Distress after Preterm Birth: A Discourse Analysis of Parents' Accounts and Photographs

Thesis (Ph.D.), College of Nursing, Washington State UniversityPreterm birth is a distressing experience for parents. This distress may continue into early childhood, with negative consequences for parents' mental health and child development. The purpose of this study was to take an in-depth look at how parents formed their accounts of premature birth, postpartum distress, and lives as parents and partners. Discourse analysis of semi-structured interviews and photo-elicitation assignments were used to analyze the parents' experiences in the context of the couple relationship. The study population included 8 parents of premature infants born from 24 to 30 weeks gestation, who had experienced significant distress in and out of the hospital. Parents participated in the study when their children were between 15 months and 8 years old. In the initial interview parents described their experience of prematurity, emotional distress, and parenting. Participants returned for a second interview where they further described their distress using photographs they had newly taken or selected. Parents described the preterm birth, hospitalization, and aftermaths as ongoing traumatic events. Discourses of distress included the perfect child, the good mother, and the good father. Parents engaged these discourses in reconciling their loss of idealized birth and parenting and their roles after prematurity. Social isolation and disciplinary power were discourses that showed how parents struggled with interaction with their social networks and with health care providers and institutions. Photo-elicitation provided additional dimensions to the participants' accounts of distress. Findings highlighted how parents described their trauma and distress in ways not captured by psychiatric diagnoses such as depression and anxiety. Findings may help nurses be aware of the negative effects of preterm birth and respond to the parents' emotional needs.College of Nursing, Washington State Universit