‘I think motherhood for me was a bit like a double-edged sword’: the narratives of older mothers

'Living in two worlds': A qualitative analysis of first-time mothers' experiences of maternal ambivalence

OBJECTIVE

The aim of this qualitative study was to examine experiences and meanings of maternal ambivalence in first-time mothers with young children.

BACKGROUND

In contrast with normative expectations surrounding contemporary motherhood, there is growing recognition that becoming and being a mother involves ambivalent feelings, and that these feelings are normal and have positive psychological consequences. Yet, little attention has been paid to women's subjective experiences of maternal ambivalence, and capacity to acknowledge and manage ambivalent feelings.

METHODS

Eleven semi-structured online interviews, with first-time mothers, were conducted and analysed using Interpretative Phenomenological Analysis (IPA) methodology.

RESULTS

Two group experiential themes were identified: Crossing boundaries of acceptable mothering feelings and Mothering from a place of 'enough'. Ambivalent mothering feelings challenged participants' expectations about motherhood and themselves as mothers, producing anxiety, self-doubt and feelings of failure. Distress accompanying maternal ambivalence was especially acute when participants perceived their feelings to be unacceptable. Viewing conflicting feelings with compassion, however, helped participants to cope with their diverse and fluctuating emotional mothering experiences, allowing them to mother with a greater sense of equanimity, agency and competence.

CONCLUSION

The study's findings indicate the potential benefits of providing information about the emotional turbulence of early motherhood as part of routine maternity care, as well as the potential value of offering parenting interventions that promote self-compassion to mothers struggling to manage feelings of ambivalence.

"It was not an accident": Women's experiences of renewing motherhood at 40

In recent decades, there has been an increase in motherhood at an advanced age that has raised several medical and social concerns. We conducted a qualitative interview study, guided by Interpretative Phenomenological Analysis, to focus on the motivations and experiences of Belgian women who 'renewed' their motherhood later in life, meaning they had one or several children and then (at least 10 years later) had another child at the age of 40 or older. We focused on ten women's experiences of motherhood later in life, as well as on the way they managed social norms and expectations regarding family building and the appropriate life course. We identified two main themes. The first theme describes the participants' encounters with social norms that challenged their decision to reproduce and parent later in life, and how they managed and anticipated criticism, surprise, disbelief and incomprehension about their renewed motherhood in various ways. The second theme shows how these women talked about taking responsibility as a (renewed) mother of advanced age. For them, responsible motherhood involved making thoughtful reproductive choices, attending to the range of needs of their children, and making extra efforts to safeguard the social and emotional wellbeing of their youngest children, thereby seeking to reduce potential harm resulting from these reproductive choices. This study provides insight into these women's self-conception and their interactions with prejudiced social views of motherhood and family building.

Occupations and balance during the transition to motherhood with a lifetime chronic illness: A scoping review examining cystic fibrosis, asthma, and Type-1 diabetes

INTRODUCTION

Throughout the transition to motherhood, changes are experienced across a woman's physical, mental, social, and occupational self. Maternal chronic illness adds the complexity of increased healthcare needs and navigating a high-risk, medicalised pregnancy, birth, and post-natal period. Literature concerning motherhood transitions in chronic illness generally focusses on the mother's medical health and pregnancy outcomes; little is known about the impacts on women's occupations, balance, and quality of life. Understanding these issues may help support women in a more tailored and holistic way.

OBJECTIVE

This scoping review aims to gather, analyse, and synthesise existing empirical research on occupational engagement and occupational balance as they impact on wellbeing and quality of life in women with a lifetime chronic illness before and during pregnancy and in early motherhood.

METHOD

The review follows the nine-stage framework described in the Joanna Briggs Institute Manual for Evidence Synthesis (2020). Five databases were searched: Embase, Medline, PsycINFO, CINAHL, Scopus, and OT Seeker. Data were extracted and examined via content analysis, described in narrative synthesis, summarised into a conceptual framework, and tabulated.

FINDINGS

A total of 8,655 papers were discovered on initial search. Following title and abstract screening, 220 full-text studies were assessed for eligibility, and 46 papers were finally included. Analysis generated four major themes: The Disrupted Transition Journey; Adaptation, Compromise and Choice; Outcomes; and Drawing on What's Available. The themes were conceptualised into a framework to explain how women sought to balance motherhood and illness-related occupations. Adequate access to information, social support, expert care, and financial resources improved both quality of life and healthcare compliance.

