ASSESSMENT OF PREGNANCY RELATED STRESS AMONG WOMEN WITH SPONTANEOUS PREGNANCY(SP) AND IN VITRO FERTILIZATION/EMBRYO TRANSFER PREGNANCY(IVF/ET-P).

Ruchi Patel 1 and Anjali Tiwari 2 . 1. M.Sc Nursing, Manikaka Topawala Institute of Nursing, CHARUSAT, Gujarat. 2. Assistant Professor and HOD, Dept. of Obstetrics & Gynaecological Nursing, Manikaka Topawala Institute of Nursing, CHARUSAT, Gujarat. ...................................................................................................................... Manuscript Info Abstract ......................... ........................................................................ Manuscript History Received: 12 September 2018 Final Accepted: 14 October 2018 Published: November 2018


Introduction and background:
A happy and trouble-free pregnancy is something that all parents and practitioners might hope for, but for many couples this is not the reality and many women can experience stress at some point during their pregnancy. 1 It was observed that pregnancy related stress in antenatal women who have adopted assisted reproductive technique due to infertility issues significantly affects maternal and fetal health and even the successful ratio of assisted reproductive technique. Also social stigma associated with it present in society about infertile women. 2 This study was conducted to assess the pregnancy related stress in women with spontaneous pregnancy and in vitro fertilization or embryo transfer pregnancy. Methodology: Descriptive comparative research design was used. The study was conducted at selected hospitals of Central Gujarat Region.45 antenatal women having spontaneous pregnancy and 45 antenatal women having IVF/ET pregnancy were conveniently selected. A baseline data questionnaire and pregnancy related anxiety questionnaire -Revised (PRAQ-R) was used for data collection. Results: The study result showed that stress level among woman is different in SP pregnancy group after 08 and 12 week. The mean stress level at 08 weeks of gestation in the SP group was 21.64 and in the IVF/ET pregnancy group was 19.78. The calculated't' value was 12.42.While after 12 weeks of gestation mean pregnancy related stress of SP group was 17.80 and in the IVF/ET pregnancy group was 28.64. The calculated't' value is 5.861.

…………………………………………………………………………………………………….... Introduction:-
Each women adopts Pregnancy in a unique manner, her psychological responses change as pregnancy advances. Once pregnancy is confirmed, almost all women have conflicting feelings about being pregnant and they are concerned about themselves, physiological changes occurring in their bodies, the ways of protecting and providing care to the foetus. 3 birthing is a unique experience, at a unique time of one's life. Giving a birth is a normal life event, yet women are exposed to significant amount of stress, anxiety, depression. 4 Giving birth after a period of infertility may well be the realization of a long awaited ambition but it might not be as unproblematic as it seems. Prior to the successful pregnancy there may have been periods of waiting and frustration. One can extrapolate that these experiences may foster an idealized and unrealistic image of parenthood. After the birth of the child, unmet expectations and beliefs may result in disenchantment and a climate conductive to mental health issues.
The stress is noteworthy because the mental state of a woman in pregnancy has a significant effect on its course and outcome. The general rate of infertility in the India is 10% for reproductive aged couples. The inhabitants of the India is 1.3 billion. 5 The World Health Organization (WHO) estimates, that approximately 8%-10% of couples experience some form of infertility problem. On a worldwide scale, this means that 50-80 million people suffer from infertility. However, the incidence of infertility may vary from region to region. 6 The general rate of infertility (2015) in the India is 10% for reproductive aged couples. The population of the India is 1.3 billion.
Experts are actively engaged in studying the specifics of the cerebral state of women in IVF programs during pregnancy of critical importance is the issue of providing psychological provision for antenatal women who are preparing for and who have received IVF pregnancy. 7

Metirial And Methods:-
Descriptive comparative research design was used for present study. The study was conducted in 6 selected hospitals of Central Gujarat Region. 45 antenatal women having spontaneous pregnancy and 45 antenatal women having IVF/ET pregnancy were selected by using convenient non-probability sampling technique. The tool used for gathering data included Baseline data questionnaire,Pregnancy related anxiety questionnaire -Revised (PRAQ-R). Pregnancy related stress was assessed for SP group and IVF/ET pregnancy group two times in antenatal period at 8 th and 12 th week of the gestation with one to one interaction with each participants.

Result:-
Descriptive and inferential statistics were used to analyse the data. 't' test was used to determine the pregnancy related stress in SP group and IVF/ET -P group. The data presented in graph no 1 indicates that there is statistically significant difference found in pregnancy related stress between SP group and IVF/ET-P group. The pregnancy related stress at 8 weeks of gestation in the SP group was 21.64 and Standard Deviation 3.86 and IVF/ET-P group was 19.78 and Standard Deviation 3.78. The calculated't' value was 12.42. (p<0.001).While the mean pregnancy related stress at 12 weeks of gestation in the SP group was 17.80 and Standard Deviation 5.861 and IVF/ET-P group was 28.64 and Standard Deviation 4.38. The calculated't' value is 5.861(p<0.001).
Hence, it was found that there is significantly higher pregnancy related stress at 8 th week of gestation among antenatal women of SP group compared to that of IVF/ET-P group. Also significantly higher pregnancy related stress at 12 th week of gestation among antenatal women of IVF/ET-P group compared to that of SP group.

Conclusion:-
The study concluded thatpregnancy related stress is increases according to gestational weeks of pregnancy were increase in IVF/ET pregnancy.