Annette Gupton

Factors influencing pregnant women's perceptions of risk.

PurposeTo explore factors women consider in determining their perceptions of pregnancy risk, and to compare and contrast factors considered by women with complicated and uncomplicated pregnancies. Study Design and MethodsDescriptive qualitative study in which women described factors they considered in making personal risk assessments. Of the 205 women in the study, half (n = 103) had pregnancy complications, while the other half (n = 102) had no known complications. Written responses to three open-ended questions were used to determine factors women considered in assessing their risks. A qualitative content analysis approach was used to interpret the data. ResultsFour major themes emerged that influenced perception of risk for both groups: self image, history, healthcare, and “the unknown.” Women with complications voiced greater risk perceptions and identified specific risks, while women with no complications mentioned potential risks that were diffuse and hypothetical.

A comparison of childbirth expectations in high-risk and low-risk pregnant women.

This study described and compared the childbirth expectations of high-risk and low-risk pregnant women and then examined the influence of anxiety, risk status, and childbirth preparation on these expectations. This descriptive correlational study employed a convenience sample of 75 high-risk nulliparas and 77 low-risk nulliparas. Results indicated that high-risk pregnant women had significantly less positive expectations for their childbirth experience than did low-risk pregnant women. In particular, high-risk pregnant women expected more medical intervention and more difficulty coping with pain during their labor and birth. For both groups of women, anxiety was negatively correlated with childbirth expectations, whereas childbirth preparation waspositively correlated with childbirth expectations.

Prevalence and Predictors of Inadequate Prenatal Care: A Comparison of Aboriginal and Non-Aboriginal Women in Manitoba

OBJECTIVE Despite the importance of prenatal care, there are no national data and limited provincial data on use of prenatal care by women in Canada, nor is there much information on racial/ethnic disparities in access to prenatal care. This study describes and compares the prevalence and predictors of inadequate prenatal care among Aboriginal and non-Aboriginal women giving birth in Manitoba. METHODS Data were obtained from interviews with 652 postpartum women who delivered a live singleton infant in 2 tertiary hospitals in Winnipeg, Manitoba. We identified inadequate prenatal care, using the Kessner Adequacy of Prenatal Care Index. We used stratified analysis to describe effect-measure modification for predictors of inadequate prenatal care among the Aboriginal and non-Aboriginal subgroups. We conducted a multivariable logistic regression analysis for the total sample. RESULTS A significantly higher proportion of Aboriginal women (15.7%) than non-Aboriginal women (3.6%) received inadequate prenatal care. After controlling for other factors, significant predictors of inadequate prenatal care included low income, low self-esteem, high levels of perceived stress, and Aboriginal background. CONCLUSION Women who do not receive adequate prenatal care are more likely to live in poverty, experience highly stressed lives, have low levels of self-esteem, and be Aboriginal. Efforts to improve the provision of prenatal care should be directed toward these women. Racial/ethnic disparities in use of prenatal care need to be addressed.

Psychometric testing of the Perception of Pregnancy Risk Questionnaire

Pregnant womens perception of risk may influence their health behaviors during pregnancy; however, no validated instrument exists to measure those perceptions. The purpose of this study was to refine a new instrument, the Perception of Pregnancy Risk Questionnaire (PPRQ), and conduct psychometric assessment of the final 9-item version. Reliability and validity were assessed using a sample of 199 women in the third trimester of pregnancy. Exploratory factor analysis resulted in a two-factor solution. Evidence of construct validity was demonstrated using the known-groups technique and through convergent validity. Ratings of pregnancy risk correlated with state anxiety level, providing evidence of concurrent validity. The PPRQ had high internal consistency reliability and excellent test-retest reliability.