Healthy Pregnancy Stress Scale (HPSS)

The Healthy Pregnancy Stress Scale is an 18-item measure that assesses the type of stressors associated with pregnancy stress for specifically low-income African American women. This scale includes different types of stressful circumstances such as being unemployed, being unable to meet work-related demands, an unstable home environment, and an unsupportive partner.


Geographies Tested: United States of America

Populations Included: Female

Age Range: Adolescents, Adults


Interviewer introduction: In this questionnaire, I will ask you a set of questions for me to understand types of stress you experienced during your last pregnancy. We would really like to know what you think. This information helps us better understand how your pregnancy needs are being met. Please be as honest about your experience as you can.

1. I had difficulty finding help with other children when I needed it during pregnancy. [Please explain.*]
2. I lost my job or was unable to find a job by me or my partner while pregnant. [Please explain.]
3. I had difficulty meeting work obligations and managing my responsibilities at home while pregnant. [Please explain.]
4. The worry about the health of my baby became a source of stress during pregnancy. [Please explain.]
5. My own health concerns during pregnancy became a source of stress. [Please explain.]
6. I had a strained or stressed relationship with partner while pregnant. [Please explain.]
7. I had to balance my personal pregnancy needs with life obligations during my pregnancy. [Please explain.]
8. I made the decision to leave a profession or job while pregnant. [Please explain.]
9. My partner was not available during pregnancy because he worked too much. [Please explain.]
10. During pregnancy I worried about the situation of childcare I would have after my baby is born. [Please explain.]
11. During pregnancy I had a fear of having another or a new child in the home. [Please explain.]
12. During pregnancy my home life was unstable or unpredictable. [Please explain.]
13. During pregnancy my partner was absent due to military service. [Please explain.]
14. During pregnancy I did not want to be pregnant. [Please explain.]
15. During pregnancy I was treated poorly by my health care providers. [Please explain.]
16. It was stressful having other family members staying with me while I was pregnant. [Please explain.]
17. My partner was not supportive and available to me during pregnancy. [Please explain.]
18. While pregnant, the father of the child would not accept the responsibility of being a father. [Please explain.]

*Interviewers have the option of recording responses to the “Please explain” question for further qualitative assessment and contextualization.

Response Options:
6-point Likert scale
Not at all a source of stress during my last pregnancy - 1
Very high source of stress during my last pregnancy - 6

Scoring Procedures

Not specified.

Original Citation

Frazier, T., Hogue, C. J., & Yount, K. M. (2018). The Development of the Healthy Pregnancy Stress Scale, and Validation in a Sample of Low-Income African American Women. Maternal and child health journal, 22(2), 247–254.

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Formative Research

Qualitative Research

Existing Literature/Theoretical Framework

Field Expert Input

Cognitive Interviews / Pilot Testing








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