Discussion
Analysis of the interviews in this study indicates that there is a delay in the stages of maternal role attainment as described by Mercer (1981) in women suffering from HG. Women suffering from continual nausea isolate themselves from family and friends. The anticipatory
stage that begins during pregnancy is altered. The 8 participants stated that they were so overcome with HG that they were not as concerned for the fetus as they may have been otherwise. The women in this study were too ill to anticipate delivery, plan for the baby, or participate in social activities. As a result, the social and psychological adjustments to pregnancy were altered until HG subsided and the women had regained some control. The formal or role-taking stage may also be affected because the woman with HG has a need to make up for lost time. Most of the participants (7 out of 8) reported that they could not become emotionally attached to the fetus, and they made extra efforts to bond with the infant after delivery at a time when learning infant cues and developing infant care skills should take place.
Previous studies have shown that HG does have a negative impact on the daily lives of women who experience it. Results of this study support many of the findings of O’Brien et al. (2002). Having HG is a daily struggle, and during the struggle, women move through a process of trying to cope with symptoms. This ultimately leads to social and psychological isolation until symptoms abate. It is evident from both this research and previous studies that women experience negative feelings throughout this struggle including guilt, loneliness, shame, frustration, and worry. The theory generated from this study does not refute the theory of O’Brien and coworkers. It provides more information about how HG may also impact maternal infant attachment and a woman’s role as a mother.
Because the participants were asked to describe how they felt about having HG, they were free to talk about any aspect of the experience they chose, not necessarily the impact on the maternal role. Grounded theory methodology strengthened this study because it provided the investigator the freedom to explore by direct questions, while focusing on the stories of people who have firsthand experiences.
A limitation of the study is that results are from a specific population. The participants were 8 White women living in the southeastern United States, whose ages varied from 19 to 35. The impact of HG on women in other cultures, specific age groups, or in other geographic areas could differ.
Implications for Nursing Practice
The findings of this study have implications for nurses in planning and providing care for women suffering from HG. Because the anticipatory stage is delayed, the usual prenatal education efforts may not be as effective for women with HG. This means that last-minute information or additional coaching may be needed as the woman moves through the intrapartum and postpartum periods.