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Updated: Jun 13, 2026

Using a Murine Model of Psychosocial Stress in Pregnancy as a Translationally Relevant Paradigm for Psychiatric Disorders in Mothers and Infants
Published on: June 13, 2021
Pregnancy care-seeking stress in the USA: a prospective cohort study
M Antonia Biggs1, Lauren Ralph2, Diana Greene Foster2
1Department of Obstetrics, Gynecology and Reproductive Sciences, Advancing Standards in Reproductive Health (ANSIRH), University of California, San Francisco, Oakland, California, USA antonia.biggs@ucsf.edu.
Objectives:
To prospectively assess pregnancy-related care sought and obstacles and stress experienced by newly pregnant people.
Design:
The ADAPT Study, a longitudinal cohort study, followed 2015 non-pregnant participants aged 15-34 years for a year. Those with confirmed incident pregnancies were followed through their pregnancies and for 3 years.
Setting:
We recruited participants from 23 reproductive and primary care facilities located in five southwestern states with different sociopolitical reproductive health contexts (restrictive, Arizona and West Texas; protective, southeastern California, Nevada and New Mexico).
Participants:
334 people reported a new pregnancy within 1 year of enrolment; 324 with outcome data are included in this analysis.
Primary And Secondary Outcome Measures:
Types of pregnancy care sought ('Have you looked into where or how you could get (prenatal care, abortion care or adoption services)?') and care-seeking stress ('How stressful was it to find (prenatal, abortion or adoption) care for this pregnancy?').
Results:
Most participants (83%, 270/324) sought prenatal care; 43% (138/324) sought abortion care; and 5% (17/324) sought adoption services. Overall, 17%, 29% and 23%, respectively, reported that care-seeking was extremely/quite a bit stressful. Abortion care-seeking was associated with significantly more stress than seeking prenatal care in the ordinal (adjusted odds ratio (aOR 1.70, 95% CI 1.10 to 2.62) but not logistic (aOR 1.33, 95% CI 0.74 to 2.38) model. Adoption care-seeking stress did not differ from prenatal care-seeking stress in either model. Participants who experienced any type of abortion care-seeking obstacle and those recruited in a state with a restrictive policy environment (aOR 2.72, 95% CI 1.09 to 6.80) reported more care-seeking stress than their counterparts.
Conclusions:
People who seek pregnancy care often experience some care-seeking stress, regardless of the type of care they seek. Findings point to the need to reduce the burden of the pregnancy care-seeking process across all types of pregnancy care.
Trial Registration Number:
NCT03888404.
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