Experiences Of Pregnant Women Research Articles

Women's and clinicians perspectives of presentation with reduced fetal movements: a qualitative study.

BackgroundWorldwide maternal perception of fetal movements has been used for many years to evaluate fetal wellbeing. It is intuitively regarded as an expression of fetal well-being as pregnancies in which women consistently report regular fetal movements have very low morbidity and mortality. Conversely, maternal perception of reduced fetal movements is associated with adverse pregnancy outcomes. We sought to gain insight into pregnant women’s and clinicians views and experiences of reduced movements.MethodWe performed qualitative semi-structured interviews with pregnant women who experienced reduced fetal movements in their current pregnancy and health professionals who provide maternity care. Our aim was to develop a better understanding of events, facilitators and barriers to presentation with reduced fetal movements. Data analysis was conducted using framework analysis principles.ResultsTwenty-one women and 10 clinicians were interviewed. The themes that emerged following the final coding were influences of social network, facilitators and barriers to presentation and the desire for normality.ConclusionsThis study aids understanding about why women present with reduced movements and how they reach the decision to attend hospital. This should inform professionals’ views and practice, such that appreciating and addressing women’s concerns may reduce anxiety and make presentation with further reduced movements more likely, which is desirable as this group is at increased risk of adverse outcome. To address problems with information about normal and abnormal fetal movements, high-quality information is needed that is accessible to women and their families.

Pregnant substance-abusing women in involuntary treatment: Attachment experiences with the unborn child

Background Use of coercion against pregnant women who misuse substances was legalised in Norway in 1996. The background for the law was that substance abuse during pregnancy represents a significant health problem for the child. Aim The main aim of this study was to explore if an attachment between the mother and her unborn child was possible in a context of coercion as experienced from the woman's perspective. The women had many challenges, such as lack of social support and poor living conditions. Material Data were collected in eight qualitative in-depth interviews. Findings The main findings show how involuntary detention enabled safety for and connection with the unborn child. Within this context, the pregnant substance-abusing women's own relational experiences and developmental histories represent the most significant barrier for their ability to bond with the expected child. Conclusions The study underlines the importance of helping women with their own attachment experiences in order to break the generational transference of risk and pathology, and in this way, start the attachment process to the unborn child during the coerced treatment stay. Implications of the findings are discussed.

Ambiguous Encounters, Uncertain Foetuses: Women's Experiences of Obstetric Ultrasound

We examine pregnant women's experiences with routinised obstetric ultrasound as entailed in their antenatal care during planned pregnancies. This paper highlights the ambiguity of ultrasound technology in the constitution of maternal–foetal connections. Our analysis focusses on Australian women's experiences of the ontological, aesthetic and epistemological ambiguities afforded by ultrasound. We argue that these ambiguities offer possibilities for connecting to the foetus in ways that maintain a kind of unknowability; they afford an openness and ethical responsiveness irrespective of the future of the foetus. This suggests that elucidating women's experience has implications for theorising ethics across maternal–foetal relations and, more specifically, for the ‘moral pioneering’ (Rapp, 2000) that reproductive technologies can demand of women. Moral pioneering cannot be reduced to moments or processes of decision-making; it must allow for greater recognition of the affective commitments entailed in and incited by ultrasound. Furthermore, focussing on experiences of the ambiguity of ultrasound allows for understanding the ways in which affectivity circulates across domains commonly understood as medical or social, public or private. In doing so, it contributes to undermining a series of tensions that currently shape feminist analysis of obstetric ultrasound, often at the expense of the experience of women.

How did you choose a mode of birth? Experiences of nulliparous women from Turkey.

One of the most important decisions that women have to make after becoming pregnant concerns their mode of birth, and these decisions are influenced by complex physiological, psychological and socio-cultural factors. To obtain in-depth descriptions of nulliparous women's experiences during the decision-making process for their mode of birth and to reveal their beliefs, attitudes and values. This is a qualitative, phenomenological study that included 29 nulliparous women. Data were collected using semi-structured, face-to-face interviews and analysed using the constant comparison method and guidelines developed by Collaizi. The women's experiences during their decision-making process for their mode of birth were placed into one of four categories, "getting confused", "no matter what happens", "others influencing women's decisions" and "make a decision one way or the other". Vaginal births were considered under the theme "natural but hard way" and caesarean sections under the theme "easy choice". The women indicated that they wanted to have vaginal births, but that they were not offered knowledge and support about modes of birth from health care professionals and, as a result, they asked their relatives for support. It is important to obtain pregnant women's preferences for modes of birth so that knowledge, support and care can be provided and so that they can be involved in the decision-making process. Therefore, health care professionals should understand pregnant women's experiences during the decision-making process for their mode of birth.