CONCLUSION

Findings of this scoping review deepen the understanding of occupational balance during the transition to motherhood in the context of lifetime chronic illness. Healthcare providers and supportive family and friends can use this knowledge to adapt their approach to assisting women with chronic illness on the motherhood journey. These findings may also inform further inquiry into the scope of occupational therapy practice with this population.

The role of motherhood schemas and life transitions in reproductive intention formation

OBJECTIVE

This study provides a theory-based snapshot of the processes involved in women's fertility intention formation and decisions regarding the timing of motherhood.

BACKGROUND

The trend to defer childbearing is linked with both empowering and challenging outcomes for women. The cognitive-social (C-S) model suggests that deliberative thinking regarding reproduction occurs following fertility-relevant life transitions, which results in fluctuations in motherhood schemas and fertility intentions. This framework was applied to explore fertility intention formation.

METHODS

Semi-structured interviews were conducted with twelve women who either had children or desired children.

RESULTS

Two overarching themes central to the C-S model are discussed: (a) passive expectations and (b) deliberative intentions. Women's motherhood schemas were often underpinned by schematic structures (e.g. group norms and scripts) and material structures (e.g. observational influences). Life transitions and personal experiences tended to prompt deliberative thinking about motherhood plans.

CONCLUSION

The results were generally consistent with the C-S model, but highlight complexities to consider when investigating fertility expectations and intentions.

'He's out of control, I'm out of control, it's just - I've got to do something': a narrative inquiry of child to parent violence

Families globally experience child to parent violence (CPV). Stories of CPV have been considered at an individual and collective level to ascertain themes in parents' accounts to identify enabling and restraining factors for CPV. However, understanding the societal narratives, defined as discourses, which have a multi-directional and entangled relationship with individual recounts of CPV have yet to be investigated. This research utilizes Narrative Inquiry with participatory approaches to explicate the societal narratives within mothers' recounts of CPV. This analysis, guided by the interactional and discursive view of violence, and response-based practice, identifies societal narratives which set the conditions for what is possible and impossible in relation to CPV. The analysis contributes to understanding the attitudes of minimization and concealment of violence within parents' accounts of CPV. The mothers' recounts were constrained and made possible by the 'good' mother narrative and narratives of adolescence and gender. This research examines the intra-actions mothers' recounts have with the societal narratives, and the performance of their roles as (en)actors of the subject positions 'mother' and 'child'. Implications for practice and research include: consideration to practitioner's views of power and subject positions in a parent and child relationship when working with CPV; and practitioners to be critical of essentialism and gender in working with CPV. This study posits a practical demonstration for using the response-based practice approach in research; and a way of viewing stories which can be incorporated in working with families experiencing CPV.

The making of 'old eggs': the science of reproductive ageing between fertility and anti-ageing technologies

This article proposes going back in the history of reproductive medicine to shed light on the role of assisted reproductive technology (ART) in the making of 'old eggs'. Focusing on two key technologies - egg donation and cytoplasmic transfer - both of which contributed significantly to the production of scientific knowledge about reproductive ageing, the article suggests that ART can be analysed as 'in-vivo models' playing a pivotal role in the shift from age as a demographic variable to ageing understood in biological terms. It will shed light on the role of ART in locating age in the eggs and producing a cellular understanding of fertility decline. It argues that ART not only offers new means of reconfiguring the biological clock by extending fertility, but also reconfigures the biology of reproductive ageing itself. This becomes both the target and the means for new technological interventions, imaginaries and norms, anchored in women's bodies and a more plastic biology, and thereby illuminates hitherto underexplored aspects of the encounter between the science and technology of reproduction and anti-ageing.

The breastfeeding and early motherhood experiences of older first-time mothers: A constructivist grounded theory study

OBJECTIVE

The objective of this paper is to present the results of a qualitative study that explored the factors surrounding decision-making related to breastfeeding and the experiences of early motherhood for 23 first-time mothers over the age of 35 in Canada. Previous studies on breastfeeding have not examined older first-time mothers as a group that is unique due to their experience of coming to motherhood in the context of the growing phenomenon of delayed childbearing in the 21st century. Many older women come to motherhood with both well- established life and professional experiences, and as such their needs may differ from their younger or multiparous counterparts. The research question was: "What factors affect how first-time mothers >35 years of age make decisions about breastfeeding, and how do these factors affect the decisions they make related to breastfeeding and their transition to motherhood in the first six months postpartum?"

