Mental health of pregnant women with a background of fertility problems: the contribution of meaning in life and cognitive appraisal

This prospective study examined the mental health of Israeli pregnant women who had had difficulty conceiving, investigating the contribution of meaning in life (presence and search) on their first visit to a fertility clinic, the change in meaning in life during the pregnancy and the cognitive appraisal of the pregnancy (threat, challenge, self-efficacy). Women (n = 136) completed questionnaires after initial consultation with a fertility specialist (Phase 1) and again during gestation week 12-33 (Phase 2). Participants belonged to three groups according to the manner of conception (spontaneous, in-vitro fertilization, other fertility treatments). Significantly higher presence of meaning in life was reported during pregnancy than following the first consultation with a fertility specialist. Presence of meaning at Phase 1, change in presence of meaning between the two phases, and cognitive appraisal of self-efficacy contributed to women’s better mental health during pregnancy. Self-efficacy also moderated the link between group and mental health. The results highlight the importance of presence of meaning in life and an appraisal of self-efficacy during pregnancy. Professionals should enhance these women’s sense of presence of meaning, as well as their belief in their competence to cope with the challenges of pregnancy.