Adult Perceptions of Healthy Pregnancy: A Focus-Group Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Study Participants
2.3. Data Collection
- What does healthy pregnancy and childbirth mean to you and why does high-risk pregnancy occur?
- What do you think that are the roles of men and women, families, government, and society in preventing high-risk pregnancy?
2.4. Ethical Considerations
2.5. Data Analysis
2.6. Study Rigor
3. Results
3.1. Healthy Pregnancy—Responsibility Requires Preparation
3.1.1. Financial Preparation
- The biggest issue, people say, is a financial thing. In Korea, it is too expensive to educate children.… I think it is the first reason in our society why it is so easy to hear that people talk about giving birth with no responsibility. (Focus Group[FG]4, unmarried Woman[W]6)
- I think that the husband’s economic capacity is important because the process throughout the pregnancy and childbirth actually includes an economic piece. As was already mentioned, our psychological comfort is somewhat affected by economic support. If I get pregnant, I need to rest from my work in some ways, so I think the husband’s economic capacity may be important. (FG3, unmarried Man[M]2)
- Most couples get married but decide not to have a baby. Too much money is needed. All the reasons have to do with money. The biggest reason for not having a second baby is actually an economic reason (FGI9, married W3).
3.1.2. Preparation for Parenthood
- Prior to pregnancy as well as birth, I think pregnancy should have planned ahead. I have seen a lot of cases when people got pregnant and then got married. I think that pregnancy should be planned and prepared thoroughly, medically and socially. (FG1, unmarried M6)
- Prepare for my health: I was talking about some medications before. Our pastor said that people should not be married without any preparation in how to be a father and how to take care of a child and must prepare for marriage, for example, by taking a course in marriage preparatory school before getting married and pregnant. (FG5, married W4)
- Preparation of the physical body: Exercise and healthy eating habits. Many participants stated they should prepare their bodies to become pregnant, regardless of gender. They advocated habits of good body management, especially exercise and eating habits.
- I think men should also do health checks. In fact, men who are in their 40s have to be examined and some issues cannot be fixed at that time. So, it is better to begin and continue to get health checkups and exercise earlier while young. I actually exercise regularly. (FG3, unmarried M3)
- I think I should keep managing my body early before marriage. Because I could get pregnant right after I got married. But, if I were pregnant and my body condition were not ready for a child, then I think it is irresponsible to be a parent. (FG4, unmarried W3)
- I think I should improve my eating habits a bit. I also eat too much fast food and too much instant food, so I think I should improve that part. And, I’ve been hearing a lot about environmental hormones since I was a kid. I think I should pay more attention to that kind of thing. (FG3, unmarried M2)
- 2.
- Preparation of parental mind: To become a parent through a healthy pregnancy, the couple should have a plan for pregnancy and think about what to do and how to prepare for the child to be born.
- Continuing my job after childbirth is a big issue. It could be very stressful, and it is also a very big issue for the baby and mother’s health. Regarding this, I think the mother should communicate enough with her husband and make a mutual plan, so that potential risks from a pregnancy can be diminished, so we can do well later. (FG8, unmarried M2)
- I have thought a lot about mentality when I thought of my pregnancy. Living with a child is not physically easy. Changes in physical health also change perceptions. I want to give birth to three children, but my body may not be able to handle it. If so, I would feel stressed and depressed about that and also pressure my children. Then, I should not think of giving birth to too many children thoughtlessly. (FG4, unmarried W5)
- 3.
- Change individual perceptions about pregnancy and childbirth: In their 20s and 30s, many unmarried participants thought pregnancy and childbirth are “difficult” and “painful.” They expressed complex and diverse ideas, feeling a heavy sense of responsibility. These thoughts about pregnancy and childbirth dominated the younger generation’s conceptions of family, preventing them from choosing to have children. They prioritized their own happiness. Participants thought it necessary to change individual perceptions for more people to give birth.
