Abstract
ABSTRACT Purpose Across the UK and USA, postpartum smoking relapse rates are high, and rates of breastfeeding and physical activity are low. This project aimed to explore these interrelated health behaviours and technology use, for intervention development to support postpartum cancer prevention. Methods Focus groups and interviews with 26 purposively selected women (15 in Vermont, USA and 11 in Norfolk, UK). Recruitment was from deprived areas experiencing multiple disadvantage. Qualitative data were thematically analysed from dual cultural perspectives, underpinned by the social ecological model. Results Women negotiate interrelated lifestyle behaviours as part of managing an identity in transition, moving through stages of disturbance, adaptation, acceptance and integration towards “becoming” a new Mother. Technology was integral to women’s process of engagement with mothering identities. Intersectionality underpins complex patterns of interrelated behaviour. Conclusions There is scope to improve electronic/digital support for postpartum women cross-nationally to promote interrelated cancer-preventative lifestyle behaviours. Abbreviations CDC: Center for Disease Control, US; PA: Physical activity; SES: Socioeconomic status; SVI: Social Vulnerability Index; UK: UK; US: USA; WIC: Women infants and children office.
Highlights
Pregnancy can motivate positive health behaviours, including smoking cessation
For the participants, becoming a Mother was experi enced as a shift in identity, away from an indepen dent sense of self, towards integrating a new relational self, with their infant, and in relation to partners and social support networks, both “real” and “virtual”, through the use of technology
Our findings demonstrate the important underlying concept of intersectionality (Bauer, 2014)—a theoreti cal construct suggesting that lifestyle behaviours that represent cancer risk behaviours are complex, inter related, and interact in multiple ways—to impact can cer preventative health behaviours following childbirth across US and UK women
Summary
Pregnancy can motivate positive health behaviours, including smoking cessation. While women might wish to remain abstinent, up to 75% of ex-smokers return to smoking within 12 months of childbirth (Orton et al, 2017). Reducing postpartum smoking relapse would significantly improve both women’s and children’s health and make a positive impact on cancer prevention efforts. Maternal smok ing is the primary cause of infant and child secondhand smoke exposure, which is directly linked to cancer risk (Kim et al, 2018). Maternal smoking increases the likelihood of children becoming smokers themselves later in life, representing generational transmission of cancer-causing lifestyle behaviours (Gilman et al, 2009). Of smoking status, breast feeding is associated with numerous cancer preven tion benefits, including reduced risk of maternal breast and ovarian cancers (Chowdhury et al, 2015). In the UK, only 1% of women are exclusively breastfeeding at 6 months (Breastfeeding in the UK, UNICEF, 2019)
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