During pregnancy, American women receive competing messages regarding appropriate behaviors that reflect society's expectations of mothers. Research reveals conflicting messages about best practices during pregnancy and childbirth frequently cause pregnant women anxiety as they try to decide which expert advice to follow. However, no studies have explored how women's experiences with making these decisions affect self-perceived stress or the biological stress response. In addition, few studies have linked society's expectations to emotional and biological stress levels. Connecting cultural beliefs to biological responses provides a mechanism for explaining the higher preterm birth rates in the U.S. (11.6% in 2012) compared to most European countries, Canada, and Australia (5-9%) even among "white" women of middle to higher socioeconomic status. This project, which trains a graduate in methods of rigorous, empirically-grounded scientific fieldwork, examines whether higher preterm birth rates can be explained by mixed messages and competing societal expectations during pregnancy.
Genevieve Ritchie-Ewing under the supervision of Dr. Barbara Piperata of the Ohio State University proposes to investigate the connections between societal expectations, women's experiences with decision-making and their emotional and biological stress levels. The objectives of the project are to 1) determine where pregnant women get messages about behaviors during pregnancy and childbirth and ascertain if these messages conflict, 2) explore how pregnant women make decisions about which practices to integrate into their daily lives and birth plans, 3) investigate links between women's experiences making decisions about which advice to follow and their emotional stress levels (particularly pregnancy-specific anxiety or anxiety associated with pregnancy-related concerns), and 4) establish if there are associations between women's experiences making decisions about expert advice, increased pregnancy-specific anxiety rates, and higher biological stress levels (i.e., steeper cortisol trajectories). Based in Columbus, OH, the researcher will collect qualitative and quantitative data to address the above objectives with focus groups, surveys, semi-structured interviews, maternal journaling, and hair samples for cortisol analysis.