Physical and emotional self-rated health among Swedish women and men during pregnancy and the first year of parenthood

Background: Self-rated health (SRH) is a valid measure that predicts mortality, morbidity, and the use of health services. We wanted to explore SRH over the time period of pregnancy and the first year of parenthood, dividing the measurement into physical and emotional SRH and also to include the fathers.

Aim: To investigate the prevalence of poor physical and emotional self-rated health in women and men during pregnancy and after childbirth and to identify associated risk factors.

Methods: A longitudinal study of 1212 pregnant women and 1105 partners recruited in gestational week 18 and follow-ups in gestational week 33, 2 months and 1 year after childbirth. Data was collected by questionnaires.

Results: In women, the prevalence of poor physical SRH increased from 20% to 37% between mid- and late pregnancy, and from 19% and 34% between 2 months and 1 year after the birth. Men had a more stable level of physical SRH, 17-19% during pregnancy and 2 months postpartum, but reached 31% 1 year after birth. A similar pattern was found for poor emotional SRH, where women's and men's poor emotional health reached 24% and 22%, respectively, at 1 year. Factors associated with poor emotional or physical SRH were: physical and emotional changes, fear of childbirth, parenthood stress, lack of partner support, bodily pain, low level of education, financial worries, tobacco use, and an emergency caesarean section.

Conclusions: Women's physical and emotional self-rated health is affected negatively by pregnancy and the first year of motherhood, but positively by childbirth. New fathers' health is stable throughout the pregnancy and the postpartum period, but is negatively affected by the first year of parenthood. Problems in mothers'and fathers' self-rated health may be longer term than many health professionals realize, generally as well as in relation to a cesarean section.