Image of woman staring at camera, holding infant

Photo by Jenny Lewis

Coping with Stress during Pregnancy: Fathima Wakeel Studies the Factors that Impact Maternal Health

Wakeel seeks to identify the internal and social protective factors that help women cope with stress during pregnancy.

Story by

Kelly Hochbein

Photography by

Main image by Jenny Lewis

Of the millions of pregnant women in the United States each year, many deal with difficult circumstances: stress, financial hardship, abusive relationships, a lack of personal or community support. Many of these women deliver their babies prematurely. Quite a few, however, carry to term, deliver healthy babies and continue to do well, despite their circumstances. This may have to do with the tools with which they’re equipped, says Fathima Wakeel.    

Wakeel, an associate professor in Lehigh’s new College of Health, is particularly interested in the role of personal capital—the “toolkit” of internal and social protective factors that help women cope with or reduce their exposure to stress—during pregnancy. She wants to identify the impact of the particular tools a pregnant woman has in her toolkit on obstetric outcomes, how those toolkits differ among different women and how they develop over the life course. These findings, says Wakeel, can help inform appropriate interventions for the women who need them. 

Wakeel based her previous work on data from the Los Angeles Mommy and Baby (LAMB) study, a multilevel, cross-sectional, population-based study of mothers who had a live birth in Los Angeles County, Calif., the first of which was conducted in 2007. Her studies, published in Advances in Preventive Medicine, Maternal and Child Health Journal and Archives of Women’s Mental Health, have explored the impact of acculturation on preconception health; racial and ethnic disparities in personal capital during pregnancy; and the balance between stress and personal capital during pregnancy and the relationship with adverse obstetric outcomes. 

Newborn infant in hospital nursery

The more stress a woman has, the more capital—self-esteem, mastery, partner and social network support, for example—she will need to overcome it. A pregnant woman’s stress-to-capital ratio may play a significant role in her baby’s health, Wakeel says.

 “I found in my previous analysis that having little personal capital relative to stress has been related to preterm birth and other pregnancy complications,” she says. “There are many long-term implications to these outcomes. … For example, preterm birth is significantly associated with infant mortality and has substantial physical, cognitive and behavioral ramifications for the child.” 

The issue is larger than one mother and her child, she says, as personal capital likely develops over the life course, starting in infancy, as a child is exposed to various risks (e.g., stressors) and resources (e.g., supports or opportunities to learn traits of resilience) in the family, school, neighborhood and other spaces; these risk and protective factors are also likely transmitted intergenerationally. 

“We want to be able to intervene and halt that transmission of risk so that we have better outcomes for women, families and the next generation. What are the protective factors that we can help everyone obtain to really bridge those health disparities and promote health equity?” 

Wakeel plans to continue measurement development of the construct of personal capital and explore how these measures may differ among women of different races, ethnicities and socioeconomic backgrounds. She intends to use large population-based datasets and conduct mixed-methods research, collecting primary data through community-based participatory research. 

“My real passion is working with the community to understand what their needs are,” she says. “I want to contribute to the community in a way that they also have shared ownership [over the work we do].”

Story by

Kelly Hochbein

Photography by

Main image by Jenny Lewis

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