Watching & worrying: early pregnancy after loss experiences.
OBJECTIVE
To describe women's early pregnancy after loss experiences (up to 25 weeks gestation), to document the timing and frequency of their common discomforts and events, and to explore changes in these over time.


METHODS
Longitudinal, qualitative descriptive, and triangulated (data, methods, analyses).


METHODS
Qualitative data were collected from 82 women pregnant after a past perinatal loss, who were followed through their 25th week gestation. Field notes were taken on all women; 75 women recorded events of their pregnancy through text and stickers on an investigator-supplied calendar. Thematic analysis was done from field notes and hand-written calendar entries; content analysis was conducted on sticker-entered events and symptoms.


RESULTS
Themes identified in the data were Growing Confident, Fluctuating Worry, Interpreting Signs, Managing Pregnancy, and Having Dreams. The first four themes comprise the see-saw nature of these pregnancies. Managing Pregnancy includes the subthemes of Being Hypervigilant, Seeking Reassurance, and Relying on Internal Beliefs. The theme of Having Dreams was a serendipitous finding, in the sense that women reported their dreams without prompting, but the data did not reach saturation. Future research in this area is suggested. Calendar stickers indicate that fatigue and headaches are the most commonly reported discomforts. Fetal movement, felt by all the women by 25 weeks gestation, was very reassuring.


CONCLUSIONS
Nurses should understand that women who have experienced a previous pregnancy loss have omnipresent worry and anxiety during a subsequent pregnancy, and seek reassurance that their pregnancy and baby are okay. Therefore, the frequent calls and visits to healthcare providers from these women represent their most common and comforting way of coping with their worry.
Côté-Arsenault
Denise
D
School of Nursing, University at Rochester, NY, USA. denise_cote-arsenault@urmc.rochester.edu
Donato
Kara L
KL
Earl
Shaleagh Sullivan
SS
D000022:Abortion, Spontaneous / Q000523:psychology*; D000223:Adaptation, Psychological; D000328:Adult; D001007:Anxiety / Q000209:etiology / Q000517:prevention & control / Q000523:psychology*; D001294:Attitude to Health; D005239:Fear; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D016389:Maternal-Child Nursing / Q000458:organization & administration; D009518:New York; D024802:Nurse's Role / Q000523:psychology; D015404:Nursing Methodology Research; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology / Q000517:prevention & control / Q000523:psychology*; D011261:Pregnancy Trimester, First / Q000523:psychology; D011262:Pregnancy Trimester, Second / Q000523:psychology; D036301:Qualitative Research; D012648:Self Care / Q000379:methods / Q000523:psychology; D020377:Self Efficacy; D012944:Social Support; D050497:Stillbirth / Q000523:psychology*; D014481:United States