DESIGN

Constructivist grounded theory FINDINGS: The theory of From Ideology to Independence: Older First-time Mothers, Breastfeeding, and Becoming a Mother provides a lens to view the underlying processes influencing the decisions the mothers made related to breastfeeding and early motherhood. The mothers worked through the processes of learning breastfeeding, redefining self, and defining motherhood. The mothers' belief that breastfeeding defines motherhood, coupled with lack of knowledge and control, had a negative effect on both early breastfeeding and their transition to motherhood. As the idea of breastfeeding equating successful mothering waned the mothers became active agents in decision-making related to infant feeding and mothering.

Oxytocin receptor gene (OXTR) variant rs1042778 moderates the influence of family environment on changes in perceived social support over time

BACKGROUND

Lack of social support is an established risk factor across health outcomes, making it important to examine its family environmental and genetic determinants.

METHODS

In a 27-year follow-up of the Young Finns Study (N = 2341), we examined with a latent growth curve model whether genes involved in the oxytocin signaling pathway-namely, oxytocin receptor gene (OXTR) variants rs1042778, rs2254298, and rs53576-moderate the effect of early-life social experiences on perceived social support across the life span. Mothers reported the emotional warmth and acceptance towards their children at baseline when the participants were from 3 to 18 years old (1980). Perceived family support and support from friends and peripheral sources were assessed in five follow-ups 18 years apart (1989-2007).

RESULTS

Maternal emotional warmth and acceptance predicted the initial level of perceived social support across subscales, while the rate of change in family support was affected by the family environment only if participants carried the T-allele of OXTR rs1042778. This gene-environment interaction was not found for the rate of change in support from friends and peripheral sources and we also did not find associations between latent growth in perceived social support and OXTR variants rs53576 and rs2254298.

LIMITATIONS

Selective attrition in perceived social support, maternal emotional warmth and acceptance, gender, and SES. Family environment was assessed by a non-standardized measure.

CONCLUSIONS

OXTR rs1042778 polymorphism seems to contribute to changes in perceived family support in that way that some individuals (T-allele carriers) 'recover', to some extent, from the effects of early-life social experiences, whereas others (G/G genotype carriers) do not.

When Your Pregnancy Echoes Your Illness: Transition to Motherhood With Inflammatory Bowel Disease

Our aim is to provide an understanding of the experience of women with inflammatory bowel disease (IBD) who have made the transition to motherhood. A total of 22 mothers with IBD were recruited from around the United Kingdom. Semi-structured interviews were conducted and analyzed using thematic analysis. The central concept- Blurred Lines-offers a novel frame for understanding the transition to motherhood with IBD through identifying parallels between having IBD and becoming, and being, a mother. Parallels clustered into three main themes: Need for Readiness, Lifestyle Changes, and Monitoring Personal and Physical Development. Hence, women with IBD are in some ways well prepared for the challenges of motherhood even though, as a group, they tend to restrict their reproductive choices. We recommend health professionals initiate conversations about reproduction early and provide a multidisciplinary approach to pregnancy and IBD in which women have confidence that their ongoing treatment will be integrated successfully with their maternity care.

Conceptualising women's motivations for social egg freezing and experience of reproductive delay

As the average age of motherhood in many Western countries continues to rise, the spectacle of the older mother and the trend towards delayed childbearing has been the subject of much public debate and interest. Concurrent to this trend has been the development and use of a new form of fertility preservation - social egg freezing - a technology which by its very nature is meant to enable reproductive delay. Whilst previous studies have been able to provide insights into the complex and often interrelating structural, economic, and relational factors shaping the timing of motherhood, and in some cases women's use of social egg freezing, fewer studies have clearly demonstrated the way these factors themselves, as well as the accounts of individual women, can be seen as being shaped by ideological and discursive forces. Drawing on interviews with 31 users of social egg freezing this article will demonstrate how women's accounts of reproductive delay and use of egg freezing technology can be seen as being shaped by neoliberal rationality, heteronormativity, discourses of 'appropriate parenting' and gendered ideologies of parenthood.

“For some people it isn’t a choice, it’s just how it happens”: Accounts of “delayed” motherhood among middle-class women in the UK

Over the past few decades the number of women having their first babies over the age of 35 in the United Kingdom has increased. Women’s timing of motherhood is invariably bound up with a discourse of “choice”, and in this paper we consider the role choice plays in the timing of motherhood among women who have been defined as “older” mothers. This article is based on data from 11 semi-structured interviews that explored the transition to motherhood among “older” middle-class mothers. The interviews were analysed using critical discursive psychology. The women drew upon two dominant repertoires when making sense of their timing of motherhood. Within the first repertoire, “older motherhood as circumstance”, older motherhood was presented as the outcome of life circumstances beyond their control, with a lack of the “right” circumstances facilitating “delayed” motherhood. Within the second repertoire, “older motherhood as readiness”, women constructed themselves as (now) prepared for motherhood. “Readiness” was bound up with notions of self-fulfilment, yet also assessments of their ability to be “good” mothers. We conclude that, far from a straightforward choice, the timing of motherhood is shaped by cultural definitions of the “right” circumstances for parenthood, but also cultural definitions of “good” motherhood, which may define when women are “ready”.

