Methamphetamine Using Mothers: Perceptions of Prepregnancy Sexual Risks, Recognizing Unintended Pregnancy, and Engaging in the Pregnancy

Methamphetamine has become the drug of choice for a growing number of women in their childbearing years. Methamphetamine reduces inhibitions and increases libido, such that high-risk behaviors are conducted in association with methamphetamine use. Women who become pregnant while using methamphetamine are likely to be younger than the general population of pregnant mothers. They have more comorbid conditions and they delay entry into prenatal care services. The number of methamphetamine-involved births has increased as methamphetamine has become more available and affordable in urban settings. This dissertation investigated prepregnancy and pregnancy experiences in a sample of 17 women, ten pregnant women and seven postpartum mothers who used meth during a portion of a recent pregnancy. Constructivist Grounded Theory fueled by Symbolic Interactionism was used for data collection and analysis of semi-structured interviews, observations, and field notes. The dissertation is comprised of three manuscripts that describe consecutive events in a transition that surrounded the participants' unintended pregnancies. The findings highlight their lives before pregnancy, learning they were pregnant, and becoming involved in the pregnancy. Three processes, Progressing to a meth-centered lifestyle, Reconciling Pregnancy, and Engaging in Pregnancy, depict the commonalities, variations, and conditions of the women's experiences. Within the process of Progressing to a meth-centered lifestyle, initiation to methamphetamine occurred and progressed to regular, chronic use. The women's age and social development were linked in the women's recollections of their initial use of methamphetamine. Reconciling Pregnancy describes two intertwining events, pregnancy and being drug-free after arrest or entry into substance abuse treatment. This combination of occurrences established a foundation for the women to begin modifying their perceptions about being pregnant and about pursuing sobriety. The third process, Engaging in Pregnancy, conveys the women's participation in their pregnancy transition by taking care of themselves for the sake of the pregnancy and bonding with their unborn child. It describes the influences that assisted the women to strengthen their involvement in their pregnancies while preparing for a sober life as mothers. The qualitative findings expand our understanding of women living a methamphetamine-centered lifestyle. Through their rich descriptions of events surrounding unintended pregnancy, we learned about the women's neglect of self and poor health-seeking practices. Their stories uncover needs for intervention in each of the three processes