Date of Award

2016

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Nursing

Abstract

During pregnancy, women frequently anticipate birth and motherhood with unrealistic images and expectations which are formed by personal experience and society’s portrayal of motherhood (e.g., books and movies). How these expectations impact the postpartum period for women has not been well studied. However, research has identified a link between maternal expectations, reality, and negative emotional responses. When expectations are met, the experience of motherhood may be a positive one. However, when these expectations are not met, the potential for negative emotional responses may be greater. The postpartum period is a significant period of adjustment, and depression occurs in about 13%–19% of women. Postpartum depression not only affects the mother and her ability to parent but her overall quality of life. The question of whether having higher expectations during pregnancy increases the potential for postpartum depression and decreases quality of life has not been studied.

This was a descriptive, longitudinal quantitative design. The purpose was to determine how expectations affect maternal quality of life and which factors are predictive of poor quality of life in women during pregnancy as well as the postpartum period. The following measures were administered during the last six weeks of the antepartum period and at 6 to 12 weeks: (1) expectations (Parenting Expectations Measure); (2) parental attitudes (Intensive Parenting Attitudes Questionnaire); (3) moods (General Anxiety Disorder 7, Edinburgh Postnatal Depression Screen); and (4) overall

quality of life (Ferrans and Powers Quality of Life Index) in the last six weeks of pregnancy and at the six-week postnatal office visit. Descriptive statistics and regression models were used to determine whether expectations are met as well as if they are predictive of maternal quality of life.

Predictors of quality of life were different for antepartum, distinct from postpartum. Antepartum predictors include expectations, anxiety, and depression, while postpartum quality of life is predicted by experience of motherhood based on expectations. Almost half of the participants had expectations of motherhood that were not met, and this group had significantly lower quality of life scores and higher anxiety scores. This is essential knowledge for the nurse in helping to prepare new mothers during the antepartum period and to understand their concerns postpartum. The importance of unmet expectations is a crucial facet to investigate in addressing modifiable risk factors of postpartum mood disorders.

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Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

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