Being Pregnant: A Qualitative Study of Women's Lived Experience of Pregnancy
Armstrong, Toni M., Pooley, Julie Ann, Journal of Prenatal & Perinatal Psychology & Health
ABSTRACT: Few studies of pregnancy have been designed to include the pregnant woman's perspective. This qualitative study was conducted to explore women's perspectives of their experience of pregnancy. Semi-structured interviews were conducted with 13 pregnant women (24-39 years). The analysis revealed six major themes: support during pregnancy; experience of pregnancy; finding information; changing values; model of care; and being responsible. Results suggest that women's experience of pregnancy may be enhanced offering guidance and enabling access to multiple sources of support. Future research into the health-care professional's role, and the ways in which pregnant women connect with each other, is supported.
KEY WORDS: Pregnancy, qualitative, social support.
Over the past century, pregnancy has come to be viewed predominantly as a physical and pathological experience, framed within a medical model of care, and has focused primarily on the physical survival of a woman and her developing baby (Bondas & Eriksson, 2001; Salisbury, Law, LaGasse, & Lester, 2003). Research conducted from a medical perspective has resulted in numerous technological advances and improved physical pregnancy outcomes for women and babies. More women, and their babies, now survive the experience of pregnancy than their pregnant predecessors who did not have access to advanced technology. However, even with the availability of advanced technology, a significant number of women and their babies continue to experience poor pregnancy outcomes that cannot be accounted for by biomedical factors alone (Korenbrot & Moss, 2000; Rini, Dunkel-Schetter, Wadhwa, & Sandman, 1999).
The medical model of care is characterized by a focus on risk assessment and complications. Pregnancy and birth care within this model is standardized and based predominantly on the physical aspects of care (Howell-White, 1997). Alternatively, the midwifery model of care focuses on pregnancy and birth as a normal and natural life event. The midwifery model is characterized by a holistic approach, taking into account each pregnant woman's unique experiences.
The quality of women's experiences during pregnancy can be influenced by their choice of model of care. Pregnant women's choice of model of care has been associated with the woman's perception of risk in relation to pregnancy and birth (Howell-White, 1997). Women who perceive pregnancy and birth as a medical condition that is risk oriented are more likely to choose an obstetrician as their careprovider than a woman who perceives pregnancy and birth as a normal and natural life event.
In an effort to better understand pregnancy experience and outcomes, researchers have increasingly focused on examining the psychosocial experience of pregnancy (Collins, Dunkel-Schetter, Lobel, & Scrimshaw, 1993). In the last three decades, pregnancy has been described as a stressful life event (Levy-Shiff, Dimitrovsky, Shulman, & Har-Evan, 1998; Park, Moore, Turner, & Adler, 1997), a major life transition requiring adaptation (Bost, Cox, Burchinal, & Payne, 2002; Harrison, Neufield, & Kushner, 1995; Rini et al., 1999; Salmero-Aro, Nurmi, Saisto, & Halmesmaki, 2001), and a maturational crisis (Aaronson, 1989; Bondas, & Erikkson, 2001). Furthermore, prenatal maternal stress has been identified as a negative psychosocial experience during pregnancy, and has been linked with adverse pregnancy outcomes, such as preterm birth and low birth weight (Stanton, Lobel, Sears & DeLuca, 2002). Preterm birth, a birth that occurs prior to 37 weeks gestation, and low birth weight, under 250Og, have been identified as significant risk factors for young children developing negative health outcomes such as hyperactivity, developmental delays, and autism (Huizink, Robles de Medina, Mulder, Visser, & Buitelaar, 2003).
Recently, prenatal maternal stress has been conceptualized as a multidimensional concept incorporating stress-provoking (e. …