34	-4.55 (.001)
	Spouses	Natural (n=50)	4.00±2.35	-0.31 (.760)	5.20±2.66	-0.21 (.842)	6.20±2.96	-0.16 (.910)
	Spouses	Subfertility (n=50)	4.14±2.24	-0.31 (.760)	5.30±2.29	-0.21 (.842)	6.26±2.20	-0.16 (.910)
Pain	Pregnant women	Natural (n=50)			6.08±2.55	-4.43 (.001)	6.66±3.29	-3.08 (.001)
	Pregnant women	Subfertility (n=50)			8.06±1.85	-4.43 (.001)	8.32±1.86	-3.08 (.001)
	Spouses	Natural (n=50)			6.32±2.59	-0.07 (.941)	6.44±2.92	-0.71 (.940)
	Spouses	Subfertility (n=50)			6.28±2.90	-0.07 (.941)	6.48±2.71	-0.71 (.940)

Table 3

Comparison of Anxiety and Pain Level between Admission and Transition Phase among Two Groups: Women and Their Spouses (N=100)

Variables	Categories		At admission	At active phase	At transition phase	t	p
Variables	Categories		M±SD	M±SD	M±SD	t	p
Anxiety	Pregnant women	Natural (n=50)	4.56±2.57		5.28±2.53	-1.52	.141
	Pregnant women	Subfertility (n=50)	6.30±2.49		7.50±2.34	-2.62	.012
	Spouses	Natural (n=50)	4.00±2.35		6.20±2.96	-5.23	.001
	Spouses	Subfertility (n=50)	4.14±2.24		6.26±2.20	-5.29	.001
Pain	Pregnant women	Natural (n=50)		6.08±2.55	6.66±3.29	1.21	.231
	Pregnant women	Subfertility (n=50)		8.06±1.86	8.32±1.90	0.88	.400
	Spouses	Natural (n=50)		6.23±2.59	6.44±2.92	-0.26	.791
	Spouses	Subfertility (n=50)		6.28±2.90	6.48±2.72	-0.42	.682

Table 4

Comparison of Maternal-fetal Attachment Level between Two Groups (N=100)

Variables	Categories	M±SD	t	p
Total	Natural (n=50)	76.02±9.22	-0.23	.821
Total	Subfertility (n=50)	76.44±9.05	-0.23	.821
Distinguish themselves and fetus	Natural (n=50)	11.08±1.12	-0.35	.370
Distinguish themselves and fetus	Subfertility (n=50)	11.16±1.17	-0.35	.370
Interaction with fetal	Natural (n=50)	15.54±2.31	0.77	.442
Interaction with fetal	Subfertility (n=50)	15.18±2.34	0.77	.442
Role accepted	Natural (n=50)	12.94±2.27	0.46	.642
Role accepted	Subfertility (n=50)	12.72±2.47	0.46	.642
Fetal properties intention guess	Natural (n=50)	19.82±2.85	-0.10	.920
Fetal properties intention guess	Subfertility (n=50)	19.88±2.85	-0.10	.920
Self-dedication	Natural (n=50)	16.64±3.19	-1.41	.161
Self-dedication	Subfertility (n=50)	17.50±2.87	-1.41	.161

Summary Statement

▪ What is already known about this topic?

During women's pregnancy period, their negative emotions and mental difficulties, such as stress, anxiety and depression, cause deadly effect on childbirth.

▪ What this paper adds?

Scores of pain and anxiety of the infertile pregnant women were higher than those of natural pregnant women.

▪ Implications for practice, education and/or policy

The study suggests that nursing intervention may be needed to reduce pain and anxiety of infertile couple during their childbirth.

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