Pregnancy Journey Research Articles

Navigating an Uncertain Journey of Pregnancy After Perinatal Loss

The purpose of this qualitative data analysis was to gain insights into women's experiences over the course of pregnancy subsequent to prior perinatal loss. Diaries from 19 pregnant women with a history of miscarriage, stillbirth, or neonatal death who participated in an intervention study were the data source. The participants were primarily Caucasian, 23 to 41 years old, with a history of one to six prior losses, high school to graduate school education, and a wide range of incomes. Inductive thematic analysis of pregnancy diary entries was done. A metaphor of navigating a pregnancy journey that feels scary and uncertain, toward the goal of reaching their desired destination, a healthy infant, was identified from women's personal accounts. Six themes were identified: (a) Staying Alert: Noting Physical Symptoms, (b) Dealing with Uncertainty: Expressing Emotions, (c) Dreaming of the Destination: Evolving Thoughts of Baby, (d) Traveling Together: Connecting with Others, and (e) Moving Forward: Reflecting on Sense of Self. The interaction of several themes is described as (f) Staying on Track: Navigating through Pregnancy. Women may find journaling helpful in dealing with the anxiety and fear that characterize pregnancy after loss. Viewing pregnancy after perinatal loss as similar to navigating an uncertain journey may provide greater understanding of the emotional, physical, and social challenges that women may experience. Recognition that women with a history of perinatal loss may be anxious and fearful during pregnancy will increase sensitive care.

Preparing for Birth: Colouring your Pregnancy Journey

by Bridget Sheeran with illustrations by Olwyn Jennings

What do consumers want to know about drugs (medication and lifestyle) in their pregnancy journey?

Introduction: Drug use during pregnancy is common; yet data to support safety are mainly case reports and retrospective studies. There is also growing evidence for harmful fetal effects when treatment of certain maternal conditions is inadequate. Seeking information is a coping strategy and can assist with decision-making.Aim: This study aimed to identify the medicines information needs of women across pregnancy stages and explore whether their questions could be justified by actual pregnancy risk.Methods: We conducted a retrospective, mixed method study of pregnancy-related calls to an Australian consumer medicines call centre, NPS Medicines Line (September 2002-June 2010). Call characteristics were compared for pregnancy (n = 4,573) and non-pregnancy (n = 118,547) questions. Drugs of interest, motivations to call and question themes were analysed across pregnancy stages, with medicines assessed for risk, using the Australian categorisation system for prescribing medicines in pregnancy. Call narratives were explored for stage-specific themes.Results: Pregnancy-related enquiries were prompted more often by conflicting or inadequate information and request for second opinion. Most questions concerned safety. Psychotropic medication and fertility were strong drivers to seek information in preconception. Everyday illnesses and self-medication with Over-The-Counter products were of increasing concern as pregnancy progressed, with medicines classified as ‘safe’ accounting for 34% of questions.Discussion: Analysis of real world, pregnancy-related questions demonstrates that women are concerned about safe drug use in pregnancy and are likely to overestimate risk. Health care professionals should proactively address drug information gaps of women’s pregnancy stage-specific information needs during routine consultations.

The pregnancy journey for women with type 1 diabetes: a qualitative model from contemplation to motherhood

The purpose of this study is to describe and develop a model of the pregnancy journey for women with type 1 diabetes.We undertook a thematic analysis of written interactions (n = 200; n = 2060 text excerpts) with an online counselling support service from 93 women with type 1 diabetes.Seven possible discrete phases in the pregnancy journey were revealed: Contemplation, Pregnancy planning, Conception, Pregnancy, Delivery/birth, and Motherhood or Pregnancy loss. Eight common themes were identified, varying in importance across phases. Diabetes‐specific distress was most evident during Contemplation and Motherhood. During pregnancy, social identity and peer support were paramount. Negative emotions in Pregnancy, while connected to diabetes, also centred on the unborn baby. In Motherhood, diabetes‐specific distress and depressed mood increased. Medicalisation was expected and offered reassurance during Pregnancy; however, some women still worried, with peer support offering the most reassurance.In conclusion, women with type 1 diabetes potentially experience seven distinct phases of the pregnancy journey, with eight themes varying in significance across phases. Contemplation begins well before Planning or Conception, and women may seek support from non‐mainstream sources. Mental health and emotional well‐being varies qualitatively and quantitatively across phases (focusing on pregnancy‐related distress, diabetes‐specific distress and general maternal well‐being), indicating a need for targeted assessment and support across the pregnancy journey. Copyright © 2016 John Wiley & Sons.