- I have not thought of the idea of pregnancy and childbirth as good since I was a child. Of course, I would like to raise a child who resembles me, but I am afraid that the process is so painful. I have no confidence in the process of enduring all that pain. I do not seem to be well aware of the way I see things often. (FG1, unmarried F1)
- In fact, the value of home, marriage, pregnancy, and childbirth does not really touch me well. Why should we marry? I do not see why I should pack up my family and why I should be pregnant. I can only say that I am indifferent to such things, and there are more people like me. It seems to be contributing to a low birth rate. I still have not changed my mind. I think the value of pregnancy and these things is not acceptable. (FG1, unmarried M3)
- I think that the value of connecting a household with the family was very important in my mother and father’s generation, but it seems that the value of my family is really blurred and the value of happiness is more important in my generation. Mom and Dad say to me, “If you want to give birth, do it; if you do not want to give birth, do not give birth.” But, I do not know if I would hear that from my grandfather. (FG1, unmarried M6)
3.2. What Are the Barriers to Healthy Pregnancy?
3.2.1. Direct Causes Related to High-Risk Pregnancy
- Old age: Most participants referred to the age of the future mother as a factor in high-risk pregnancy. Participants considered that various personal and social factors about marriage and childbirth delayed marriage and, as an outcome, caused high-risk pregnancies and late childbirth.
- In my opinion, the age to get a job is delayed; then, the age to marry is also delayed, and the age to prepare for a house is delayed. [High-risk pregnancy] seems to be naturally occurring. (FG8, unmarried M5)
- As far as I know, a mother gets pregnant with a physical disease or is not ready for pregnancy. I heard that the mother’s older age is going to be more than mid-30s for high-risk pregnancy. (FG3, unmarried W5)
- My mother always says, “so you should get married as soon as possible, and when you get much older, then you may not be able to even have a baby.” (FGI2, unmarried F2)
- 2.
- Diseases and Stress: Participants said that various stresses, such as work and family conflicts, may cause high-risk pregnancies as well as underlying diseases.
- I also remember that pregnant women with diabetes and hypertension and so on is called a high-risk pregnancy. (FG3, unmarried F6)
- At first, I had an irregular menstrual cycle due to polycystic ovary syndrome. I have not been pregnant for a year. Then, I went to the hospital and was prescribed medication. (FGI6, unmarried W2)
- I felt stress as I got older and stressed more when things come. I felt like I had some worse results. (FG8, unmarried M5)
3.2.2. Indirect Causes Related to High-Risk Pregnancy
- 1. Changes in women’s values and perceptions: Young women in their 20s and 30s have quite different perceptions about pregnancy and childbirth from their mothers. Young participants said they would choose marriage or pregnancy as a choice rather than an obligation or responsibility and with a firm preference for an independent life and thorough preparation. Some participants perceived their life changes as becoming irreversible throughout a pregnancy.
- I am 42 and working. My colleagues around me are 38, 36, and 34 who are all unmarried. When I ask why not, they said, “I have a boyfriend, but I do not feel the need for marriage.” I think they are able to be responsible for themselves, so they seem to find others similar to themselves. And, there is something annoying about a child. ”Why should I do such a thing because of the baby?” (FG7, married W8)
- I tend to think that pregnancy and childbirth are somewhat irreversible because, before and after the process of pregnancy and childbirth, there are many changes, whether physical or mental, personal, or social, anyway. It may be a little dangerous, a process that is destroying a process in my life, or a process of living just by taking a physical risk. When I think about it a little bit, I think it is impossible to recover. The feeling of being in an unrecoverable situation rather than a transition period, I think that’s a negative thought. (FG1, married W5)
- I married when my husband was in the military. At that time, I was not mature, so I thought that if I really had love, I would live, and I thought it was all done with just getting married. I got married without thinking about the culture of my husband’s family. (FG5, married W2)
- Young couples, I wish they knew that the process of birth is worthwhile. (FG7, married W2)
- We have to work hard in our generation to be dedicated to our children, but our kids are not like our parents. Our kids say, “I’m free. Unlike my mother and father, I’m making money to go travel and I’m not going to be interrupted.” I would like them to change the concepts of marriage. If the concept of marriage changes, the rest of the issues will be solved. (FG5, married W1)
- 2.
- Lack of (poor) school and home education about sex: Sex education in school is quite basic and biologically oriented, so knowledge related to the process of pregnancy and childbirth is insufficient among adults.
