Background
Methods
Study setting and participants
Data collection
1 | What did you want to know when you got pregnant? What information did you need? What information do you think a woman who gets pregnant should have? Need to have? |
2 | From whom did you get this information? From where? How did you determine that it is correct and appropriate? Please explain to me? Please tell me your experiences? |
3 | Search questions: Can you explain more about this? Can you give an example? For example, one of the topics you learned about, what steps did you take to ensure and apply what you learned? May you give an example of this? Please explain more to me. |
Data analysis
Results
Characteristics of the participants
Code | Education | Employment status | Pregnancy number | Gestational age | Place of receiving care | Participation in delivery preparation classes |
---|---|---|---|---|---|---|
1 | PhD student | Employed | First | 29 | – | No |
2 | MSc student | Employed | Third | 20 | Private GP clinic | No |
3 | Associate Degree | Housekeeper | First | 24 | Hospital | Yes |
4 | Diploma | Employed | Second | 23 | Hospital | No |
5 | BSc | Housekeeper | First | 20 | Hospital | No |
6 | Diploma | Housekeeper | Second | 35 | Hospital | No |
7 | third grade high school | Housekeeper | Third | 37 | Health center + hospital | No |
8 | Diploma | Housekeeper | Fourth | 7 | Health center | No |
9 | Diploma | Housekeeper | First | 13 | Health center + Private GP clinic | No |
10 | MSc | Employed | First | 36 | Hospital | Yes |
11 | third grade High school | Student | First | 18 | Health center | No |
12 | Third grade High school | Student | First | 33 | Health center | Yes |
13 | BSc | Housekeeper | Third | 26 | Health center + Private GP clinic | No |
14 | BSc | Employed | Second | 38 | Hospital + Health Center | Yes |
15 | BSc | Employed | Third | 39 | Hospital | No |
16 | Pre-university | Student | First | 37 | Hospital | Yes |
17 | Diploma | Housekeeper | First | 24 | Hospital + GP private clinic | No |
18 | BSc student | Employed | First | 32 | Hospital | Yes |
19 | BSc | Employed | First | 22 | GP private clinic | No |
Identified categories
Categories | Subcategories | Codes |
---|---|---|
Validity of information resources | Invalid sources | -Lack of trust in the internet resources given their being virtual and the existence of errors -Non-updated and incomplete information of the people around them for today’s world -Non-reference to some sources due to non-belief in their scientific basis -Lack of trust in the internet due to no-consideration of individual differences |
Valid source | -Book is a reliable source for mothers -Full trust in the elderly given the belief in their wisdom Considering those around them as equal to the doctor in scientific regard -The priority of receiving advice from health professionals compared to other sources -Belief in the correctness of all contents of health network -The importance of the experiences of individuals despite the lack of scientific proof | |
Reliance on information resources | Indicators of assurance | -Complete source, how to write a resource, Simple and understandable maternal health information, -Trust the scientific, professional and up-to-date source of information citing the source of the content -Generalization and similarity of the information received -The frequency of a content heard as a standard for the correctness of it -Accepting more proper information with individual circumstances -Experience, being welcomed and approval of others -Acceptance of information obtained based on reason and logic -Selecting a resource without a specific criterion |
Confusion and trying to obtain assurance | -Searching and recognizing valid sources to get information -Asking health professionals to confirm information from other sources Comparing the information received -Searching multiple sources to achieve consensus and confidence -Search for the validity of the source expressed in maternal health information -Ignore the very slight differences in the content of different sources |
Validity of information resources
Invalid sources
P13: I do not have much confidence in the Internet because some Internet information is wrong. It is possible for the opposite to be true regarding the information you get, and it may not be the same for all women……
P4: Among the relatives, I do not accept what middle-aged women say because they speak like old people... I do not believe it.
Valid source
P5: Look, there are things that you need to be sure of and you need experts. For example, if I go to a midwife and she says yes, this happens to you and it is natural…well, I accept it.
Another interesting finding in this study was the women’s emphasize on the value of experiences of other people, even if there is no scientific proof of that experience. Participant number ten said: A series of information are experimental information…They have little scientific basis, but since they come from experience, they can still be used…P17: I asked something and my mother said that there was no problem. It is not normal, so I did not ask anyone else. My mother answered me. I accept her, even as much as I accept my doctor.