Staff perspectives of barriers to women accessing birthing services in Nepal: a qualitative study.

BackgroundNepal has made significant progress with regard to reducing the maternal mortality ratio but a major challenge remains the under-utilisation of skilled birth attendants who are predominantly facility based. Studies have explored women’s views of the barriers to facility birth; however the voices of staff who offer services have not been studied in detail. This research explores the views of staff as to the key reasons why pregnant women do not give birth in a maternity-care facility.MethodsThis mixed methods study comprised qualitative interviews and non-participant observation. The study was conducted in two small non-governmental hospitals, one semi-rural and one urban, in Kathmandu Valley. Twenty interviews were conducted with health care providers and other staff in these hospitals. The interviews were undertaken with the aid of a Nepali translator, with some interviews being held in English. Twenty-five hours of non-participant observation was conducted in both maternity hospitals . Both observation and interview data were analysed thematically. Ethical approval was granted by the Nepal Research Health Council and Bournemouth University’s Ethics Committee.ResultsKey themes that emerged from the analysis reflected barriers that women experience in accessing services at different conceptual levels and resembled the three phases of delay model by Thaddeus and Maine. This framework is used to present the barriers. First Phase Delays are: 1) lack of awareness that the facility/services exist; 2) women being too busy to attend; 3) poor services; 4) embarrassment; and 5) financial issues. Themes for the second Phase of Delay are: 1) birthing on the way; and 2) by-passing the facility in favour of one further away. The final Phase involved: 1) absence of an enabling environment; and 2) disrespectful care.ConclusionThis study highlights a multitude of barriers, not all of the same importance or occuring at the same time in the pregnancy journey. It is clear that staff are aware of many of the barriers for women in reaching the facility to give birth, and these fit with previous literature of women’s views. However, staff had limited insight into barriers occuring within the facility itself and were more likely to suggest that this was a problem for other institutions and not theirs.

Walking a tightrope, teetering on the edge, fighting demons: women’s experiences of having an eating disorder while pregnant

Whilst extant literature demonstrates the aetiology, incidence and outcomes of eating disorders in women, with evidence showing the impacts on pregnancy, the fetus and parenthood adjustment, there is a paucity of research regarding how women make meaning of the experience. A phenomenological study provided a description of the pregnancy experience as perceived by a cohort of women with diagnosed eating disorders. Data were collected via semi structured interviews with women with a known diagnosis of an eating disorder either in the past or present and who had been pregnant within the previous twelve months. Data were analysed using constant comparative approach seeking themes and patterns. The study identified fourteen key themes that describe the women's experience of living with an eating disorder while pregnant. These themes included a basic description of the pregnancy journey itself; the use of metaphor; perceptions of motherhood; concerns about the baby; and body image. In addition, eating disorder behaviour; eating disorder status; secrets; wishes; misconceptions; support; emotions; health professionals' interactions and healthcare improvements were also identified. It is important that healthcare providers have an awareness that pregnant women may be undergoing personal distress and to be sensitive to the specific needs of women with eating disorders. This study has raised awareness of this issue and provided a baseline for further research in the area. This abstract was presented in the Learning from Consumers stream of the 2014 ANZAED Conference.

Your Pregnancy and Newborn Journey

Your Pregnancy and Newborn Journey