Effectiveness of Childbirth Education on Childbirth Experiences of Pregnant Women in a Tertiary Hospital, Kerala, South India

Effectiveness of Childbirth Education on Childbirth Experiences of Pregnant Women in a Tertiary Hospital, Kerala, South India

Transition to motherhood in women with eating disorders: A qualitative study.

The aim of this study was to examine in depth the individual experience of transition from pregnancy to motherhood, among women with current eating disorders (EDs), focusing on differences between the first and subsequent pregnancies. We analysed the narratives of 12 women with severe ED during pregnancy using interpretative phenomenological analysis. We employed a sequential structure, and the emerging themes were ordered according to consecutive pregnancy stages. Our results indicate that experiences of pregnancy vary across pregnancy stages and in the first pregnancy compared to subsequent pregnancies. In particular, during their first pregnancy women with an ED seem to experience an inner conflict and questioned the continuity of their ED identity leading them to be more open to change. The first pregnancy, during its early stages, should be considered a potentially unique window for intervention for women with current ED. Eating disorders (EDs) are known to seriously affect fertility, pregnancy, and pregnancy outcomes. Our research sheds a light on experiences of pregnancy in women with ED and ultimately helps to define a window for intervention. Our findings have important implications in understanding mechanisms of relapse in the post-partum period and consequently could help in tailoring an adequate intervention for women with ED and in preventing ED relapse.

Viewing the unborn child – pregnant women's expectations, attitudes and experiences regarding fetal ultrasound examination

ObjectiveTo gain a deeper understanding of pregnant women's expectations, attitudes and experiences regarding ultrasound examination during pregnancy. MethodsIn-depth interviews were conducted with eight pregnant Norwegian women prior to their 18-week scan. The data were analyzed through systematic text condensation. ResultsThe analysis generated three main themes: (1) I want to know if everything is fine, (2) Viewing the unborn child, (3) Holistic care. The women had a strong wish for ultrasound scanning and medical knowledge about their “baby” was their first priority interest. Visualizing the “baby” represented a strong emotional dimension for the parents-to-be and initiated the bonding process and the planning of a new life. The women wanted to be empowered and approached in a holistic way, where dialogic communication was needed. ConclusionThe women wanted medical knowledge about the fetal health. They considered the examination a visual experience together with their partner. The scan provided a personification of and an attachment to the fetus. This experience was the first step in the planning of a new life. The women had ambivalent feelings related to the ultrasound examination and they highlighted the importance of holistic care, where the sharing of information happens on an individual basis.

Perspectives on Pregnancy in Women With CKD: A Semistructured Interview Study

Women with chronic kidney disease (CKD) often have difficulty achieving pregnancy and are at increased risk for adverse pregnancy outcomes. Given the medical, ethical, and emotional complexities of pregnancy in CKD, the clinical approach should involve explicit consideration of women's values, for which there are sparse data. This study aims to describe the beliefs, values, and experiences of pregnancy in women with CKD to inform prepregnancy counseling and pregnancy care. Qualitative study. 41 women (95% response rate) aged 22 to 56 years with CKD stages 3 to 5 (n=5), receiving dialysis (n=5), or received a kidney transplant (n=31) from 2 renal units in Australia. Semistructured interviews. Transcripts were analyzed thematically. 6 themes were identified: bodily failure (conscious of fragility, noxious self, critical timing, and suspended in limbo), devastating loss (denied motherhood, disempowered by medical catastrophizing, resolving grief, barriers to parenthood alternatives, and social jealousy), intransigent guilt (disappointing partners, fear of genetic transmission, respecting donor sacrifice, and medical judgment), rationalizing consequential risks (choosing survival, avoiding fetal harm, responding to family protectiveness, compromising health, decisional ownership, and unjustifiable gamble), strengthening resolve (hope and opportunity, medical assurance, resolute determination, and reticent hope), and reorientating focus (valuing life and gratitude in hindsight). Only English-speaking women were recruited, which may limit transferability of the findings. Decisions surrounding pregnancy in the context of CKD require women to confront uncertainties about their own survival, disease progression, guilt toward their family and kidney donor, the outcomes of their offspring, and genetic transmission. Communicating the medical risks of pregnancy to women with CKD must be carefully balanced with their values of autonomy, hope, security, and family. Informed and shared decision making that addresses women's priorities as identified in this study may help contribute to improved pregnancy, health, and psychosocial outcomes in this vulnerable population.

