A concept analysis of women's vulnerability during pregnancy, birth and the postnatal period

Abstract

Aim To report an analysis of the concept of vulnerability associated with pregnancy, birth and the postnatal period. Background The concept of vulnerability during childbirth is complex and the term, ‘to be vulnerable’ frequently attains a vague application. Analysis about vulnerability is needed to guide policy, practice, education and research. Clarity around the concept has the potential to improve outcomes for women. Design Concept analysis. Data sources Searches were conducted in CINAHL, EMBASE, PubMed, Psychinfo, MEDLINE, MIDIRS and ASSIA and limited to between January 2000 – June 2014. Data were collected over 12 months during 2014. Methods This concept analysis drew on Morse's qualitative methods. Results Vulnerability during pregnancy, birth and the postnatal period can be defined by three main attributes: (a) Threat; (b) Barrier; and (c) Repair. Key attributes have the potential to influence outcome for women. Inseparable sub‐attributes such as mother and baby attachment, the woman's free will and choice added a level of complexity about the concept. Conclusion This concept analysis has clarified how the term vulnerability is currently understood and used in relation to pregnancy, birth and the postnatal period. Vulnerability should be viewed as a complex phenomenon rather than a singular concept. A ‘vulnerability journey plan’ has the potential to identify how reparative interventions may develop the woman's capacity for resilience and influence the degree of vulnerability experienced. Methodology based around complex theory should be explored in future work about vulnerability.

Journey of vulnerability: a mixed-methods study to understand intrapartum transfers in Tanzania and Zambia

“…Qualitative findings suggest a level of vulnerability for women during transfer that resonates with the concept analysis described by Briscoe et al [35]. Briscoe discovered three attributes to vulnerability directly related to childbirth: 'threat', 'barrier' and 'repair'.…”

PTSD post-childbirth: a systematic review of women’s and midwives’ subjective experiences of care provider interaction

“…In other words, women's constructions of midwives' attitudes and behaviour towards them reflect their views of how they perceived they were treated as opposed to physically what happened to them. The further finding that women lacked confidence in their midwives, being related to either the midwife's competency or level of control in the situation, reflect that women need to rely on and trust their midwives at a time of vulnerability (Briscoe, Lavender, & McGowan, 2016;Simkin & Hull, 2011). These assertions are strengthened by the finding that an unmet desire for support was a significant factor predisposing the development of PTSD-PC.…”

The COVID-19 Pandemic in Spain: Experiences of Midwives on the Healthcare Frontline

“…This type of methodological technique is very useful since it is understood as “a communication process that occurs in previously negotiated and planned meetings between subjects” [ 23 ] in order to take a closer look at the experiences surrounding the studied phenomenon. To prepare the interview outline ( Figure 1 ), we started with a bibliographical search of the literature published up to the time that we started our research on the experiences of professionals in the care of childbearing women with COVID-19, and also in relation to vulnerability within the area of obstetric care [ 24 ].…”