Experiences Of Pregnant Women Research Articles

Virtual Childbirth Preparation Courses to Reduce the Fear of Childbirth and Improve the Pregnancy Experience in Pregnant Women: Protocol for a Quasi-Experimental Clinical Trial (Preprint)

Virtual Childbirth Preparation Courses to Reduce the Fear of Childbirth and Improve the Pregnancy Experience in Pregnant Women: Protocol for a Quasi-Experimental Clinical Trial (Preprint)

Lived experiences of young pregnant women who smoke

Background Smoking tobacco during pregnancy can lead to adverse pregnancy and child health outcomes. Aim To gain insight of smoking during pregnancy from young pregnant women's lived experience. Method A descriptive phenomenological approach was used. Semi-structured interviews were conducted with five women aged 18-20 years who had smoked tobacco during pregnancy. Findings Themes that emerged from the data were related to culture and routine, psychological wellbeing, self-efficacy, public opinion, recognition of harm, whom they spoke to about smoking, and the approaches that helped behaviour change. Conclusions Midwives were seen as the trusted health professional by the young women and a non-judgemental approach was valued to promote self-efficacy. Smoking cessation services were not recognised as beneficial, and cutting down, rather than using nicotine replacement therapy or e-cigarettes, was preferred.

Exploring Women's Experiences in Accessing, Understanding, Appraising, and Applying Health Information During Pregnancy.

This study explored pregnant women's experiences in accessing, understanding, evaluating, communicating, and using health information and services during pregnancy. Pregnant participants (aged 18-45 years) were recruited from an obstetrics and gynecology department of a large urban training hospital. Focus groups were facilitated by a moderator's guide developed from health literacy domains (access, understand, evaluate, and communicate and use), audio recorded, transcribed, and uploaded into ATLAS.ti. Constant comparative and thematic analysis were employed. Participants (N = 17) were predominantly Hispanic (53%), married (67%), college educated (87%), employed (80%), insured (100%), and nulliparous (59%). Health care providers and online and digital sources were preferred sources of information. Participants' understanding was facilitated by plain language, pictures and other visuals, numbers and statistics, and tailored information. Participants evaluated information credibility by source (health care provider, advertisement, multiple sources) and personal circumstances (eg, health history, gestational age). In addition, these women used the information to communicate with health care providers, family, and partners and to change health-related behaviors. Participants described rich, contextual health literacy experiences. Future interventions that maximize access to health care providers and online and digital sources, while ensuring materials are easy to understand, convenient, and patient centered, could facilitate informed decision making during this critical period. Future prenatal education and counseling interventions could be developed and evaluated using established health literacy principles to ensure that information is accessible, understandable, and actionable.

Pregnant Women's experiences of Birth Preparedness and Complication Readiness in Ghana

Background & aim: Most of the maternal mortalities are preventable when safe maternal healthcare practices adhere to antenatal care. Lack of birth and emergency preparedness is one of several factors contributing to maternal mortalities. Adequate birth preparedness (BP), as well as emergency, and complication readiness (CR) planning can determine the survival rate of a pregnant woman and her unborn neonate. The present study aimed to describe the experiences of pregnant women at Jachie Health Center regarding BP and CR. Methods: In this qualitative study, a phenomenological approach was used for data collection. In-depth interviewing was conducted with a total of 15 pregnant women from Jachie Health Center. The interviews were digitally recorded, transcribed verbatim, reviewed several times, and thematic analysis was performed. NVivo software (version 11) was utilized to manage the data and help with thematic analysis. Results: The pregnant women practiced preparations towards the place of delivery, support person, layette, and warning signs of pregnancy. The majority of the cases were not aware of obligatory preparations in terms of transportation and the need for emergency compatible blood donor prior to delivery. Most of the respondents were not sufficiently prepared for delivery due to poverty and low educational status. Conclusion: The role of community members could include the instruction of pregnant women to attend antenatal clinic to receive education regarding birth preparedness and complications readiness. The district health directorate and public health nurses should train community leaders for the benefits of birth preparedness and complications readiness.

