Abused pregnant women's interactions with health care providers during the childbearing year

Objective: To explore how intimate partner abuse during pregnancy influences women's decisions about seeking care and disclosing abuse and their preferences for health care professionals' responses. Design: A qualitative, grounded theory approach using dimensional analysis. Data were collected via 21 interviews. Setting: Participants were interviewed in their homes, at their prenatal clinic, at a hospital, and at the investigator's office. Participants: A convenience sample of 12 English-speaking women abused during pregnancy. Five participants were recruited from two prenatal clinics in the Pacific Northwest; 7 were recruited via snowball sampling. Results: The grounded theory "living two lives: women's experiences of intimate partner abuse during pregnancy" emerged from the investigation. Abused pregnant women engaged in a process of guarding and revealing their public and private lives. This process affects how women seek and attend prenatal care, their perceptions of health care providers' interventions, and abuse disclosure. Conclusions: Intimate partner abuse profoundly affects women's pregnancies and pregnancy-related decisions. Embarrassment, shame, and fear are common emotions. Pregnant, abused women want health care providers to treat them respectfully and empathetically, to recognize the conflict between their public and private lives, to support their decisions, and to be available to help them. They do not expect or want health care providers to fix their situation.