Changes in Purines Concentration in the Cerebrospinal Fluid of Pregnant Women Experiencing Pain During Active Labor.

Labor pain has been reported as a severe pain and can be considered as a model of acute visceral pain. It is well known that extracellular purines have an important role in pain signaling in the central nervous system. This study analyzes the relationship between extracellular purines and pain perception during active labor. A prospective observational study was performed. Cerebrospinal fluid (CSF) levels of the purines and their metabolites were compared between women at term pregnancy with labor pain (n = 49) and without labor pain (Caesarian section; n = 47). Control groups (healthy men and women without chronic or acute pain-n = 40 and 32, respectively) were also investigated. The CSF levels of adenosine were significantly lower in the labor pain group (P = 0.026) and negatively correlated with pain intensity measured by a visual analogue scale (r = -0.48, P = 0.0005). Interestingly, CSF levels of uric acid were significantly higher in healthy men as compared to women. Additionally, pregnant women showed increased CSF levels of ADP, GDP, adenosine and guanosine and reduced CSF levels of AMP, GTP, and uric acid as compared to non-pregnant women (P < 0.05). These findings suggest that purines, in special the nucleoside adenosine, are associated with pregnancy and labor pain.

What constitutes a good abortion and a good birth? A qualitative analysis of women's pregnancy experiences

What constitutes a good abortion and a good birth? A qualitative analysis of women's pregnancy experiences

Pregnant women's reactions to routine CO monitoring in the antenatal clinic

Guidelines from the National Institute for Health and Care Excellence (NICE, 2010) recommend the use of routine carbon monoxide (CO) monitoring in all pregnant women. However, there is no research describing pregnant women's experiences of being offered the CO test at booking. Method: This was part of a phenomenological study conducted to examine midwives’ experience of using CO monitoring for smoking cessation in pregnancy. Individual semi-structured interviews were carried out and recorded with 10 midwives who use CO monitoring at booking. They were asked about women's reactions to the test. Data were analysed using Colaizzi's (1978) approach and bracketing. Results: Midwives reported that women were generally happy to accept the test. However, pregnant women appeared to be uninformed about it. Other reactions described include curiosity, shock, relief, guilt and surprise at the results. Conclusion: Overall, women's reactions were positive but an increased public awareness of the test would smooth its implementation.

Pregnant women's experiences of male partner involvement in the context of prevention of mother-to-child transmission in Khayelitsha, South Africa

Male partner involvement (MPI) has been identified as a priority intervention in programmes for the prevention of mother-to-child transmission (PMTCT) of HIV, but rates of MPI remain low worldwide. This study used a quantitative survey (n = 170) and two focus group discussions (FGDs) with 16 HIV-positive pregnant women attending a public sector antenatal care service in Khayelitsha, South Africa, to examine the determinants of high levels of involvement and generate a broader understanding of women's experiences of MPI during pregnancy. Among survey participants, 74% had disclosed their status to their partner, and most reported high levels of communication around HIV testing and preventing partner transmission, as well as high levels of MPI. High MPI was significantly more likely among women who were cohabiting with their partner; who had reportedly disclosed their HIV status to their partner; and who reported higher levels of HIV-related communication with their partner. FGD participants discussed a range of ways in which partners can be supportive during pregnancy, not limited to male attendance of antenatal care. MPI appears to be a feasible intervention in this context, and MPI interventions should aim to encourage male partner attendance of antenatal care as well as greater involvement in pregnancy more generally. Interventions that target communication are needed to facilitate HIV-related communication and disclosure within couples. MPI should remain a priority intervention in PMTCT programmes, and increased efforts should be made to promote MPI in PMTCT.

