How Do I Assess?

How do I assess my patient's stress?

Assessment Tools

Although various assessment tools have been used to measure stress based on daily hassles, psychological distress, life events, perceived stress, and anxiety and depression levels, many only highlight general life events occurring during the pregnancy, and fail to accurately measure pregnancy-related stress (Arizmendi et al.). Resultantly, several pregnancy-specific stress assessments have been created and implemented in order to measure such items as discomfort during pregnancy, feelings about pregnancy, body changes, and thinking about labor and delivery (DiPietro et al., 2004). Nonetheless, identification of stress symptoms can aid in prescribing proper management techniques and/or resources that can improve maternal and child health and birth outcomes.

Common Stress Scales

  • Perceived Stress Scale
    Perceived Stress Scale assesses the degree to which situations during the last month were experienced as stressful (Cohen, 1983).
  • Life Events Inventory
    Life Events Inventory by Cochrane and Robertson assesses acute stress in personal, family, interpersonal, social, financial, and work-related areas (Cochrane & Robertson, 1973).
  • State-trait Anxiety Inventory
    State-trait Anxiety Inventory by Spielberger et al. assesses levels of anxiety related to how the respondent "typically feels" (Gorusch & Lushene; 1970).
  • The Daily Hassles Scale (DHS) proved reliable for stress measurement in pregnant women as an alternative to measuring life events (Ruiz 1999). Daily hassles are defined as "the irritating, frustrating, distressing demands that to some degree characterize the everyday transactions with the environment".

Stress During Pregnancy Scales

  • Prenatal Distress Questionnaire (PDQ) assesses stress originating from issues common in pregnancy (Yali & Lobel, 1999).
  • Pregnancy Experience Scale (PES)
    Pregnancy Experience Scale (PES) developed to measure maternal appraisal of exposures to daily, ongoing hassles and uplifts specific to pregnancy. (DiPietro et al., 2004).
  • PES - Short-form developed DiPietro et al. 2008.
  • Prenatal Life Events Scale (PES), 28 events experienced during pregnancy (Lobel et al., 1992, 2000).


  • Prenatal Health Behaviors Scale, examines range of behaviors including nutrition, exercise, smoking, substance abuse (DeLuca & Lobel, 1995).
  • The Healthy Start Program, a psychosocial screening tool system that incorporates assessment of maternal stress, has been successfully used in Florida Department of Health since 1992 and is included in ACOG's Committee Opinion, Psychosocial Risk Factors: Perinatal Screening and Intervention (ACOG today).

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