The absence of a psychosocial approach to prenatal care in primary care: challenges and impacts on the health of pregnant women

Abstract

The psychosocial dimension of prenatal care still occupies a secondary place in the routine of Primary Health Care, owing to the emphasis historically placed on the biomedical parameters of pregnancy follow-up. This assistance gap hampers the early identification of emotional, social, and contextual vulnerabilities that affect the health of both the pregnant woman and the fetus. This integrative literature review aimed to understand how the absence of a psychosocial approach during prenatal care in Primary Health Care generates challenges that compromise quality of life and the promotion of comprehensive health for pregnant women and newborns. The descriptors “Pregnant Women,” “Psychosocial Impact,” “Prenatal Care,” “Psychological Stress,” and “Social Support” were combined using the Boolean operator AND and searched in Google Scholar, the Scientific Electronic Library Online (SciELO), and the Virtual Health Library (VHL), restricted to publications from 2005 to 2025. After applying the eligibility criteria, ten studies composed the final sample. The results show that stress, socioeconomic hardship, fragile social and marital support, and low self-esteem are recurrent psychosocial determinants during pregnancy, whose clinical neglect is associated with unfavorable outcomes such as anxiety symptoms, perinatal depression, low birth weight, and prematurity. It is concluded that the systematic incorporation of the biopsychosocial model into prenatal care, supported by continuing professional training and specific public policies, is a necessary condition for comprehensive, effective, and humanized care for pregnant women.