Women's Experiences of Midwifery Support during Pregnancy A step in the Validation of the Scale: “The Mother Perceived Support from Professionals”

Background: Pregnancy can be physically and emotionally stressful for the parents, which means they need adequate professional support. Easy-to-use, validated scales are important in order to develop professional support in Antenatal care as well as in research. The aim: Our aim was to illuminate pregnant women's experience of professional support at the Antenatal care, in relation to the Mother-Perceived-Professionals-Support (MoPPS) scale. Method: A qualitative study design using the method Think aloud with both inductive and deductive approaches, was used. Five first-time mothers were interviewed with open questions followed by questions related to the MoPPS scale items. Data was analyzed using inductive and deductive qualitative content analyses. Results: The inductive analysis resulted in one theme: Professional support from midwives made women created a feeling of security and unique or rejected and lonely during pregnancy and three categories: Continuity and Perceiving trust or not and Parental groups or individual visits. The deductive analysis described the mothers' understanding of each item. However, coherence between the inductive and deductive analyses varied and the MoPPS-scale needs development. Conclusion: The result shows that women's experience of professional support affects their sense of feeling safe or lonely during pregnancy. Important for midwives were to meet the women's unique individual needs. The MoPPS scale was considered to be relevant and easy to understand, but it needs development to include questions about continuity, parental groups and the perception of midwives' competence, which all were important for the women during their pregnancies.

How do health professionals support pregnant and young mothers in the community? A selective review of the research literature.

The cultural phenomenon of "teenage pregnancy and motherhood" has been socially constructed and (mis)represented in social and health care discourses for several decades. Despite a growing body of qualitative research that presents an alternative and positive view of young motherhood, there remains a significant gap between pregnant and young women's experience of young motherhood and current global health and social policy that directs service delivery and practice. This paper aims to heighten awareness of how a negative social construction of young motherhood influences global health and social policy that directs current community health models of practice and care for young mothers in the community. There is clear evidence on the vital role social support plays in young women's experience of pregnancy and motherhood, particularly in forming a positive motherhood identity. This discussion paper calls us to start open and honest dialogue on how we may begin to re-vision the 'deficit view' of young motherhood in order to address this contradiction between research evidence, policy discourse and current practice and service provision. Qualitative research that privileges young women's voices by considering the multidimensional experiences of young motherhood is an important step towards moving away from universally prescribed interventions to a non-standard approach that fosters relational and responsive relationships with young mothers that includes addressing the immediate needs of young mothers at the particular time.

PHARMACOTHERAPY OF PULMONARY HYPERTENSION DURING PREGNANCY AND POSTPARTUM PERIOD

Pregnancy in women with pulmonary hypertension is associated with a high risk of poor outcomes and high maternal mortality rates, therefore contraindicated in this category of patients. Yet the world has accumulated some experience of pregnancy in women with pulmonary hypertension, who refused abortion, or in whom the disease was diagnosed in later stages of gestation. In this paper results of randomized and observational studies of the main and supportive pharmacotherapy in pulmonary hypertension are given, characteristics of modern drugs for the treatment of pulmonary hypertension and data on their safety during pregnancy are recommended, as well as expert opinion on drug therapy in pregnant women with pulmonary hypertension.

Resisting, reproducing, resigned? Low‐income pregnant women's discursive constructions and experiences of health and weight gain

In this article, we use qualitative methodology to explore how 15 low-income women of diverse sociocultural location construct and experience health and weight gain during pregnancy, as well as how they position themselves in relation to messages pertaining to weight gain, femininity and motherhood that they encounter in their lives. Discussing the findings through a feminist poststructuralist lens, we conclude that the participants are complex, fragmented subjects, interpellated by multiple and at times conflicting subject positions. While the discourse of maternal responsibility (i.e. managing personal behaviours for the baby's health) is very much in evidence in their narratives, embodied experiences of pregnancy, lived experiences of financial constraints and religious beliefs provided some with an alternative discourse and resistant subject position. Participants also had mixed emotions about weight gain; they recognized the need to gain weight in order to have a healthy pregnancy, but weight gain was also not welcome as participants reproduced the dominant discourse of obesity and the discourse of 'feminine' bodily norms. Based on our results, we advocate for change to recent clinical guidelines and social discourses around pregnancy and weight gain, as well as for policies that provide pregnant women with a range of health-promoting resources.

