Date of Award

2012

Document Type

Campus Access Dissertation

Department

College of Nursing

Sub-Department

Nursing Science

First Advisor

DeAnne K H Messias

Abstract

Transitions are processes, occurring over a period of time, that involve a change in health, identity, relationships, and/or environments (Meleis et al., 2000). Pregnancy transitions are central to nursing, given the health, education and support needs of women and their families during this time. The transition to motherhood during pregnancy sets the stage for future emotional and physical health of mother and child and the stability of the family unit (Nelson, 2003). The dissonance between a woman's expectations and the reality she experiences can affect how she navigates the transition and personally incorporates the new maternal roles, activities and identities.

Some groups of women may be at increased risk for pregnancy and birth related complications and are more likely to experience dissonance, discord, and stress during this transitional period (Zachariah, 2009). These include first time mothers, women with low income and racial/ethnic minorities. Yet the primary focus of prior maternal transition research has been white, married, educated women from middle to upper class income levels. The current study focused on exploring the transition to motherhood for first term pregnant low income mothers. This qualitative, descriptive research study examined the journal and interview data of 27 women throughout pregnancy and the postpartum period to develop a picture of the transition to motherhood. Data from individual journal entries and interviews were examined. The experiences of low income women during their first term pregnancy indicated that transition to motherhood was often characterized by uncertainty and unmet expectations as they also dealt with other complex situational, developmental, and health transitions in their lives. Factors complicating the maternal transitions included economic distress, strained family relationships, and multiple complex transitions. Support throughout the transition focused on the women's mother, significant other, healthcare provider and peers. Rather than conceptualizing the transition to motherhood as a single continuous transition from conception and pregnancy through delivery and postpartum, it is important to recognize the multiplicity and complexity of what often results in concurrent and sequential health, developmental and situational transitions.

Prenatal education appears to be a non-factor since many of the women state the experience did not "match" the education they received. These research findings suggest implications for nursing practice and research and for public policy initiatives include developing, testing and implementing a new prenatal education curriculum for its appropriateness and effectiveness within vulnerable populations to prepare women for a menu of options of how it may be and giving them tools to work through the most common scenarios to help decrease maternal anxiety associated with pregnancy and first time motherhood.

Rights

© 2012, Lisa Bennett Duggan

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