The experiences of prenatal depression among Taiwanese women

Title. The experiences of prenatal depression among Taiwanese women. Aim. This paper is a report of a study to describe Taiwanese women’s experiences of prenatal depression. Background. Despite its long‐term adverse effects for both mother and child, prenatal depression has received less scholarly attention than postpartum depression. Studies to date have proposed structured measures for quantifying prenatal depression, but the characteristics of this phenomenon have not been qualitatively analysed. Method. A convenience sample of 12 Taiwanese pregnant women scoring above 15 on the Edinburgh Perinatal Depression Scale participated in in‐depth interviews during 2005. The interviews were transcribed verbatim and analysed using content analysis. Findings. Unbalanced commitment to motherhood was the primary theme of the life experiences of prenatal depression in these Taiwanese women, which summarized their feelings of engagement and ambivalence towards their experiences of transition to motherhood. Five recurring sub‐themes were identified: multiple conflicting roles, lack of social support, dissatisfaction with body image, future uncertainty and emotional instability. Conclusion. Prenatal depression is a painful growth experience represented by silent and unbalanced commitment during the maternal role transition. Our findings may help healthcare professionals to understand the vulnerable experiences of pregnant women and devise preventive intervention strategies, such as prenatal education for both parents and comprehensive screening for prenatal depression in at‐risk pregnant women, so that they are better prepared for the transition to motherhood.     

Motherhood in the shelter context: the perspectives of sheltered adolescents

The objective of this study is to describe the understanding that sheltered female adolescents have regarding motherhood and analyze their experience of this process from their perspective, for the purpose of identifying a support structure for young sheltered mothers. This exploratory and qualitative study was performed at two municipal shelters in Rio de Janeiro. The data were collected through focal groups performed with 10 sheltered adolescents. The content analysis of the data revealed two categories: Motherhood in adolescence: the perspective of the sheltered adolescent and Being a mother at the shelter: positive and negative experiences. Being a mother during adolescence is an ambivalent experience for the sheltered adolescents. The shelter is described as a supportive environment, but difficulties still exist in helping them to construct a healthy image of motherhood. There is a need to sensitize the social actors involved in terms of creating intersectoral interventions regarding the context and lifestyles of these youths, which could prevent vulnerability/disaffiliation of mother and child.     

Experiencing neonatal death: an ambivalent transition into motherhood

OBJECTIVE: To illuminate the lived experience of women facing the threat of lossing their newborn child and then experiencing the reality of their infant's death. STUDY DESIGN: Sixteen women were interviewed approximately 2 years after the death of their infant using a hermeneutic phenomenological approach. FINDINGS: The main theme was ambivalent transition into motherhood. The women went through the whole life-span of their infant during a very short time. The women's narratives were interpreted as broken expectations, total confusion, reality awareness, consciously leave-taking, and elusive grief. CONCLUSIONS: Women need the opportunity to evolve their own patterns and rhythms in the ambivalent transition from expected motherhood to experiencing neonatal dying and death. Knowledge about the individuality of this process may assist nurses in improving the quality of care.     

Growth versus stability: older primiparous women as a paradigmatic case for persistence

The early pregnancy experience of women over 30 offers paradigmatic evidence which supports the significance of persistence for the study of nursing phenomenon Pregnancy and first-time motherhood have come to be associated with change, growth and development This research, which was undertaken to describe the changes experienced by older primiparous women during early pregnancy, illustrates how research grounded in a particular paradigm, in this case the growth or developmental paradigm, can limit the interpretation of data When viewed from a developmental perspective, women in this sample were seen as resistant to change and could be said to be having trouble 'adapting' to their impending motherhood However, when these women were viewed from the perspective of stability they were seen to engage in activities that allowed them to persist in their current self-view In the biological sciences, persistence refers to a compensatory process which allows a system to maintain goal-directedness in spite of both internal and external disturbances Women in this sample used balancing and buffering to continue their self-patterns Balancing represented the verbal and behavioural processes women engaged in to integrate their experience of themselves as pregnant into their sense of themselves as not pregnant Buffering included those activities that women used to maintain a sense of themselves in the face of the threat posed by their impending motherhood Balancing and buffering represent mechanisms used in the service of persistence and reflect pattern maintenance activities     

