High-Risk Pregnancy Experience and Antepartum Hospitalization

Purpose: The focus of maternal role development, historically, has been on the tasks and processes during pregnancy as they relate to postpartum role transition. The purpose of this study was to investigate how women hospitalized with high-risk pregnancy cognitively construct pregnancy and impending motherhood.

Methods: This ethnographic study included open-ended, semi-structured interviews with 13 primigravid women hospitalized for preterm labor or preterm premature rupture of membranes and field work to explore the development of maternal role in this population and associated nursing care. The interview focused on exploring the woman’s experiences of pregnancy and impending motherhood while hospitalized.

Findings: Thematic analysis of the qualitative data provided an understanding of the cognitive process that occurs as the pregnant woman builds a relationship with the fetus and resulted in a conceptual model with two complementary components that occur throughout the pregnancy: Establishing a Relationship and Dynamic Equilibrium. Establishing a Relationship includes subthemes of: Courting, Building a Connection, and Engagement. Dynamic equilibrium is the balance between expectations and reality and may exist regardless of pregnancy complications.

Conclusions: An understanding of the cognitive process involved in establishing a relationship with the developing fetus related to impending motherhood and the importance of dynamic equilibrium can allow healthcare providers and those who interact with pregnant women to support development of the maternal role and anticipate those barriers that may impede that process. Findings from this study identify those triggers and mediators that influence development of the maternal role and suggest potential intervening strategies for those involved in the care of childbearing families.