Exploring perceptions of vulnerability among women facing psychosocial adversity before, during and after pregnancy: A qualitative interview-study using thematic analysis

• Published in: Sexual & reproductive healthcare 2024-09, Vol.41, p.100999, Article 100999
• Main Authors: van der Meer, L., Ernst-Smelt, H.E., Lambregtse-van den Berg, M.P., van ’t Hof, M., Weggelaar-Jansen, A.M., Bijma, H.H.
• Format: Article
• Language: English
• Subjects: Adult; Early life course; Female; Humans; Interviews as Topic; Lived experience; Perception; Perinatal period; Pregnancy; Pregnancy Complications - psychology; Pregnant Women - psychology; Prenatal Care - psychology; Qualitative Research; Qualitative study; Social Stigma; Stereotyping; Stigmatization; Vulnerability; Vulnerable Populations - psychology; Young Adult
• ISSN: 1877-5756; 1877-5764; 1877-5764
• DOI: 10.1016/j.srhc.2024.100999

•The ‘vulnerable’ label holds a dichotomy: it facilitates acces to appropriate care but also risks stigmatization by the women it intends to describe.•For women, being vulnerable during pregnancy and after birth means not being able to sufficiently care for themselves or their children.•The ‘vulnerable’ label becomes more accurate and less stigmatizing when it concurrently acknowledges women’s personal narratives and their intrinsic strengths.•Prioritizing women’s perceptions in the discourse on vulnerability can lessen its stigmatizing impact and significantly improve the quality of maternal care. The term ‘vulnerable’ is often used to describe women facing psychosocial adversity during pregnancy, implying a heightened risk of experiencing suboptimal pregnancy outcomes. While this label might facilitate the pathway to appropriate care, it can be perceived as stigmatizing by the women it intends to help, which could deter their interaction with healthcare services. This study explores how women facing psychosocial adversity before, during and after pregnancy perceive the concept of vulnerability and experience being labeled as such. We conducted a thematic analysis of semi-structured, in-depth interviews. Through purposive sampling targeting maximum variation, ten women of diverse backgrounds were included. Three central themes emerged: defining vulnerability, embracing vulnerability and the feeling of being stigmatized. Women perceived vulnerability as an inability to adequately care for themselves or their children, necessitating additional support alongside routine antenatal care. Acceptance of the ’vulnerable’ label came when it also acknowledged their proactive efforts and strengths to improve their situation. Conversely, if discussions surrounding vulnerability failed to recognize women’s agency – specifically, their personal journeys and the courage needed to seek support – the label was perceived as stigmatizing. Addressing vulnerability effectively in maternity care requires a nuanced, patient-centered approach, acknowledging both the challenges and strengths of women facing psychosocial adversities. Emphasizing personal narratives and their courage in seeking support can mitigate the stigmatizing effects of the ’vulnerable’ label. Integrating these narratives into maternal healthcare practices can foster deeper connections with the women involved, enhancing the overall quality of care.