Perceived Social Support and Women’s Empowerment and Their Associations with Pregnancy Experiences in Anxious Women: A Study from Urban Pakistan

Objectives: Psychological distress in pregnancy is associated with adverse postnatal outcomes. We aimed to identify how social support and women’s empowerment are associated with pregnancy-specific daily experiences among women suffering antenatal anxiety in Pakistan. Methods: Data were collected as part of a randomized controlled trial of a psychosocial intervention for antenatal anxiety in a tertiary hospital in Pakistan. We included 594 women in early pregnancy (≤ 22 weeks) who endorsed mild to severe anxiety symptoms. Generalized linear regression models were used to analyze the associations of perceived social support and women’s empowerment in relation to pregnancy-specific daily hassles and uplifts using a culturally adapted and psychometrically validated version of the Pregnancy Experience Scale-Brief. Results: High social support was positively associated with frequency and intensity of positive pregnancy-specific experiences (B = 0.39, 95% CI 0.23–0.54 uplifts frequency; and B = 0.17, 95% CI 0.12–0.22 uplifts intensity), and was inversely associated with frequency of negative pregnancy-specific experiences (B = − 0.44, 95% CI − 0.66, − 0.22). Women’s household empowerment was associated with greater uplifts frequency and intensity (B = 0.55, 95% CI 0.20–0.90 frequency; and B = 0.28, 95% CI 0.17–0.40 intensity). High social support and household empowerment were inversely related to PES hassle-to-uplift ratio scores. Conclusions for Practice: Greater social support and household empowerment were associated with positive pregnancy-specific experiences in the context of antenatal anxiety in Pakistan.