Hearing voices: re/presenting the findings of narrative research into patient experience as poems

The study aimed to understand the experience of being a patient on an acute psychiatric inpatient ward. A further aim was to open up spaces for the voices of participants to be heard. Contemporary government policy places patient experience at the centre of healthcare policy and service development. Despite this, those who occupy marginalized discourses struggle to be heard within the dominant discourse of health care. A qualitative approach was used, and narrative was conceptualized as representing experience. Sociolinguistic theories informed the development of the analytic framework treating meaning as contextual and arising from both content and structure of narratives. Concepts of representation, voice and authorship were problematized. Thirteen people who had been inpatients on an acute psychiatric inpatient ward participated. Narrative data were gathered using unstructured interviews. The data were analysed holistically using a method that attended to both the structure and content of the narrative. The product of these holistic narratives was the development of a poem representing each participant's experience. This paper focuses on the development of these poems as a method of decentring the authorial voice and opening up spaces for the voices of the participants to be heard.

'It should be the most natural thing in the world': exploring first-time mothers' breastfeeding difficulties in the UK using audio-diaries and interviews

Breastfeeding is a practice which is promoted and scrutinized in the UK and internationally. In this paper, we use interpretative phenomenological analysis to explore the experiences of eight British first-time mothers who struggled with breastfeeding in the early post-partum period. Participants kept audio-diary accounts of their infant feeding experiences across a 7-day period immediately following the birth of their infant and took part in related semi-structured interviews a few days after completion of the diary. The overarching theme identified was of a tension between the participants' lived, embodied experience of struggling to breastfeed and the cultural construction of breastfeeding as 'natural' and trouble-free. Participants reported particular difficulties interpreting the pain they experienced during feeds and their emerging maternal identities were threatened, often fluctuating considerably from feed to feed. We discuss some of the implications for breastfeeding promotion and argue for greater awareness and understanding of breastfeeding difficulties so that breastfeeding women are less likely to interpret these as a personal shortcoming in a manner which disempowers them. We also advocate the need to address proximal and distal influences around the breastfeeding dyad and, in particular, to consider the broader cultural context in the UK where breastfeeding is routinely promoted yet often constructed as a shameful act if performed in the public arena.

'Inconvenient biology:' advantages and disadvantages of first-time parenting after age 40 using in vitro fertilization

BACKGROUND

As ages at first birth have steadily risen in the industrial west over the last several decades, the phenomenon of 'delayed childbearing' has come under research scrutiny by demographers, medical specialists and social scientists. In this study, we specifically explore the perceived advantages and disadvantages of postponed conception as well as participants' retrospective opinions on the 'optimal age' for parenting.

METHODS

To this end, we examined a cohort purposely chosen to epitomize delayed childbearing, i.e. men and women who used IVF to conceive at the very end of their reproductive capability. In-depth qualitative interviews were conducted between 2009 and 2011 with 46 couples and 15 individual self-selected US women and men who had used IVF to conceive their first child when the woman was aged 40 or older at the time of delivery. Although the demographics of this cohort were consistent with others who use IVF in the USA, their median income was 3-4 times higher than that of the average US family, which may bias their largely positive parenting experiences.

RESULTS

Most women and men believed that childbearing later in life resulted in advantages for themselves and their families. These included having established careers with financial security and career-time flexibility, enhanced emotional preparedness, committed co-parenting relationships and a positive overall family experience. The main disadvantage was the unexpected difficulty in conceiving that culminated in the use of IVF and resulted in a smaller family than desired, although many expressed feeling 'lucky' to have children at all. Other disadvantages were lack of energy for parenting, less available lifetime to spend with children and anticipated stigma as older parents.

CONCLUSIONS

These disadvantages appear to have influenced conception and parenting experiences so that in hindsight the majority of participants identified the optimal age for first-time parenting as 5-10 years earlier than they had conceived. This age range was imagined to maximize the financial and emotional advantages of later parenting while minimizing the impact of age-related infertility, diminished energy, anticipated health issues and the social stigma of appearing too old to parent.