Pregnant Women's Experiences of Crisis Pregnancy Centers: When Abortion Stigmatization Succeeds and Fails

There is broad consensus that abortion is stigmatized, but the role of interpersonal interaction in this process is underspecified. I examine interviews with 25 women in the United States who visited crisis pregnancy centers (CPCs)—antiabortion organizations that offer one‐on‐one “prolife counseling”—for how and when interactions matter for abortion stigmatization. I identify two primary ways CPC counselors stigmatized abortion and describe variation in their impact: counselors' efforts were “successful,” were misrecognized as ideologically‐neutral, or were resisted. The findings demonstrate the importance of women's current consideration of abortion and preexisting beliefs for understanding how interpersonal interactions contribute to abortion stigma.

The experience of pregnancy in women with high body mass: a hermeneutical/phenomenological study

The experience of pregnancy in women with high body mass: a hermeneutical/phenomenological study

Is there an association between pregnant women's experience of violence and their partner's drinking? A Swedish population-based study

ObjectivePregnancy is a time of heightened vulnerability for women, especially for experiencing violence in their close and intimate relationships. Alcohol misuse by a male intimate partner is a known contributor to increased risk and severity of intimate partner violence generally, however less is known about the relationship between partner drinking patterns and women's experience of violence in their relationship, and particularly in early pregnancy. This study aimed to explore these associations in a large, population-based sample of Swedish expectant parents. Design, setting and participantsData for this cross-sectional study were drawn from 11 461 couples (22 922 participants) enrolled in Salut, a child health promotion programme in Västerbotten County Council, Sweden. Data were collected at women's antenatal care visits during the first trimester of pregnancy. MeasurementsQuestionnaires included male partners’ self-reported drinking patterns using AUDIT (Alcohol Use Disorders Identification Test) and pregnant women's reports of violence. Descriptive and logistic regression analyses were undertaken to examine prevalence of reported violence and association with partner drinking patterns. FindingsThere was a strong association between male partner alcohol misuse and the odds of pregnant women experiencing violence in general, experiencing violence since becoming pregnant, and fear for their own safety at the time of enrolment in ANC. The odds of having experienced being controlled or physically hurt in a relationship, or having ever experienced sexual violence, were higher with more serious alcohol misuse by the male partner. Most striking was that women whose partners reported hazardous drinking or alcohol dependence had nearly nine times higher odds of experiencing being physically hurt by a partner since becoming pregnant, compared to women whose partners reported non-harmful alcohol use (OR 8.50, CI 2.39–30.17, p = 0.001). Fearing for current safety was also strongly linked to more severe alcohol use by their current male partner (OR 7.65, CI 1.02–57.24, p = 0.048). Key conclusions and implications for practiceThis study contributes population-level evidence that the risk for women of experiencing violence in general or in early pregnancy is exacerbated when a male partner drinks in harmful ways. Health professionals and those supporting pregnant women should pay attention to the role of risk factors such as partner alcohol use. Ensuring the health of pregnant women and safety in their relationships is important for maternal, foetal and infant health and family functioning.

"If He's Abusing You . . . the Baby Is Going to Be Affected": HIV-Positive Pregnant Women's Experiences of Intimate Partner Violence.

Pregnancy represents a time of increased risk for intimate partner violence (IPV), and an HIV diagnosis further increases the vulnerability of this at-risk group. This study explores experiences of recent IPV using qualitative interviews with N = 12 HIV-positive pregnant women recruited from a clinical setting in South Africa, a location with a high global prevalence of IPV and HIV. Partner dynamics around IPV resulted in HIV shame and stigma and adversely affected engagement in HIV care and HIV treatment behaviors. The results highlight the challenges women face in navigating disclosure of both IPV and HIV, accessing necessary support, and engaging in both HIV-related and pregnancy-related care in the context of an abusive relationship.