Reliance on information resources
Indicators of assurance
P11: For example, I research about how sex is investigated in pregnancy or about fetal development ...There are good things written about them, but sometimes they are not perfect. You have to search a few places to find everything you want…
P10: TV and health network help a lot ... I was searching about pregnancy information and the quality of the programs, and I found that the health network has rich information compared to the television networks …
P12: The internet is a good source, and its content can be read and understood in any language and any age ….
The participants referred to the specialized and up-to-date source of information and believed that, the acceptance of information depends on the scientific nature of its resource, especially when there is confusion about different information.P8: Doctors who talk about health and disease on television speak a simple and understandable language for all people.
One of the standards that most participants expressed was to ensure the information they have gained is common and the same as information presented by other sources. This criterion, since it looks into resources, especially during confusion, gradually affects the ability of mothers to determine the accuracy of information.P1: The radiologist who conducted ultrasound on me for NT had the license for it. It was very important to me ... I could not trust someone just because he/she is a sonologist... I tried to search for my answer rather than asking someone, because his/her information may not be up-to-date and may mislead me.
Another finding of this study was that, in regard to contradictory information, some mothers preferred to select information that was more consistent with their current conditions.P16: Well, when you search in many sources, naturally you get answer for your question.
In a number of mothers, hearing information on a topic in different sources for several times could help them to ensure the accuracy of information.P7: I have a sister who said; if you have sex when you approach the last month of your pregnancy, you will give birth more easily. She said she had heard it from our cousin. I read a book that opposed that idea…So I listened to what the book said, because I could not do it when I was 28 weeks pregnant as it was hard for me.
Moreover, the participants trusted the information sources if they have been acceptance by other mothers and mentioned by them.P8: To check whether or not the information I received is correct, I check it by how many times I have heard it. If I have heard it many times, I think it is correct.
Results showed that when judging the information, some mothers paid attention to the fact that whether the information is reasonable and logical or not, and then accepted or rejected them.P10: I try to read the books that others have read and were satisfied with them. I ask several people both from staff and from those who have had childbirth experience to make sure the information is valid... For example, internet sources are very visitor-friendly and I believe them to be more reliable.
One mother stated that studying and confirming the events that occurred to her during pregnancy made her more confident in the source of information.P7: My sister said that if I have more sex in last month of my pregnancy, I will have an easier delivery. I asked who had told her, she said she had heard it from friends. Then I read a book and realized that is not true... I tried to follow the book, because I couldn't have sex as I was in 7 months of pregnancy.
Another interesting finding was the emphasis the mothers had on the value of other people’s experiences, even if there was no scientific evidence for them. Participant 10 said that, there are series of information which are experiential...they are not so scientific, but they are still experience and can be used. Using everything, even small things, is good.P10: I search the internet every week from the first week of pregnancy. For example, I had a burning feeling in my stomach this week, and in the internet I found that, if you have a burning sensation in the stomach this week, you should not be worried. This makes me to trust that website.
P7: When you search, there are a few websites that are not the same. I do not read all of them. I only read some that are different. I click at random to see what they say, and I do not read all of them.
One of the measures taken by most participants to ensure the accuracy of information they received was asking several sources the same question in order to reach a consensus and assurance:P1: I have not faced contradictory information, because I probably had access to good resources. In fact, I knew, for example, if I had a problem, then of course, the source could give me the right information.
Another way of information assessment used by most participants was asking healthcare professionals to confirm information from other sources. On the other hand, it was argued that searching in non-physician resources was merely for getting extra information on the subject, and the physician was the main source for their decision-making.P3: I first look at the Internet, and then I check other places for reassurance….
Comparison of multi-source information was also a way of assessing the maternal health information obtained by the pregnant womenP19: No matter how many places I search; I finally listen to my doctor. The reason I am doing searching is just to learn more about the subject.
A participant also argued that when facing contradicting information, she would ignore minor contradictions.P12: Well, I compare some types of answers with each other; for example, doctor, midwife, and the Internet to see which one is better to choose...
P5: I read two or three programs that had similar information about the size of fetus. For example, one of them stated, it should be 433 gr, another stated it should be 354 gr, so I ignored the difference.