'Becoming a mother'— developing a new theory of early motherhood

This paper explains the methods used in a grounded theory analysis of the experience of 55 first-time mothers in Australia, presented in the first of this series of two papers. The categories identified in the research are realising, readiness, drained, aloneness, loss and working it out, encompassed in the core category becoming a mother. Specifically, this paper extends the analysis and explains the application of a'paradigm model' and the identification of a Basic Social Process (BSP). The paper links the analysis to the literature on early motherhood from nusing, midwifery, feminist, and sociological research. A substantive theory is proposed to explain women's experience in becoming mothers that demonstrates how, when responsive to the needs of those researched, a grounded theory analysis can provide a framework for nursing and midwifery care.     

Women's voices: the lived experience of pregnancy and motherhood after diagnosis with HIV.

The objective of this study was to explore the meaning of pregnancy after diagnosis with HIV. Study design was a qualitative analysis of individual informant interviews conducted in two academic health centers in metropolitan New York. Participants were a purposive sampling of 9 women, 34 to 53 years old, who had been diagnosed with HIV and were currently pregnant or who had become mothers postdiagnosis. The result of the study included themes of extreme emotional distress after HIV diagnosis, feeling stigmatized, emotions related to the pregnancy and baby, experiences with health care providers, and motherhood for women with a diagnosis of HIV. The author concluded that the experience of pregnancy for a woman with HIV is one fraught with isolation, anxiety, and distrust, but it is also one of hope for the normalcy that motherhood may bring. Further research is needed to determine best practice for care delivery as women with HIV enter the health care system, especially for perinatal services.     

Juggling identities of rheumatoid arthritis,motherhood and paid work – a grounded theory study

Purpose: To explore how women with rheumatoid arthritis manage their illness, motherhood, and work life.

Methods: A constructivist, grounded theory approach based on individual interviews and participant observations with 20 women with rheumatoid arthritis who participated in work life and had children living at home or were pregnant. After initial and focused coding Goffman’s concepts of social identity were applied.

Results: A core category: “Juggling meaningful identities” and three conceptual categories were developed: (1) Work life as the strongest identity marker; (2) Motherhood: a two-sided act; (3) Living with rheumatoid arthritis as an identity? Paid work, motherhood, and illness are linked to the women’s social identities. The women construct and change their identities in interactions with children, partners, other parents, colleagues, and employers.

Conclusion: The women attribute the highest priority to their professional identity, spending the majority of their time and energy in an effort to appear as “good stable workers”. The disease is seen as a hindrance in this regard, and the illness identity is almost completely rejected. In motherhood, the women prioritize close interaction with their children, and deprioritize external activities. Extended outbreaks of the disease and issues regarding the children force the women to deprioritize working life.

• Implications for rehabilitation

• Juggling meaningful identities of rheumatoid arthritis, motherhood, and paid work challenge women in managing their everyday lives. Therefore, rehabilitation professionals should support individuals to develop new strategies to manage the challenges they experience regarding juggling motherhood and work ability.

• Work is a dominant identity marker for women with rheumatoid arthritis therefore, rehabilitation professionals have an important role to play in investigating possible ways for the individual to maintain employment or return to work.

• Living with rheumatoid arthritis and being a paid worker challenge women’s role performance and thereby their identification as mothers. Therefore, rehabilitation professionals have to support the women and their families.