364. Perspectives of pregnancy in women with chronic kidney disease: A National Registry Survey Study

Background Women with chronic kidney disease (CKD) are at risk of complications in pregnancy. Understanding of the experience of pregnancy for women with chronic kidney disease is limited. Currently, care for many pregnant women with CKD is provided by nephrologists and obstetricians in tertiary centres. This survey will seek to determine care received. The aim of this questionnaire study is to describe variability in care received by women with CKD during and after pregnancy, and explore the impact of model of care delivery on their experiences of care. Methods An online questionnaire was developed and sent to women with CKD who had at least one pregnancy and who had consented to be contacted for research from the UK Rare Renal Diseases Registry (RaDaR), Pre-eclampsia Chronic Hypertension rEnal and SLE study (PEACHES) and Pregnancy Adaptation In Renal disease Study (PAIRS). Results There was a 10% response rate. Most women (90%) were of white ethnicity. Most women had successful pregnancies, however, approximately one in seven women had previously had a fetal or perinatal loss. There were no differences in model of care (joined up or fragmented) according to disease severity. Anxiety for health was similar between women with ‘mild’ and ‘severe’ disease. Fewer women in the fragmented care group found the care by their midwife reassuring. Conclusion Findings suggest variability in care is not necessarily based on disease severity but geography or hospital resource. Women are more satisfied with ‘joined up’ care, supporting a move to MDT care for women with high risk pregnancies as suggest by NICE. The trend toward lower satisfaction levels with midwives when fragmented care is experienced highlights an area of further research needed, with possibly more training for midwives into CKD pregnancies and more integration of midwives into care for these women.

The experiences of pregnant migrant women in detention: A qualitative study

Background Pregnant migrant women held in detention centres in the UK can be particularly vulnerable. They may have poor physical and mental health, which is exacerbated by their incarceration, and are at a disproportionally increased risk of maternal and perinatal mortality. Unpublished studies have found that pregnant migrant women have poor experiences in detention. Aim To explore pregnant migrant women's experiences of living in detention. Method Four migrant women who had been held in detention while pregnant and two volunteer health professionals were interviewed. Findings Results suggest that migrant women have very poor experiences in detention. Four key themes emerged: ‘challenges to accessing UK healthcare’, ‘exacerbation of mental health conditions, ‘feeling hungry’ and ‘lack of privacy’. Conclusion These findings could be used to review maternity care in detention and ensure that detention staff understand the experiences of detained pregnant women so that the needs of this vulnerable group can be met.

Culture, bathing and hydrotherapy in labor: An exploratory descriptive pilot study

ObjectiveThough bathing (hydrotherapy) is widely used during labor to decrease anxiety and pain and to promote relaxation, the influence of cultural beliefs about bathing by parturients is virtually unknown. This pilot study explored pregnant women's experiences of bathing, bathing in labor, and cultural beliefs about bathing. DesignAn exploratory, descriptive design. SettingLow risk obstetrical clinics. ParticipantsHealthy Hispanic, Black, White, American-Indian and Asian women (N = 41) at >37 weeks gestation. MethodsDuring a routine prenatal visit women responded to a brief openended questionnaire on the use of bathing. Data was captured using a modified ethnographic method involving observation and note taking with thematic analysis and quantification of percent response rates. FindingsForty-six percent (N = 41) of women used bathing for purposes other than hygiene but only 4.9% (N = 41) of these women bathed during a previous labor. The women described bathing as relaxing, easing, calming, and efficacious for relief of menstrual cramps and labor contractions. Ten percent of women reported cultural beliefs about bathing. ConclusionsWomen who bathe, report relief of anxiety, menstrual and labor pain and promotion of mental and physical relaxation. The findings do not support the view that bathing is associated with identifiable cultural beliefs; rather, they suggest that bathing is a self-care measure used by women. This practice is likely transmitted from generation to generation by female elders through the oral tradition. Assumptions that race or ethnicity precludes the use of bathing may be faulty. Cautionary instructions should be given to pregnant women who are <37 completed weeks of gestation, to avoid bathing for relief of cramping or contractions and to seek immediate health care evaluation. Study of culturally intact groups may uncover additional themes related to bathing in labor and as a self-care measure for dysmenorrhea.

