Experiences of pregnant women in avoiding harmful substances

Abstract

Exposure to harmful substances during pregnancy may result in potential short and long term anomalies to the unborn baby. However, there is no exploration of the perspectives of pregnant women on this issue. This phenomenological study aimed to gain an in-depth understanding of the experiences of pregnant women in avoiding harmful substances in their everyday life. Between July 2019 and May 2020, data were collected from 17 pregnant women living in Nakorn Si Thammarat Province through in-depth interviews and reflexive journals. An interpretive process based on Cohen, Kahn, and Steeves (2000) was used for data analysis. Trustworthiness was achieved through member checking and peer debriefing. Four themes emerged from the informants’ experiences. Theme 1. Contextual sense of harmful substances: Informant understanding of harmful substances based on their personal context was grouped into the following 4 categories: 1) low, moderate, high, and false recognition of harmful substances; 2) categorizing harmful substances as a chemical/synthetic/unnatural group and a miscellaneous group; 3) justification of harms based on harmful characteristics, direct exposure and transmission, exposure magnitude, elimination and accumulation, vulnerable period, and body’s defense mechanism; and 4) sources for justifying harms from oneself and obtained information. Theme 2. The fundamentals of SIX: The practices and barriers to avoiding harmful substances included: 1) six practices of choosing, eliminating, ceasing, reducing, distancing, and using equipment; and 2) six barriers of non-recognition, working obligation, residence location, sharing household products/food and family tradition, unavailability of safe substances, and non-compliance with equipment usage. Theme 3. Safety in daily activities: The practices to achieve safety in 4 main daily activities: 1) safety in personal/household products usage; 2) food safety; 3) work safety; and 4) air quality safety. Theme 4. Overcoming challenges: Challenges in avoiding harmful substances were overcome through: 1) personal changes including being more careful, making efforts, sacrificing, enduring, and relying on maternal instinct; 2) obtaining non-professional support, needing more professional support; and 3) ensuring safety with regards to maternal mind and fetal well-being. In conclusion, pregnant women were concerned about harmful substances but not all harmful substances were well recognized and avoided due to some barriers. Pregnant women have their own ways of preventing exposure to harmful substances. The findings can be used as basic information for developing guidelines in helping pregnant women reduce exposure to harmful substances by tailoring them to pregnant women’s perspectives and lifestyles, leading to improved quality of nursing care practice.