Evolving meaning from being pregnant and becoming a new mother over the period of a major earthquake : a grounded theory study

Abstract

It has been reported in the literature that an earthquake, as an adverse life occurrence, could affect the physical and mental health of pregnant women, which might further affect the health of their baby. Family, as the major source of social support, may play a key role in the recovery and maintenance of maternal psychological health after a major disaster such as an earthquake. However, researchers have put their focus on quantitative investigation of such problems and related risk factors, yet the in-depth exploration of perinatal women's experience of earthquakes and related buffers or interventions, such as family support, remain scarce. This limitation would curtail the design of effective and efficient interventions targeting this population after a major disaster. This study aimed to investigate the experience of women who were pregnant and gave birth during the period of a major earthquake, and the roles and dynamics of family in relation to the health of these women. Charmaz's constructivist grounded theory (GT) method was used for this study. The research setting was Ya'an, which was the epicentral area of the 2013 earthquake in Sichuan (China). Twenty-two women who were pregnant during the earthquake and two of their husbands were recruited through purposive and theoretical sampling. The constant comparative analysis was guided by coding practice of the constructivist GT approach, and aided by NVivo 10 for data management. After the earthquake, the pregnant women experienced three dynamic stages, which include 'being disturbed', 'alleviating disturbances' and 'growing up' until their return to normal life. During the first phase, the earthquake disturbed the daily lives of perinatal women and curtailed their family support due to decreased family resources and abilities, which led to 'negative psychological responses'. Yet the earthquake brought 'positive' effects as well, by increasing family cohesion and interpersonal relationships with others outside of their family. The women subsequently entered the second phase of 'alleviating disturbances' through 'being there of the family members' and 'love and hope instilled by the baby'. Motivated by love and hope instilled by the baby, and supported by 'being there of the family members', the women were able to alleviate their negative psychological responses and change their values about their relationship with their families and baby rearing. During the last phase of 'growing up', the women gained a new meaning in life and returned to their normal lives in their role as a mother. The women experienced a change in their values, and the core process for them in being pregnant and becoming a new mother over the period of a major earthquake was 'evolving meaning'. This study provides implications for clinical practice and future research, which include integrating disaster preparedness courses into prenatal/rearing programmes for perinatal women and their families; providing more humanistic nursing services with an emphasis on psychological health around delivery; and establishing government policies and resources that support husbands in participating in pregnancy-related activities. In order to enhance 'being there of the family members' over the period of recovery from disaster with a new baby.