Pregnancy experiences of women in rural Romania: understanding ethnic and socioeconomic disparities

Women in rural Romania face significant health disadvantages. This qualitative pilot study describes the structural disadvantage experienced during pregnancy by women in rural Romania, focusing on the lived experiences of Roma women. We explore how women in rural communities experience pregnancy, their interactions with the healthcare system, and the role that ethnic and social factors play in pregnancy and childbearing. We conducted 42 semi-structured interviews with health and other professionals, seven narrative interviews with Roma and non-Roma women and a focus group with Roma women. Data were analysed using thematic analysis. We identified intersectional factors associated with women’s pregnancy experiences: women perceiving pregnancy as both unplanned and wanted, joyful, and normal; women’s and professionals’ differing prenatal care perceptions; transport and cost related barriers to care; socioeconomic and ethnic discrimination; and facilitators to care such as social support, having a health mediator and having a doctor. Talking directly with professionals and Roma and non-Roma women helped us understand these many factors, how they are interconnected, and how we can work towards improving the pregnancy experiences of Roma women in rural Romania.

Mo1817 - The Psycho-Emotional Experience of Pregnancy in Women with IBD and Correlation with Gut Microbiome

Mo1817 - The Psycho-Emotional Experience of Pregnancy in Women with IBD and Correlation with Gut Microbiome

The Experience of Pregnant Women With a History of Addiction at a High Risk Clinic [16R

INTRODUCTION: 5.0% of pregnant women use one or more addictive substances. Drug use during pregnancy significantly increases the risk of adverse maternal and fetal outcomes. The Prenatal Recovery Clinic (PRC) is a specialty clinic at Jackson Memorial Hospital that provides care for pregnant women with a history of addiction. The objective of our study is to gain a greater understanding of the patients, their drug habits, health care experiences, and health outcomes at the PRC. METHODS: Pregnant women 18-50 years old that used substance and were patients at the PRC between March 2016 and April 2017 were eligible to participate in the study. Surveys was administered at two different times; the first at a PRC prenatal visit and another postpartum. Birth outcome data was extracted from medical records manually. RESULTS: Twelve patients were enrolled in the study. Of these patients, 33% reported more than one drug as their drug of choice. Participants rated the PRC clinic experience overall more favorably than their experience at the hospital for delivery, although the two experiences were not found to be statistically significant. Averages of PRC patient birth outcomes, such as gestational age, birth weight, and APGAR scores fell within normal limits. CONCLUSION: Pregnant patients with addiction can benefit from specialized clinics like the PRC that provide specialized care and assistance for pregnant women with a history of substance use. The results from our study indicate a potential for establishing a model similar to the PRC, that can be replicated to other clinics to address addiction in pregnancy.

Material Hardship and Mental Health Symptoms Among a Predominantly Low Income Sample of Pregnant Women Seeking Prenatal Care.

Introduction Although poverty is an established correlate of poorer mental health for pregnant women, limited research has examined the mental health effects of material hardship (i.e., difficulties meeting basic needs such as for food, transportation, or stable housing) during pregnancy. Methods The current research examined rates of material hardship among pregnant women seeking prenatal care and the relationships of both income and material hardship with depression and anxiety during pregnancy. Pregnant women (N = 892) responded to self-report measures of mental health symptoms, annual household income, and current material hardship in the waiting areas of community-based obstetrics/gynecology practices serving primarily financially disadvantaged patients. Results About 56% of the sample reported some form of material hardship. About 19% of the sample reported elevated depression, and 17% reported elevated anxiety. Both depression and anxiety were uniquely associated with lower income and greater material hardship, even after controlling for age, race/ethnicity, relationship status, and number of children in the home. Furthermore, material hardship partially mediated the effect of income on mental health symptoms. Discussion The physical, emotional, and social effects of deprivation of basic daily needs may contribute to pregnant women's experiences of mental health symptoms. These results converge with the broader literature focused on the social determinants of physical and mental health. When symptoms of depression and anxiety reflect distress related to material hardship, addressing unmet social needs may be more effective than mental health treatment.