- I do not know exactly what we are talking about, even though we are in the mid-20s, as to what is high-risk pregnancy. It is a problem that should be treated in sex education. So, I thought that if I knew a little more, I could prepare and plan. (FG3, unmarried M2)
- If you look at young people or those people, you can have sex without thinking and get pregnant before you are ready. If so, a high-risk pregnancy or something like that might happen. I think men need to know more about high-risk pregnancies. I think it would be nice to know some more about if there are precaution strategies. I did not learn about high-risk pregnancy in sex education. (FG8, unmarried M4)
- Sex education, it is important in the school, but in the family, I think I should learn it from childhood. I have heard something in foreign countries that they are saying these things are fairy tales from childhood, but it is not so in Korea. We think it is a shame. (FG3, unmarried W4)
- My husband did not teach my children regarding masturbation during our boy’s puberty. We have to do that (education), but we could not do that because it was awkward. (FG5, married W1)
3.3. Improving Strategies for Healthy Pregnancy
3.3.1. Family (Parental) Support
- Nowadays, parents should not force their child to get pregnant. I think pregnancy should be planned under the couples’ own will. If someone around me presses me about why I don’t have a baby, then I may not be prepared. (FG8, unmarried M2)
- It seems to be good to reduce the burden of being attached to a certain sex (girl or boy) mentally. I do not think that many people can do that in a positive way, such as if I am in a position to be able to care for a child later by buying a house near my parents’ house. There may be a negative part, but a positive part is helpful for me. I think that’s part of the role of the family too. (FG8, unmarried M2)
3.3.2. Support in the Workplace
- It is a same matter for a man or woman, more than anything else in pregnancy and childbirth in Korea. Is it a social restriction? I think I should be rewarded with a little more social benefit. When women give birth to a baby, women need to take maternity leave so they can give birth freely. I think my job should be guaranteed when I go on vacation. (FG8, unmarried M5)
- I have to be promoted, but it seems delayed because of childrearing. This kind of invisible discrimination exists from the time of planning a pregnancy to the childbirth, even though I do not tell anyone that I seem to be getting stressed. (FGI9, married W3)
3.3.3. Building a Systematic Education System
- I want to receive education like that about high-risk pregnancy. I think we need that too. So, we get to know about it and prepare for it so that we can make it. Then, if we eat appropriate food in a good environment, it will help us much more. We did not have such education or such a system at all. I’m just going to be a mom. (FG7, married W2)
- I think we should be educated by the nation. It would be awesome if we had something like pregnancy, childbirth, or high-risk pregnancy in our national education policy. (FG8, unmarried M2)
- I think it is necessary to start with things like pregnancy and the risk of giving birth, starting from adolescence and teaching it precisely. (FGI2, unmarried W1)
- Nowadays, it is better to find a website such as a mom café. I would use it when I have a baby or later.… What is the role of a man and a woman in the case of high-risk pregnancy? If there are easier ways to find better information in apps or in other ways, I would choose those ways. (FG8, unmarried M2)
3.3.4. Substantial Support for Pregnancy/Childbirth/Childrearing
- I do not know what kind of support is being given in the country right now. (FG3, unmarried W7)
- The first problem is policy as well, and there should be a lot of support for childbirth and childrearing. (FG7, married M6)
- I do not know where I am now. If we say a high-risk pregnant woman is older than 35 years old, supporting health checkups or only screening for pregnancy-related items into the 30s or late 20s, would that be helpful? (FG3, unmarried M2)
3.4. The Healthy Pregnancy Model
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Focus Group | No. of Participants | Gender | Age | Marital Status | Duration of Interview (min) | Interview Time | |||
