Exploration of women's experiences of antenatal long term hospitalisation

Abstract

This thesis explored the experiences of four women who were hospitalised for more than two weeks in their most recent pregnancy and how they adjusted to an environment where they lost control of their lives. Rubin (1995) believes pregnancy is a period of striving to achieve four developmental tasks, two being directed toward the outer world on behalf of the mother's unborn child and the other two are directed toward the formulation of the maternal role and relationship. Pregnancy is a period of identity reformulation and personality maturation. Failure to complete any of the tasks due to a high risk pregnancy and uncertain motherhood can result in severe stress. Women in this situation need to undertake additional tasks as described by Stainton, McNeil, and Harvey (1992) to adapt emotionally to their situation. Stress was a major problem for the women, their families and significant others in their lives and elements of achieving additional tasks were seen for all four women in the analysis of the data. Semi-structured interviews using trigger questions were used for collecting the data which were fully transcribed and analyzed using a process of thematic analysis. Insights revealed how the women coped with the enforced period of hospitalisation; how their families coped; how child care was arranged and the impact of this on family relationships. Thematic analysis of interview transcripts identified five major categories which were viewed through the lens of Rubin's (1975) four developmental tasks of pregnancy. The major category was 'doing the best for my baby' and identified how the four women in the study were clearly focused on the safety of their babies. Raising awareness of pregnant women's experiences when hospitalised for a long period of time adds weight to other research in this field and may lead to improvements in the way women's care is managed. Several recommendations for further research and practice development initiatives were made. These include recommendations for more randomised controlled trials investigating the safety and efficacy of out of hospital care for women with a variety of high risk pregnancy conditions. There is a need for further research examining women's mental health support needs during high risk pregnancy crisis situations and following preterm birth. Further research exploring a woman's continuing relationships with her baby and significant others in her life following hospitalisation during pregnancy needs to be undertaken. Further studies into the physical effects of bed rest for women with high risk pregnancies is also required. The feasibility of practice improvements in terms of mobile outreach services and purpose built family units for in-hospital stay needs to be explored. Finally there is a requirement for improved antenatal education for women experiencing high risk pregnancy and long term antenatal hospitalisation.