Women of advanced maternal age undergoing amniocentesis: A period of uncertainty

Aims. To generate a descriptive model for understanding patterns and interpretations concerning women's experiences of amniocentesis in Taiwan. Background. In light of scientific technology and social change, it would be important to recognise the complexity of a woman's situation and the meaning of her in-depth experience while undergoing amniocentesis. Earlier studies on the experience of these women often relied on quantitative data obtained from questionnaires at only one point in time; however, the changes in older pregnant women, known to be at increased risk for foetal chromosomal abnormalities, from the time of pregnancy until test results of their amniocentesis has not been clearly understood. Design. A grounded theory approach was applied. Methods. Data were collected through in-depth interviews and participant observation. Sampling and major coding continued from 2002-2003 until theoretical saturation occurred; 20 women (≥35 years of age) participated in this study; data were analysed using constant comparative and content analysis. Results. A prevailing sense of uncertainty was the core category for describing and guiding the process of this study with five main stages identified: (1) ambivalence toward pregnancy; (2) decision to undergo amniocentesis; (3) concerns regarding maternal and foetal safety during procedure; (4) anxiety while awaiting results and (5) thoughts about a lifetime maternal commitment. Conclusions. Identification and appreciation for emerging themes enables nurses to address women's concerns in a meaningful way as they undergo amniocentesis. Also, it is hoped that understanding key themes allows nurses to facilitate constructive interactions between women, physicians and other members of the obstetric team. Relevance to clinical practice. Women in Taiwan undergoing amniocentesis had concerns about safety and dealt with cultural taboos of pregnancy in advanced age; health education should include coping strategies and decision making in dealing with these issues. To facilitate constructive interactions between clients and health care teams, the ethical guidance of informed consent and respecting the women's autonomy should be emphasised.