Sharing Bodies: The Impact of the Biomedical Model of Pregnancy on Women’s Embodied Experiences of the Transition to Motherhood

This paper explores how a medicalized view of pregnancy shapes the process of pregnant embodiment and women's experiences postpartum. Analyzing interviews with 42 pregnant women and new mothers, I show that while women's experiences of pregnant embodiment are shaped by biomedical notions of pregnancy, women also bring new meaning to the biomedical guidelines. Women view pregnancy as a process of sharing their bodies with their children, and they continue to share their bodies with their newborns during the postpartum period. I conclude the paper by reflecting on the role of the body in shaping our understanding of medicalized phenomena.

Tensions around risks in pregnancy: A typology of women's experiences of surveillance medicine

The experience of pregnancy is currently driven by the development of surveillance medicine focused on the monitoring of a wide range of risks. Research usually relies on binary categories opposing women accepting medical surveillance to those resisting it. Recent studies have however underlined the complexity of women's experiences, as well as the ambivalence of their attitudes toward medical procedures and recommendations. Based on 47 qualitative semi-structured interviews conducted in Switzerland between 2008 and 2009, this paper presents the diversity of pregnant women's experiences of surveillance medicine through the description of four contrasting groups: “endorsing surveillance medicine”, “coping with risks”, “striving for certainty” and “questioning surveillance medicine”. Taking into account various risks related to pregnancy, these empirically-grounded groups are discussed in relation to the cultural dynamics of contemporary risk discourses.

When it hurts I think: Now the baby dies. Risk perceptions of physical activity during pregnancy

A decrease in the level of physical activity from pre-pregnancy to pregnancy seems to be a general problem, despite the obvious health benefits of physical activity. Quantitative studies indicate that pregnant women's fears might explain why they reduce their level of physical activity, but still no qualitative research has investigated the experiences influencing these women. To explore healthy women's perceptions of risk associated with physical activity during pregnancy. An interpretive narrative approach was used to gain insight into pregnant women's personal stories and lived experiences. Five Danish pregnant women aged 26-36 years participated in semi-structured, in-depth interviews between September and December 2010. The analysis method was based on two types of narrative inquiry: (1) a narrative analysis to cover the story, and (2) a paradigmatic analysis to cover the themes. Most of the pregnancy stories highlighted a specific experience, which made the women anxious. These experiences were: previous miscarriages, fertility treatment and shortened cervix. Also bodily challenges and pain scared the women, such as hypertonic pelvic muscles, Braxton Hicks contractions, abdominal pain, exhaustion, and shortness of breath. The stories also described the impacts of women's relatives and friends on their perceptions of risk. Special consideration should be given to pregnant women who have had negative experiences in previous pregnancies and bodily challenges, which make them anxious and discourage them from being physically active. Healthcare professionals could also pay attention to the fact that women's relatives and friends play a major role in women's perceptions of risk.

Women's perspectives are required to inform the development of maternal obesity services: a qualitative study of obese pregnant women's experiences

Increasing maternal obesity trends and accompanying risks have led to the development of guidelines internationally. However, the evidence-base is poor for effective intervention, and there is a lack of representation from the perspective of obese pregnant women in guidelines. Women's engagement with weight management support services is low. To explore obese pregnant women's experiences to better understand factors which need to be considered when developing services that women will find acceptable and utilize. Obese women referred to an antenatal dietetic service in the Northeast of England, UK. Low-structured depth-interviews allowed women to freely discuss their own experiences. Discussion prompts were included; however, issues that women raised were explored thoroughly. Women summarized what they considered most important to ensure the analyses placed appropriate emphasis on factors women perceived as important. Thematic analysis identified common themes. Saturation was confirmed after 15 interviews. Key issues included: women's weight; families; experience of negativity; and priorities and desired outcomes. These combined represented women's perspectives of issues which they considered important and integral to their lived experience of being obese and pregnant. The theme incorporates women's pregnancy-related experiences, as well as life experiences which contributed to how they felt about their weight during pregnancy. There are strong associations with women's lived experiences and engagement with antenatal weight management services. Incorporating women's perspectives in the development of these services could encourage engagement by focussing on women's priorities and motivations, while taking into consideration their socially related experiences in addition to their clinical health needs.