Processes used by urban black women to prepare for childbirth : a grounded theory

Women prepare for childbirth in a variety ways. These preparations include visits to healthcare providers, seeking information from family, friends, and the media, and attendance at childbirth classes. Documentation of birth preparation comes primarily from studies of middle class white women. Few researchers have identified or included middle class black women in their samples. Instead, research with black women often highlights pregnancy problems in low income populations. Also unexamined, except tangentially, is how the social context impacts childbirth for black women. Therefore, nursing practice knowledge lacks an understanding of the processes black women use to prepare for birthing within their social context. The aim of this qualitative study was to identify a theory that described the processes used by urban black women to prepare for childbirth. Also explored was the social context within which these processes occurred. Women in the last four months of pregnancy were recruited through churches, hair salons, newspapers, radio and internet web sites. Data were collected from five focus groups and two individual interviews (n=22). More than half the women reported income adequate for daily needs, were partnered or married, were employed, had at least a high school education and were younger than 23 years. Data analysis followed the grounded theory methods advocated by Strauss and Corbin (1998). The theory describing the processes used by the participants was weighing the impact on me. These women actively engaged in determining the best course of action for themselves. They weighed and considered advice from others, what relationships were crucial, what information was most important to them, and many other issues. Woven throughout were the importance of relationships and the social context in which the women lived. The processes used for birth preparation were divided into four, discovering pregnancy, managing pregnancy, preparing for delivery, and experiencing personal change. These processes were not sequential but represented the dynamic and constant need to assess and decide the best choices in preparing for childbirth. Building on this theory, future research should identify ways in which black women can more readily access the quality healthcare and services they so desire.