Silent Struggles: How Prenatal Mental Health Affects Marriage Dynamics

Abstract

Background: Pregnancy is often viewed as a time of joy and anticipation, yet many expectant mothers experience psychological challenges such as depression and anxiety. Objective: The objective of this study was to assess the prevalence of prenatal depression and anxiety among pregnant women and to evaluate their association with marital adjustment. Methods: This descriptive cross-sectional study was conducted at School of Dentistry, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad from 15th January 2025 to 15th June 2025. A total of 175 pregnant women and their spouses using non-probability consecutive sampling were included in the study. Prenatal depression and anxiety were assessed using the Edinburgh Postnatal Depression Scale (EPDS) and the Generalized Anxiety Disorder Scale (GAD-7), while marital dynamics were evaluated through the Dyadic Adjustment Scale (DAS). Results: The mean age of women was 28.9 ± 4.6 years, and the mean age of spouses was 32.7 ± 5.1 years. Depressive symptoms were observed in 39.4% of women, while 43.4% reported anxiety. Women with higher depressive or anxiety scores had significantly lower DAS scores, indicating poorer marital adjustment (p < 0.001 and p = 0.002, respectively). Socioeconomic disadvantage and lower education were significantly associated with higher prevalence of depression and anxiety (p < 0.05). Primigravida women reported higher anxiety compared to multigravida women (p = 0.04). Conclusion: Prenatal mental health significantly influences marital dynamics, with depression and anxiety emerging as key predictors of reduced relationship quality.