---|---|---|---|---|---|---|---|---|---|
Male | Female | Range | M | SD | (M ± SD) | ||||
A | 7 | 4 | 5 | 21–24 | 22.57 | 0.98 | Unmarried | 77 | Evening |
B | 5 | 2 | 3 | 25–32 | 28.60 | 3.29 | Unmarried | 72 | Evening |
C | 7 | 3 | 4 | 20–25 | 23.29 | 2.06 | Unmarried | 73 | Evening |
D | 6 | 2 | 4 | 26–35 | 30.83 | 3.43 | Mixed | 93 | Afternoon |
E | 8 | 3 | 5 | 50–62 | 57.25 | 3.81 | Married | 82 | Afternoon |
F | 7 | 4 | 5 | 31–39 | 34.43 | 2.76 | Married | 108 | Evening |
G | 8 | 3 | 5 | 42–52 | 46.38 | 3.66 | Married | 110 | Afternoon |
H | 5 | 5 | 32–34 | 32.80 | 0.84 | Unmarried | 72 | Evening | |
I-1 | 6 | - | 6 | 33–37 | 34.33 | 1.75 | Married | 63 | Afternoon |
I-2 | 7 | - | 7 | 33–44 | 35.71 | 3.99 | Married | 68 | Afternoon |
Total | 60 | 25 | 35 | 20–62 | 36.26 | 11.67 | 81.80 ± 16.48 |
Characteristics | Total | Male (n = 26) | Female (n = 34) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
N | % | M | SD | n | % | M | SD | n | % | M | SD | |
Age | 35.55 | 11.52 | 34.62 | 11.48 | 36.26 | 11.67 | ||||||
20–29 | 19 | 31.7 | 8 | 30.8 | 11 | 32.4 | ||||||
30–39 | 24 | 40.0 | 12 | 46.2 | 12 | 35.3 | ||||||
40+ | 17 | 28.3 | 6 | 23.1 | 11 | 32.4 | ||||||
Marital status | ||||||||||||
Single | 28 | 46.7 | 15 | 57.7 | 13 | 38.2 | ||||||
Married | 32 | 56.7 | 11 | 42.3 | 21 | 61.8 | ||||||
Experience of pregnancy 1 | ||||||||||||
Yes | 24 | 40.0 | 7 | 26.9 | 17 | 50.0 | ||||||
No | 36 | 60.0 | 19 | 73.1 | 17 | 50.0 | ||||||
Experience of birth 1 | ||||||||||||
Yes | 21 | 35.0 | 6 | 23.1 | 15 | 44.1 | ||||||
No | 39 | 65.0 | 20 | 76.9 | 19 | 55.9 | ||||||
Number of children (n = 24) | 2.61 | 1.16 | 3.33 | 0.82 | 2.33 | 1.18 | ||||||
Age at last pregnancy or birth (n = 24) | 35.5 | 4.75 | 37.00 | 3.42 | 34.88 | 5.16 | ||||||
Education level | ||||||||||||
High school | 14 | 23.3 | 7 | 26.9 | 7 | 20.6 | ||||||
College | 35 | 58.3 | 14 | 53.8 | 21 | 6.18 | ||||||
Graduate school | 11 | 18.3 | 5 | 19.2 | 6 | 17.6 | ||||||
Religion | ||||||||||||
Yes | 44 | 73.3 | 17 | 27 | 79.4 | |||||||
No | 16 | 26.7 | 9 | 7 | 20.6 |
Core theme | 3 Categories | 8 SubCategories | 12 Codes | 18 Initial Codes |
---|---|---|---|---|
Healthy pregnancy influencer | Theme 1: Prepared pregnancy that can take responsibility | Financial preparation | Economic power | Child support expense |
Preparation for parenthood | Preparation of the body | Exercise | ||
Healthy eating habits | ||||
Preparation of the mind | Planned pregnancy | |||
Stress management | ||||
Perception changes about one’s parental role in members of the younger generation | Need of alternatives for negative perception about pregnancy and childbirth | |||
Theme 2: Factors that interfere with healthy pregnancy | Direct causes | Old age | Advanced maternal age | |
Diseases and stress | Chronic disease | |||
Stress | ||||
Indirect causes | Changes in modern women’s values | Focus on self-centered life | ||
Lack of education at school and home | School education | |||
Home education | ||||
Theme 3: Improving strategies for healthy pregnancy | Support in the family | Parent’s assist, help for childrearing | Parent’s support for child-caring | |
Support in the workplace | Ensure maternity rights at work | Ensuring career of working women, maternity leave | ||
Support of systematic education | Building educationalsystem | Preparing an education program | ||
Providing education through various media | ||||
Support of the government | Substantial support for pregnancy/childbirth/childrearing | Financial support | ||
Health screening support |
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Share and Cite
Kim, H.W.; Kim, D.H.; Lee, H.Y.; Lee, Y.J.; Ahn, H.Y. Adult Perceptions of Healthy Pregnancy: A Focus-Group Study. Int. J. Environ. Res. Public Health 2020, 17, 2460. https://doi.org/10.3390/ijerph17072460
Kim HW, Kim DH, Lee HY, Lee YJ, Ahn HY. Adult Perceptions of Healthy Pregnancy: A Focus-Group Study. International Journal of Environmental Research and Public Health. 2020; 17(7):2460. https://doi.org/10.3390/ijerph17072460
Chicago/Turabian StyleKim, Hae Won, Duck Hee Kim, Hyang Yuol Lee, Young Jin Lee, and Hye Young Ahn. 2020. "Adult Perceptions of Healthy Pregnancy: A Focus-Group Study" International Journal of Environmental Research and Public Health 17, no. 7: 2460. https://doi.org/10.3390/ijerph17072460