‘They’ll be judging us’ a qualitative study of pregnant women's experience of being offered participation in a supportive intervention

Objectiveto explore pregnant women's experience of being offered participation in a supportive intervention and how their experience influenced the outcome of the intervention. Design and settinga qualitative, phenomenological hermeneutic study based on semi-structured interviews with eight Danish first-time mothers. Findingsthe study revealed a divergence between the professional's and the women's perception of their vulnerability. The women typically felt the offer of participation as a stigma, which they met with anxiety and confusion. Insufficient information led to uncertainty and a feeling of being evaluated as inadequate mothers or parents. The information offered failed to provide the basis of informed choice. However, the development of a trusting, supportive and non-judgemental relationship with the health professionals ensured most women a positive outcome of the intervention. Key conclusionbeing invited to participate in an intervention targeting vulnerable women may induce unintended feelings in relation to stigmatization and judgement, leading to doubt about own ability to cope with motherhood. Inadequate information and explication about aims and contents of the intervention are likely to cause confusion and anxiety and a feeling of being judged as parents. Information combined with establishing a trusting and non-judgemental relationship between women and professionals appears to have significant impact on outcomes. Implications for practicecare providers should be aware of the induced negative feelings and sense of judgement and stigmatization as a result of being categorized as vulnerable and perceived in need of help to cope with motherhood, and that they may play a key role in helping women cope with this. Furthermore, detailed information about the intervention and the background of the offer should be ensured as well as an informed choice of participation.

P873 The psycho-emotional experience of pregnancy in women with IBD and correlation with gut microbiome

IBD patients experience greater stress, anxiety and depression which impair quality of life and increase disease burden. It is not known whether women with IBD have more stress and anxiety than healthy controls (ctl) during pregnancy or how these psychosocial factors influence their experience of pregnancy. We investigated measures of stress, anxiety and depression affecting pregnant women with and without IBD participating in the MECONIUM (Exploring MEChanisms Of IBD traNsmission In Utero through the Microbiome) Study. 34 IBD women (median age = 33, 62%CD, 88%white, median parity = 2) and 145 matched ctls, all pregnant/recent delivery, completed the Perceived Stress Scale-14, Autonomic Function Questionnaire (AFQ), Brief Symptom Inventory (BSI) and the Pregnancy Experiences Scale (PES). Questions were answered based on current feelings. Women not currently pregnant answered the PES based on their most recent pregnancy. Mean scores comparison was conducted between four groups (IBD vs. ctl pregnant, IBD vs. ctl not pregnant) using one-way ANOVA with planned comparisons. We conducted a stepwise linear regression to find potential predictors of negative pregnancy experiences in IBD. We ran correlation network analysis between stress variables and pregnancy stool microbiome profiled using 16s rRNA sequencing. There were significant differences in the mean scores of the four groups of subjects across four subscales: PES frequency, intensity and total uplifts (positive feelings about pregnancy) and the BSI somatic symptoms subscale, with higher mean uplift scores in the ctl/non-pregnant groups vs. pregnant/IBD groups and higher BSI somatic scores in the pregnant groups vs. non-pregnant groups. Higher BSI somatic scale scores and parity were significant predictors of hassles (negative feelings about pregnancy) in pregnant women with IBD. There was strong crosstalk between psychological scores and maternal gut microbial genera at third trimester but not second trimester. Boxplots of statistically significant psychological variable comparisons (PES uplifts frequency, uplifts intensity, and total uplifts: p < 0.05; BSI somatic symptoms subscale: p < 0.01) by ANOVA. Correlation networks between psychological scores and maternal gut microbial genera. Left panel: second trimester; right panel: third trimester. Red line indicates positive correlation (q [adjusted p-value] < 0.05); blue line indicates negative correlation (q<0.05); grey line indicates correlation (p < 0.05, q > 0.05). A negative pregnancy experience for IBD women is predicted by somatic symptoms of psychological distress as indicated by the BSI and parity. Higher crosstalk between microbiota and psychological scores was observed in stool collected during third trimester than second trimester. Further analysis of microbiome correlation to psychological variables is on-going.

