UBC Theses and Dissertations
The childbearing experience for women with stomas : A multiple-case study Hawkins, Margery Edith
Although much research has been done on the daily challenges facing individuals with stomas, the experience of childbearing for women with stomas has not been addressed in the nursing literature. The research question put forth therefore was: how does a stoma affect the childbearing experience? Case study methodology was used to answer this question. This design allowed the researcher to use a variety of evidence to explore in depth a subject about which little is known. Six cases were selected for the study and data collection and analysis procedures were replicated for each case. An informal interview guide consisting of open and closed-ended questions was used to solicit information from six women with stomas who had experienced childbirth in the past eighteen months, their respective partners, and the physicians who provided their obstetrical care. Data were analyzed according to the major concepts of Snyder's (1979) holistic model of the childbearing experience and findings were presented in six individual case reports. Common issues were identified, expanded, and compared in a cross-case report. In each case, the stoma affected the woman's physiological, self, family, social, and cultural systems and these interacted to create six unique childbearing experiences. Although all the women delivered healthy babies, two serious physiological implications of having a stoma during pregnancy were noted. These included 2 cases of stomal prolapse and 3 cases of partial or complete bowel obstruction. Both complications necessitated hospitalization and caused anxiety and inconvenience for the woman and her family. However, the findings revealed that many of the technical, psychosocial, and cultural challenges faced by women with stomas during pregnancy are similar to those experienced on a daily basis by any individual with a stoma. It was concluded that women with stomas need pre-natal counselling to learn what to anticipate with pregnancy, labour and delivery, and postpartum and they need to participate in formulating a management plan for their pregnancy and hospitalization. Finally, basic and continuing nursing education programs need to address the affective, cognitive, and psychomotor skills necessary to care for these individuals during their childbearing experiences.
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