     

Dutch women's perceptions of childbirth in the Netherlands

PURPOSE: To explore the lived experience of childbirth in Dutch women who had given birth at home in the Netherlands. METHODS: Qualitative study using audiotaped interviews with 14 women. RESULTS: Themes included the advantages of giving birth in the home, where the women felt more in control of their environment; the difficulty and normalcy of the pain associated with giving birth; the feelings of fulfillment and empowerment that come with childbirth and motherhood; and the importance of the supportive role of the midwife-caregiver. NURSING IMPLICATIONS: Women in a culture different from that of the United States who gave birth at home felt fulfilled and empowered by the experience. These results can help U.S. nurses more fully understand the meaning of childbirth in a different culture and may help identify possible improvements in the design of care for women and newborns in the United States.     

Barriers to accessing safe motherhood and reproductive health services: the situation of women with disabilities in Lusaka, Zambia

Purpose: To ascertain how well health services in Lusaka, Zambia currently meet the safe motherhood and reproductive health care needs of women who have physical impairment leading to disability.

Methods: A qualitative study was conducted in Lusaka, Zambia. In-depth tape-recorded interviews were conducted with 24 purposively selected women with disabilities and with 25 safe motherhood/reproductive public sector health service providers. Qualitative analysis was conducted using NVivo software.

Results: Women with disabilities encounter various social, attitudinal and physical barriers to accessing safe motherhood and reproductive health (RH) services in this particular setting. The strong desire for children and affection can increase vulnerability to sexual exploitation. At the same time, a generalized assumption among reproductive health service providers that women with disabilities will not be sexually active, and not require RH services, leads to increased vulnerability to sexually transmitted infection including HIV. Once pregnant, traditional beliefs about transmission of disabilities can create barriers to integration in ante-natal clinics. Nurse-midwives' fear of delivery complications in women with physical impairments can also result in routine over-referral to a tertiary maternity facility which is outside the locality and harder for women with mobility limitations to get to.

Conclusion: Greater understanding of the influences underpinning societal attitudes towards sexuality and disability in this setting, and more extensive communication between health care staff and women with disabilities would facilitate positive action towards improving safe motherhood and reproductive health services for women with disabilities.     

A journey of restoring self-confidence: the life experiences of women recipients of augmentation mammaplasty

The purpose of this qualitative research study was to explore the preoperative through postoperative phase experience of women who had undergone augmentation mammaplasty. Nine women undergoing augmentation mammaplasty were selected by purposive sampling and interviewed using semi- structured, open-ended interview guidelines. Researchers used Symbolic interactionism to frame their overall perspective and analyzed data with the content analysis method. Rigors of data analysis were adopted credibility, transferability, dependability and confirmability proposed by Guba and Lincoln. The main theme of living experience of women who received augmentation mammaplasty could be summarized as "a journey to restore self-confidence". The categories identified within this journey included: (1) the invisible standards of breast beauty; (2) Taking courageous action to make changes; (3) conflicts between the natural and artificial. The above findings provided initial qualitative data from Taiwanese women's perspective. By better understanding their experience, nurses can become increasingly sensitive to patients' psychosocial adjustment and provide prudential nursing care.     

Intensive‐invisible mothering: The experiences of mothers of adult children with dual diagnosis

The experiences of mothers of adult offspring with a dual diagnosis have rarely been discussed in the literature, despite growing involvement and responsibility of mothers for daily care of their children. Interpretive phenomenological analysis of in‐depth interviews was used to examine the mothering experience of 12 mothers of adult offspring with dual diagnosis. The analysis revealed that the mothers’ experiences were intensive, abusive, and isolating, and simultaneously rendered them invisible, undervalued, or ignored by professionals, community, and family. Furthermore, the analysis indicated that this experience of ‘intensive‐invisible’ mothering was promoted or prevented by three intersecting mechanisms, identified here as discursive, institutional, and spatial. The research contributes to the fields of knowledge regarding family members of people with mental health problems, by adding a theoretical layer that takes into account how public discourses of motherhood mould women’s accounts of their mothering experience. Practical implications of these findings for professionals working with these mothers are discussed. Specifically, therapeutic intervention that focuses on identifying and modifying the underlying psychological and social processes associated with the ‘intensive‐invisible’ mothering experience could be useful.     

