Defining the Role of Caregivers in Promoting Maternal Adaptation in Unintended Pregnancies
Objective: The purpose of this study is to identify the psychosocial needs and views about desired services and decision making of women with unintended pregnancies who seek the help of pregnancy counselors or caregivers. Women were asked to describe in their own words what they found helpful and unhelpful in counseling. This information will be used to more clearly define the role of caregivers with women during their experience in hopes of improving maternal and newborn outcomes in unintended pregnancies. Design: A mixed-method design with a quantitative descriptive component and a qualitative descriptive component was used Setting: Data were collected over the course of several months and took place at two locations of Pregnancy Help. Pregnancy Help are pregnancy resources centers located in Brighton and Natick near Boston, MA. Population: Pregnancy Help serves women ranging from teenage years to women over 40, with mostly of lower socioeconomic status, and lower educational attainment with a wide range of backgrounds such as Caucasian, African-American, Haitian, Brazilian, and women from other countries. Methods: Prospective participants were contacted on the telephone and invited to participate in the study during their third trimester and up to 2 years postpartum. All 23 participants were included in the 15 to 35 minute quantitative descriptive component which consisted of completing a questionnaire composed of three instruments: (1) Prenatal Self-Evaluation Questionnaire (Lederman & Weis, 2009), (2) Pregnancy Decision-Making Questionnaire, and (3) Demographic Information Questionnaire. Of all participants, 10 women were asked to partake in the qualitative component which consisted of a 30 to 60 minute open-ended Pregnancy Counseling Interview. Results: As with the national demographics of women with unintended pregnancies, the women who participated in this study were mostly young, single African American or Latina women of lower socioeconomic status, and lower educational attainment. Their psychosocial profiles indicated decreased maternal adaptation in every psychosocial dimension. Qualitative data from interviews served as an illustration of the psychosocial and demographic profiles, revealing background and the experience of unintended pregnancy for each woman. This data provided insight into the difficulty and complexity of their experience and of pregnancy decision-making. Aspects of counseling such as being welcoming, encouraging, non-judgmental, motherly, and informative were perceived as beneficial to the women. Women also appreciated the combination of counseling with material support and referrals to social, financial, and medical services.