PREGNANCY EXPERIENCES AND PERCEIVED SOCIAL SUPPORT AMONG PREGNANT WOMEN IN POOR RURAL ROMANIA

A Photovoice Pilot Study

VU University Amsterdam:

Marijn Voorhaar

Center for Health Policy and Public Health, Babeş-Bolyai University, Cluj-Napoca, Romania:

Dumitrela NegurăAlexandra BrînzaniucEmanuela Marton-VasarhelyiIoana Cazan

In this presentation:

Introduction Methods:

Photovoice Focus groups

Results Discussion Conclusion Acknowledgements Questions

Introduction

Life changes and psychological adjustments1

1Da Costa et al., 1999

Transition to motherhood2

2Modh et al., 2011

Hormonal swings3

3Glazier et al., 2004

Stress and anxiety4

4Da Costa et al.., 1999

Worries and concerns about pregnancy4

Relationship difficulties4

Postpartum depression2

Introduction

Possible consequences of anxiety anddepression during pregnancy4:

Complications during pregnancy and/or birth Low birth weight Poor neonatal status Prematurity

4Da Costa et al.., 1999

Introduction

By taking the pregnant women’s experiences seriously, a postpartum depression might be prevented5

Importance of sharing experiences of pregnancy with other pregnant women6

Connectedness with other future mothers and sharing the feeling of both joy and suffering is considered meaningful7

5Lundgren, 2002 6Bondas & Eriksson, 2001 7Callister, 2004

Introduction

It is hypothesized that social support has a positive effect on psychological and emotional well-being of pregnant women by buffering the impact of life stress.

Little research has been done to examine social support during pregnancy and the pregnancy experiences of women in poor rural communities.

Introduction: Romania

67% of the total poor population in Romania lives in rural settings.

Need for qualitative research: explore and conceptualize pregnancy experiences and role of social support.

This study is the first study that aims to provide insights into pregnancy experiences and perceived social support among pregnant women in poor rural communities in Romania.

Photovoice method

Introduction: Research question

How do pregnant women in poor rural Romania

experience their pregnancy and how do they perceive

social support?

Methods: the participants

N = 8

N = 9

Methods: Photovoice

Photovoice (Wang & Burris, 1994)

High value on the power of visual images Everyday realities Own interpretation Participants are experts

Methods: Data collection

METHODS: DATA COLLECTION

MEETING I: PHOTOVOICE ASSIGNMENT

Pregnancy experiences: Positive Negative Feelings about pregnancy

Social support: Perceived social support Forms Sources

Written informed consent Instructions disposable camera

Meeting I Aghireşu

Meeting I Aghireşu: portraits

Methods: Data collection

Meeting II

Collection of cameras

Methods: Data collection

Meeting III: Focus group

“First round”

Exchange photographs

Pile sorting exercise

SHOWED: What do you See here? What is really Happening here? How does this relate to Our lives? Why do these issues exist? How can we become Empowered by our new social understandings? What can we Do about it?

Meeting III: Pile sorting exercise

Meeting III: SHOWED

Meeting III: Evaluation

Methods: Data analysis

Content analysis: photographs

Thematic analysis: group interviews

Concept mapping: represent identified themes

Results (preliminary)

Pregnancy positive experience

Main sources social support: Children (group Cojocna) Husband (group Aghireşu)

Need for support groups

Evaluation Photovoice project “We were glad we could communicate with other pregnant women.” “Here we were able to share our troubles.”

Discussion

Differences between Cojocna and Aghireşu groups:

Ethnicity: Roma & Romanian

Interaction during sessions

Sharing experiences

However: both groups would participate again

Conclusion

Photovoice encouraged the participants to share their pregnancy experiences and to describe their social support networks.

Sharing experiences and worries with other pregnant women could be an important form of social support during pregnancy.

Support groups for poor pregnant women living in rural areas could contribute to a better insight in the needs of these women.

Acknowledgements

Participants, family physicians, mediator

Research Team:

Dumitrela Negură, MA

Alexandra Brînzaniuc, MA

Emanuela Marton-Vasarhelyi, MA

Ioana Cazan, BA

Supervisors:

Răzvan Cherecheş, MD PhD, executive director CHPPH

Anne Belonje, MD PhD, lecturer International Public Health, Athena Institute

Advisor:

Vincent O'Brien, Professor of International Health and Visual

Ethnography, The University of Cumbria

Questions