Anxiety, stress, and psychological capital among multiparous women: a cross-sectional study of second pregnancies

The transition to motherhood during a second pregnancy can present distinct psychological challenges, particularly anxiety and stress, despite prior maternal experience. Psychological capital (PsyCap), comprising hope, optimism, self-efficacy, and resilience, may buffer these adverse effects. This study explores the interrelationships between anxiety, perceived stress, and psychological capital among women pregnant with their second child. A descriptive correlational study was conducted on 400 women attending antenatal clinics in Port Said, Egypt. Participants completed structured interviews using validated tools: the Self-Rating Anxiety Scale (SAS), the Perceived Stress Scale (PSS), and the Psychological Capital Questionnaire (PCQ-24). Sociodemographic and obstetric data were also collected. Moderate anxiety (84.8%) and moderate-to-high perceived stress (90.8%) were prevalent, while 71.0% of women demonstrated low psychological capital. Anxiety and stress were significantly correlated (p < 0.01), and both were negatively correlated with psychological capital (p < 0.01). Multivariate regression identified working status, income, healthcare quality, pregnancy planning, and fetal gender preference as significant predictors of psychological outcomes. Women experiencing their second pregnancy are at high risk of moderate psychological distress. Low psychological capital intensifies vulnerability to anxiety and stress. Antenatal interventions that assess and strengthen psychological capital could be key to improving maternal mental health outcomes in subsequent pregnancies.