African American women describe support processes during high-risk pregnancy and postpartum

Objective: To explore social support processes in low-income African American women during high-risk pregnancy and postpartum. Design: A qualitative grounded theory approach. Interview was the primary data collection technique and was combined with observation, medical chart review, and literature review. Setting: A higk-risk pregnancy clinic and participants' homes. Participants: Ten pregnant women, 3 social network members, and 11 health care providers. Four of the women at high risk tell their in-depth stories in this article: Yolanda, coping with gestational diabetes; Frances, participating in drug rehabilitation; Trista, waiting to deliver a fetus with severe congenital anomalies; and Beatrice, HIV positive and carrying her seventh child. Results: The substantive theory of support developed in the study was termed mutual intentionality. Narratives illustrate the mutual roles that women at high risk and support givers played in the helping process. Support themes included being there, caring, respecting, sharing information, knowing, believing in, and doing for the other. Conclusion: The theorsy of mutual intentionality suggests that social support is a process or transaction involving intentionality. For support to happen, the therapeutic relationship must be valued as a mutual resource.