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Women's realities shape their experiences of health during pregnancy and postpartum

  • Author / Creator
    Quintanilha, Maira
  • Low socioeconomic status can negatively affect many aspects of a healthy pregnancy, including women’s ability to access and consume healthy foods. Food insecurity, defined as “inadequate or insecure access to food because of financial constraints,” has well-known effects on women’s health and stress levels, with increased nutrient and caloric demands during pregnancy placing women of low socioeconomic status at a higher risk of food insecurity. The overall purpose of these PhD studies was to explore the perceptions and experiences of health during pregnancy and postpartum among women facing difficult life circumstances (e.g., low income, recent immigration to Canada, social and geographical isolation) while receiving support from community-based perinatal programs offered through the Multicultural Health Brokers Cooperative (MCHB) in Edmonton, and Healthy Moms Healthy Babies (HMHB) in Southern Alberta. The prevalence and experiences of household food insecurity among immigrant and refugee women connected to the MCHB perinatal programs were also examined.
    Using a community-based research approach, focused ethnography was conducted with pregnant and postpartum North African women connected to MCHB perinatal programs, and women living in rural Alberta connected to HMHB. The method of focused ethnography involved focus groups with women (80 North African women; 28 women in Southern Alberta), interviews with health care and service providers (8), and observations of community-based perinatal program activities. All generated data were analyzed using qualitative content analysis to inductively derive codes and categories. The prevalence and experiences of household food insecurity were investigated using an exploratory sequential mixed method research design, which involved both quantitative (213 women connected to MCHB) and qualitative (17 Somali women) methods of data collection and analysis. Data were collected sequentially, analyzed separately, and then integrated in the discussion of findings.
    Northeast African women discussed that in their home countries regardless of their socioeconomic status they felt supported in pregnancy and postpartum as their kinship provided them with “everything they needed” to be healthy, including nutritious foods, physical activity opportunities, and adequate time for rest. In Canada, these women faced many difficult life circumstances, such as low income, that increased stress and created a sense of isolation. Rural women connected to HMHB perceived being healthy during pregnancy and postpartum as eating healthy foods, taking prenatal vitamins, being physically active and emotionally well; however, they commonly described facing many barriers to being healthy for themselves and their babies. These barriers included food insecurity, pregnancy complications, spousal issues, among others. Women connected to both MCHB and HMHB identified many aspects of community-based perinatal programs that addressed barriers they faced, and enabled better health during pregnancy and postpartum. The total prevalence of household food insecurity among women connected to MCHB was 94% (n=199). In the year prior to the survey, 39% (n= 79) of women’s households cut meal sizes or skipped meals because there wasn’t enough money for food. In semi-structured interviews, Somali women commonly described not having enough money to buy vegetables, fruit and meat, and perceiving low sense of control over food availability at home.
    Community-based perinatal programs, such as those offered through MCHB and HMHB, provided supports that facilitated women’s health in the face of difficult life circumstances during pregnancy and postpartum. When community-based programs show such potential to alleviate some of the burdens experienced by women, they should be well supported through policies, and connected to health care and social systems.

  • Subjects / Keywords
  • Graduation date
    Spring 2020
  • Type of Item
    Thesis
  • Degree
    Doctor of Philosophy
  • DOI
    https://doi.org/10.7939/r3-6jqv-8275
  • License
    Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.