Open Access Highly Accessed Research article

Anxiety symptoms and coping strategies in the perinatal period

Astrid George1*, Rita F Luz1, Claude De Tychey2, Nathalie Thilly34 and Elisabeth Spitz1

Author Affiliations

1 Department of Psychology, Laboratory EA 4360 Apemac-EPSaM, University of Lorraine, Ile du Saulcy BP 30309 57006 METZ, Cedex 1, France

2 Department of Psychology, Laboratory Interpsy, EA 4432, University of Lorraine, Nancy, France

3 Department of Epidemiology and Clinical Evaluation, CIC-EC CIE6 Inserm, Academic Medical Centre, Brabois, Nancy, France

4 University of Lorraine EA 4360 Apemac Nancy, 9 Avenue de la Forêt de Haye, 54500 Vandoeuvre-lès-Nancy, France

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BMC Pregnancy and Childbirth 2013, 13:233  doi:10.1186/1471-2393-13-233

Published: 13 December 2013



The aim of the present study was to explore the prospective relationship between anxiety symptoms and coping strategies during late pregnancy and early postpartum.


Participants completed the Hospital Anxiety Depression-Anxiety subscale and Carver’s Brief COPE at two time points, namely during the last trimester of pregnancy (N = 400) and at two months postpartum (N = 158).


Antenatally, 18.8% of pregnant women presented severe anxiety symptoms while 20.2% of women presented severe anxiety symptoms after birth. Carver's proposed coping styles allowed to significantly distinguish between anxious and non anxious women during these two periods. Anxious women used significantly more inappropriate coping and less adaptive coping responses, such as self-blame and denial of reality, which remained associated with anxiety in the perinatal period. Our results also indicated a decrease in adaptive coping in women without anxiety after birth (e.g. acceptance, positive reframing).


Our findings confirm that antenatal and postnatal anxiety symptoms occur frequently and that inappropriate and/or non functional coping may account for persisting anxiety after childbirth. Limitations: Data were based on self-reports and participating women were predominantly primiparous. A high drop-out rate at two months postpartum must also be acknowledged.

Childbirth; Anxiety; Coping; Ante- and postnatal