Women's experiences of becoming a mother after prolonged labour

Title.  Women's experiences of becoming a mother after prolonged labour.
Aim.  This paper is a report of a study to explore women's experiences of becoming a mother after prolonged labour.
Background.  The negativity associated with a complicated labour such as prolonged labour can lead to a struggle to become a healthy mother and could restrict the process of becoming a mother.
Methods.  Interviews were conducted in 2004 with 10 mothers who had been through a prolonged labour with assisted vaginal or caesarean delivery 1–3 months previously. Thematic content analysis was used.
Findings.  Three themes were formulated, describing women's experiences as fumbling in the dark , struggling for motherhood and achieving confidence in being a mother. The difficulties and suffering involved in becoming a mother after a prolonged labour were interpreted to be like 'fumbling in the dark'. Women experienced bodily fatigue, accompanied by feelings of illness and detachment from the child. Having the child when in this condition entailed a struggle to become a mother. In spite of these experiences and the desire to achieve confidence in being a mother, the reassurance of these women regarding their capacity for motherhood was crucial: it was central to their happiness as mothers, encouraged interaction and relationship with the child, and contributed to their adaptation to motherhood.
Conclusion.  Women experiencing prolonged labour may be comparable with the experience of and recovery from illness, which could contribute to difficulties transitioning to motherhood and limit a woman's ability to be emotionally available for the child.     

Women's experience of early miscarriage: a phenomenological study.

This paper describes the experience of three women who had experienced early miscarriage within the previous 12 months. Three major themes of loss emerged: the loss of a baby, the loss of the role of motherhood and the loss of the hopes and dreams the women possessed for their baby. These losses were complicated by the women's negative thoughts about the care they received while in hospital, their perceptions of health professional's negative attitudes, the lack of information given to them, and the lack of understanding shown by family and friends about their situation. The authors recommend a number of changes to practice including the need for an increased sensitivity towards women following early miscarriage.     

Barriers to accessing safe motherhood and reproductive health services: the situation of women with disabilities in Lusaka,Zambia

Purpose:?To ascertain how well health services in Lusaka, Zambia currently meet the safe motherhood and reproductive health care needs of women who have physical impairment leading to disability.

Methods:?A qualitative study was conducted in Lusaka, Zambia. In-depth tape-recorded interviews were conducted with 24 purposively selected women with disabilities and with 25 safe motherhood/reproductive public sector health service providers. Qualitative analysis was conducted using NVivo software.

Results:?Women with disabilities encounter various social, attitudinal and physical barriers to accessing safe motherhood and reproductive health (RH) services in this particular setting. The strong desire for children and affection can increase vulnerability to sexual exploitation. At the same time, a generalized assumption among reproductive health service providers that women with disabilities will not be sexually active, and not require RH services, leads to increased vulnerability to sexually transmitted infection including HIV. Once pregnant, traditional beliefs about transmission of disabilities can create barriers to integration in ante-natal clinics. Nurse-midwives' fear of delivery complications in women with physical impairments can also result in routine over-referral to a tertiary maternity facility which is outside the locality and harder for women with mobility limitations to get to.

Conclusion:?Greater understanding of the influences underpinning societal attitudes towards sexuality and disability in this setting, and more extensive communication between health care staff and women with disabilities would facilitate positive action towards improving safe motherhood and reproductive health services for women with disabilities.     

Women's perceptions on risk pregnancy and family implications

This study aimed to identify the women's perceptions of risk pregnancies and to investigate its implications to the families. The data was collected through a qualitative approach, using semi-structured interviews during the months of March and April of 1999. Five pregnant women were interviewed at the Obstetric Clinic of the University Hospital Júlio Müller in Cuiabá/MT. It was found that the women sometimes experience confused and contradictory feelings, since the "myth of motherhood and maternal love" is still very strong in our society. It was observed that the involvement and support of the family during a risky pregnancy are very important to the pregnant woman.