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Document Type

Thesis - University Access Only

Award Date

1996

Degree Name

Master of Science (MS)

Department

Graduate Nursing

First Advisor

Dianna Sorenson

Keywords

pregnancy complications, psychological aspects of childbirth, interpersonal communications

Abstract

The purpose of this naturalistic inquiry was to identify communication patterns described by women who endured traumatic perinatal experiences (TPE). TPE is an intense perinatal process that creates psychological and emotional disruption irrespective of the baby's outcome. Ten vaginally delivered women, ages 25-40 years gave retrospective accounts of their TPEs. Women ranged from 2 months to 17 years post trauma and had between 1 and 4 pregnancies. TPEs were unrelated to any birth order.
Positive and Negative communication dimensions were identified from written transcripts of interviews with participants. Interactions within these dimensions occurred between the woman and health care, social, and/or macro systems. Categories of Positive Interactions included: 1) Supporting/Encouraging (n=10); 2) Educating/Informing (n=9); Validating/Understanding (n=7). Categories of Negative Interactions included: 1) Abandoning/Withholding Support (n=10); 2) Withholding Information (n=8); 3) Denying Experiential Validity (n=7); 4) Denying Options/Coercing (n=7); 5) Conveying Incongruence (n=5); 6) Pacifying/False Reassuring (n=4); 7) Blaming (n=4); 8) Conveying Incompetence (n=2); 9) Attending to Tasks (n=3); 10) Stigmatizing (n=l). Although both dimensions were represented, traumatized women identified negative interactions 43% more frequently than positive interactions. Most of these negative interactions occurred postpartum with health care providers. Each participant in the study experienced abandoning at least once during the perinatal period.
One contrast case, who denied long-term psychological trauma and had no repetitive negative thought patterns, was analyzed for validation support. This gravida II contrast case had a history of infertility, pregnancy induced hypertension, preterm labor with extended bedrest, delivery at 32 weeks, postpartum hemorrhage with a near death, out-of-body experience, and an acutely ill neonate. The contrast case reported only positive communication interactions.
Nursing implications include: individualistic treatment of women; reinforcement of identity as unique vs. abnormal; maintenance of a trusting relationship; validation of personal significance and personal experience; mutual goal setting; presenting and permission to have and express emotions. Assessments and interventions for TPE need to emphasize the postpartum period.

Library of Congress Subject Headings

Pregnancy -- Complications
Childbirth -- Psychological aspects
Interpersonal communication

Number of Pages

162

Publisher

South Dakota State University

Rights

Copyright © 1996 Elizabeth Hinkley. All rights reserved

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