An Awareness and Experiences of Pregnant Women towards Antenatal Weight Management at a Maternity Hospital in Najran City, KSA

Background: One of health priorities for women during pregnancy is the attainment of healthy weight both in the antenatal and postpartum periods. This study is aiming to evaluate pregnant women awareness and experiences towards the management of obesity and weight gain during pregnancy. Method: This was a cross-sectional study (n=416) conducted over 3 months in 2017 of pregnant women attending antenatal clinics at a maternity hospital, Najran city, KSA. An interviewer administered, questionnaire was used. Findings: Results were shown 58.7% of participants (n=244) had low awareness for management of obesity and weight gain during pregnancy, with the highest level of awareness regarding management objectives and strategies (77.2%), while the lowest level of awareness folic acid (44%). In addition, 90.4% (n=376) showed poor experience in counselling about obesity management in pregnancy. Four risk factors were shown to be important indicators of awareness and experience of participants with largest being an occupation (Adjusted OR=2.7, p=0.001), nationality (Adjusted OR=2.4, p=0.015), regular follow up (Adjusted OR=1.7, p=0.049) and education level (Adjusted OR=1.3, p=0.009). Conclusion: Study findings are consistent with earlier findings indicating that low level of awareness for management of bodyweight during pregnancy in addition to bad experience in counselling about recommended guidelines for that may explain up to some extent why women are not being served appropriately regarding bodyweight and its health risks in the antenatal care.

961: Pregnant Black women's experiences of racial discrimination

To describe situational domains in which publicly insured pregnant Black women experience racial discrimination during pregnancy. This analysis includes data collected between January 2016 and June 2017 from a study that examined how stress, resiliency, and coping during pregnancy influence publicly insured Black women's (N = 55) risk for preterm birth in Oakland, California. Racism-associated stress (racial discrimination) was measured three times during pregnancy (18-20, 24-26, 30-32 weeks) using the modified experiences of discrimination (EOD) scale. Participants responded “yes” or “no” to ever experiencing discrimination based upon their race/ethnicity in nine situational domains (e.g., “getting medical care”). Women included in this analysis had at least one data point across the three times. Descriptive statistics were used to describe the sample demographics and the burden of racial discrimination across the nine situational domains. Most women were aged 20-29 years old (n = 30, 55%), single/never married (n = 33, 60%), Christian (n = 34, 62%), and reported having poor physical or mental health at least one day during the past 30 days (n = 28, 51%). Three quarters (n = 42, 76%) of the women reported experiencing racial discrimination in one or more situational domains [across their lifetime]; 15% (n = 9) indicated EODs in all nine situational domains (M = 6.11). The most frequent reports of racial discrimination occurred in school (n = 25, 46%), stores or restaurants (n = 24, 44%), and public settings (n = 24, 44%) (Figure). Experiences of racial discrimination were widespread in a sample of pregnant Black women. Given the previously documented association between experiences of racial discrimination and poor birth outcomes (e.g. preterm birth, low birth weight, fetal loss), further research is warranted to explore the specific situations and processes by which racism influences birth outcomes. Additionally, explorations of the healthcare workforce and their contribution to these experiences should be considered.

妊産婦の歯周疾患とう蝕罹患 : CPITN CodeとDMFTの関連性

妊産婦の歯周疾患とう蝕罹患 : CPITN CodeとDMFTの関連性