(PS10-81) A Thematic Analysis of Peripartum Perceived Self-efficacy and Negative Cognition

Abstract Text: Many first-time mothers express anxious feelings as they progress through pregnancy and move closer to their delivery date. The childbirth process has been studied in some detail; however, researchers have seldom attempted to understand the cognitive aspects of women’s fear of childbirth. Studying expecting mothers’ anticipatory anxiety using a framework of social cognitive theory with a focus on perceived self-efficacy may allow researchers to understand better how women process anxiety about both physical pain and perceived control over anxious thoughts. Those with high self-efficacy are much less likely to engage in apprehensive thinking and less bothered by obtrusive anxious thoughts. Understanding that most environmental events are not always completely under a person’s control and contain some risk is critical to controlling anxiety. Exercising control over anxiety requires not only behavioral coping but also efficacy in controlling dysfunctional apprehensive thoughts. Thus, it is not calamitous or intimidating thoughts per se but the perceived self-efficacy to accept, that is the major source of anxiety arousal. First-time pregnancies provide a unique circumstance in which fears of the unknown, mixed with shifting hormones, can create a context in which more anxious thoughts than usual is experienced. Although much of the literature focuses on the content of anxious thoughts, little is known about how time to deliver mediates a woman’s anticipatory anxiety. The first set of research questions will aim to 1a) identify when women’s fear of childbirth begins, 1b) if different fears emerge and intensify over time, and 1c) determine to what extent does outside information influence anxiety at different points during pregnancy? The second question to be addressed in the study is 2) where do women’s childbirth expectations come from? No qualitative study has investigated acquisition of fear from vicarious experiences. It stands to reason that the more positive experiences a woman has with the childbirth process, the more confident she will feel in her own. Women in this study will be asked about their experiences viewing childbirth and how that impacted both their confidence and anxiety. Lastly, the study proposes to examine cognitive aspects of childbirth fear. Research question 3) will ask if pain catastrophizing and self-efficacy of anxiety management must be co-occurring phenomena. These themes will be discussed in relation to the overall pregnancy as well as in expectations for labor and delivery. Quantitative and qualitative analyses will be conducted following the completion of recruitment. Correlational analyses will be used to study the relationship between childbirth expectations and broad symptoms of anxiety and depression. Qualitative analyses will be analyzed using Thematic Analysis (TA). The study will use the six-step process of TA identified by Braun and Clarke (2006). The research team will familiarize itself with the data, generate initial codes, search for themes, review the themes by checking against the coded data and the full data set, define and name themes, then finalize the named themes for reporting. The proposed study would be the first to identify a sense of direction in the generation of the two phenomena.