Franklin & Marshall College

Psychosocial Determinants of Pregnancy Outcomes Among the Amish

Whether she is bringing medical supplies to the Masai tribe in Tanzania or interviewing Amish women on their pregnancy outcomes, Jen Stuart is passionate about improving public health.

Her current research is based on a data set she first encountered in her sophomore year during the interdisciplinary course Public Health Research: Pregnancy Outcomes in American Women. Collected through the Central Pennsylvania Women’s Health Survey, the data looked at the behaviors and pregnancy outcomes of different groups, including Amish women in Lancaster County and minority women in Lancaster City.

When the survey was recently updated, Stuart seized the opportunity to examine the information longitudinally. “I’ve been looking at the Amish and how their behaviors and outcomes differ from their non-Amish neighbors,” she says. “They have similar exposures in terms of their environment, but obviously very different behaviors. For the most part, there’s no alcohol, there’s no smoking—those are important variables that affect pregnancy outcomes in the mainstream population.”

The results are surprising. Looking at psychosocial factors such as stress, depression, social support and self-esteem, she noticed an intriguing relationship between lower self-esteem and improved outcomes among Amish women. “It’s the opposite of what you would expect, and the reverse of what we found among the rest of the population,” Stuart says.

To explore the reasons why this is occurring, Stuart plans to interview 20 to 30 Amish women. It’s not easy to gain access to this community, but the established contacts at the Center for Opinion Research and the Clinic for Special Children are making this exceptional opportunity possible.

“The Amish actually are very willing to take the time to be involved in studies like this because they understand that we’re trying to help them,” Stuart says. “They are a closed community. They’re very proud of that and they try to maintain that, so to allow us in is a relatively new thing.”

Although Stuart came to Franklin & Marshall expecting to prepare for medical school, her interests began to evolve within her first-year Foundations course in Epidemiology, where she was first introduced to the field of Public Health. She hasn’t looked back since.

“I realized I wanted to be more actively involved in improving health on the population level rather than on the level of the individual,” Stuart says. This focus led Stuart, already accepted to six graduate programs, to design her own Special Studies Major in Public Health, incorporating coursework from Biology, Government and Science, Technology and Society.