Pregnant women in their last trimester of pregnancy who were 18 years old or older attending antenatal care clinic were eligible. Women facing an imminent health crisis, those in active labor, or those being admitted to the hospital were excluded (despite the generally stable nature of optimism and pessimism, those women in active labor were excluded because of concerns about disproportionate reporting of a pessimistic attitude if it was assessed during painful, active labor when compared to assessments obtained during a routine prenatal visit). After describing the study and obtaining verbal approval to continue, research assistants talked patients through an informed consent form, answering any questions the women may have had. All participants signed a written informed consent document and were given a copy to keep. Women were then given a self-administered survey to complete before their appointment. Translators were used when necessary. Surveys were designed to be selfadministered, but women were given the option to have the survey administered verbally.